Free CPO Ocular Emergencies and Triage Questions and Answers 1 — Questions and Answers
Question 1: A patient calls stating they splashed a chemical cleaning agent in their eye. What is the most critical immediate instruction to give them?
- Cover the eye with a patch and come in immediately.
- Irrigate the eye with copious amounts of water for 15-20 minutes. (Correct answer)
- Apply a cold compress to reduce swelling.
- Instill artificial tears to soothe the eye.
Correct answer: Irrigate the eye with copious amounts of water for 15-20 minutes.
Immediate, copious irrigation is the most important first step to dilute and flush out a chemical from the eye. This should be done for at least 15-20 minutes with sterile saline, tap water, or any clean water source available before seeking further medical attention.
Question 2: A patient reports a sudden, painless, complete loss of vision in one eye, describing it as a 'curtain falling.' This is a classic symptom of what condition?
- Acute angle-closure glaucoma
- Conjunctivitis
- Retinal detachment (Correct answer)
- Corneal abrasion
Correct answer: Retinal detachment
The symptom of a 'curtain' or 'veil' falling over the vision is a hallmark sign of a retinal detachment. This is a true ocular emergency that requires immediate referral to an ophthalmologist for potential surgical repair to prevent permanent vision loss.
Question 3: When triaging a patient with a red eye, which symptom is the most urgent and requires an immediate appointment?
- Mild itching and watering
- Moderate crusting of the eyelids upon waking
- A gritty, foreign body sensation
- Severe deep, aching pain and light sensitivity (Correct answer)
Correct answer: Severe deep, aching pain and light sensitivity
Severe pain and photophobia (light sensitivity) associated with a red eye are warning signs of serious conditions like acute glaucoma, uveitis, or infectious keratitis. These conditions can be sight-threatening and require immediate evaluation, unlike mild itching or mattering which are often less urgent.
Question 4: A patient calls after being hit in the eye with a fist. They are now experiencing double vision. This symptom strongly suggests what type of injury?
- Orbital floor fracture (Correct answer)
- Subconjunctival hemorrhage
- Traumatic iritis
- Simple corneal abrasion
Correct answer: Orbital floor fracture
Double vision (diplopia) following blunt trauma to the eye is a key indicator of an orbital floor fracture, also known as a 'blowout fracture.' This occurs when the bones of the eye socket break, potentially entrapping the muscles that control eye movement, leading to misalignment and double vision.
Question 5: A patient reports a sudden onset of new flashes of light (photopsia) and a shower of floaters. What is the most appropriate triage action?
- Schedule the patient for the next available routine appointment.
- Advise the patient to monitor symptoms for a week.
- Arrange for the patient to be seen the same day. (Correct answer)
- Tell the patient these are normal signs of aging and not to worry.
Correct answer: Arrange for the patient to be seen the same day.
The sudden appearance of flashes and floaters are classic symptoms of a posterior vitreous detachment (PVD), which can lead to a retinal tear or detachment. This is considered an ocular urgency, and the patient should be seen by the ophthalmologist the same day to rule out a retinal break.
Question 6: A welder calls complaining of severe eye pain, light sensitivity, and a foreign body sensation that started several hours after they finished working. What is the most likely diagnosis?
- Allergic conjunctivitis
- Ultraviolet (UV) keratitis (Correct answer)
- Intraocular metallic foreign body
- Acute angle-closure glaucoma
Correct answer: Ultraviolet (UV) keratitis
This presentation is classic for ultraviolet (UV) keratitis, also known as 'welder's flash' or 'arc eye.' The UV radiation from the welding arc damages the corneal epithelium, causing a delayed onset of severe pain and other symptoms. It is essentially a sunburn of the cornea.
Free CPO Ocular Emergencies and Triage Questions and Answers 1
A patient calls stating they splashed a chemical cleaning agent in their eye.
What is the most critical immediate instruction to give them?