Globe luxation reduction - Revision history

ClaireLewis at 16:17, 9 October 2019

2019-10-09T16:17:46Z

← Older revision		Revision as of 16:17, 9 October 2019
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	==Background==		==Background==
	*Extreme proptosis which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation		*Extreme [[proptosis]] which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation
	*Can be traumatic, spontaneous or voluntary		*Can be traumatic, spontaneous or voluntary
	**In spontaneous globe luxation, extraocular muscles and optic nerve generally remain intact.<ref>Tok L, Tok OY, Argun TC, et al. Bilateral Traumatic Globe Luxation with Optic Nerve Transection. Case Reports in Ophthalmology. 2014;5(3):429-434. doi:10.1159/000370043.</ref>		**In spontaneous globe luxation, extraocular muscles and optic nerve generally remain intact.<ref>Tok L, Tok OY, Argun TC, et al. Bilateral Traumatic Globe Luxation with Optic Nerve Transection. Case Reports in Ophthalmology. 2014;5(3):429-434. doi:10.1159/000370043.</ref>

Rossdonaldson1: Text replacement - "r/o" to "rule out"

2016-07-31T09:36:37Z

Text replacement - "r/o" to "rule out"

← Older revision		Revision as of 09:36, 31 July 2016
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	==Procedure==		==Procedure==
	*Perform rapid eye exam including visual acuity		*Perform rapid eye exam including visual acuity
	*If traumatic, consider imaging to ~~r/o~~ orbital deformity, retrobulbar hemorrhage, etc		*If traumatic, consider imaging to rule out orbital deformity, retrobulbar hemorrhage, etc
	*Place patient in recumbent position		*Place patient in recumbent position
	*Apply topical ocular anesthetic (e.g. tetracaine)		*Apply topical ocular anesthetic (e.g. tetracaine)

Rossdonaldson1: Text replacement - "f/u" to "follow up"

2016-07-12T14:49:26Z

Text replacement - "f/u" to "follow up"

← Older revision		Revision as of 14:49, 12 July 2016
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	==Follow-Up==		==Follow-Up==
	*Traumatic luxation requires emergent ophthalmology consult		*Traumatic luxation requires emergent ophthalmology consult
	*Spontaneous luxation (s/p reduction) with no visual impairment → ~~f/u~~ in 24-48 hours, avoid triggering maneuvers		*Spontaneous luxation (s/p reduction) with no visual impairment → follow up in 24-48 hours, avoid triggering maneuvers

	==References==		==References==

Neil.m.young: Text replacement - " pt " to " patient "

2016-07-02T00:23:55Z

Text replacement - " pt " to " patient "

← Older revision		Revision as of 00:23, 2 July 2016
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	*Perform rapid eye exam including visual acuity		*Perform rapid eye exam including visual acuity
	*If traumatic, consider imaging to r/o orbital deformity, retrobulbar hemorrhage, etc		*If traumatic, consider imaging to r/o orbital deformity, retrobulbar hemorrhage, etc
	*Place pt in recumbent position		*Place patient in recumbent position
	*Apply topical ocular anesthetic (e.g. tetracaine)		*Apply topical ocular anesthetic (e.g. tetracaine)
	*When lashes are visible, have asst apply steady upward and outward traction to lids. If unable to grasp lashes, use lid retractor to apply countertraction		*When lashes are visible, have asst apply steady upward and outward traction to lids. If unable to grasp lashes, use lid retractor to apply countertraction

Ostermayer at 15:45, 22 March 2016

2016-03-22T15:45:13Z

← Older revision		Revision as of 15:45, 22 March 2016
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	<references/>		<references/>

	[[~~category~~:~~ophtho~~]]		[[Category:Ophthalmology]]
	[[~~category~~:~~procedures~~]]		[[Category:Procedures]]

Catierey: added internal link

2015-09-09T22:05:44Z

added internal link

← Older revision		Revision as of 22:05, 9 September 2015
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	==Contraindications==		==Contraindications==
	*Globe rupture (relative)		*[[Globe rupture]] (relative)

	==Procedure==		==Procedure==

Mholtz at 01:06, 27 June 2015

2015-06-27T01:06:53Z

← Older revision		Revision as of 01:06, 27 June 2015
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	==Background==		==Background==
	*Extreme proptosis which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation		*Extreme proptosis which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation
	*Can be traumatic or ~~spontaneous~~		*Can be traumatic, spontaneous or voluntary
	**In spontaneous globe luxation, extraocular muscles and optic nerve generally remain intact.<ref>Tok L, Tok OY, Argun TC, et al. Bilateral Traumatic Globe Luxation with Optic Nerve Transection. Case Reports in Ophthalmology. 2014;5(3):429-434. doi:10.1159/000370043.</ref>		**In spontaneous globe luxation, extraocular muscles and optic nerve generally remain intact.<ref>Tok L, Tok OY, Argun TC, et al. Bilateral Traumatic Globe Luxation with Optic Nerve Transection. Case Reports in Ophthalmology. 2014;5(3):429-434. doi:10.1159/000370043.</ref>
	**In traumatic globe luxation, optic nerve avulsion is common (occurs in 38.2%)<ref>Amaral MB, Carvalho MF, Ferreira AB, Mesquita RA. Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review. J Maxillofac Oral Surg. 2015 Mar;14(Suppl 1):323-30.</ref>		**In traumatic globe luxation, optic nerve avulsion is common (occurs in 38.2%)<ref>Amaral MB, Carvalho MF, Ferreira AB, Mesquita RA. Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review. J Maxillofac Oral Surg. 2015 Mar;14(Suppl 1):323-30.</ref>
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	==Follow-Up==		==Follow-Up==
	*Traumatic luxation requires emergent ophthalmology consult		*Traumatic luxation requires emergent ophthalmology consult
	*Spontaneous luxation with no visual impairment → f/u in 24-48 hours, avoid triggering maneuvers		*Spontaneous luxation (s/p reduction) with no visual impairment → f/u in 24-48 hours, avoid triggering maneuvers

	==References==		==References==

Rossdonaldson1: /* References */

2015-06-22T01:36:46Z

References

← Older revision		Revision as of 01:36, 22 June 2015
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	==References==		==References==
	~~Roberts: Clinical Procedures in EM, 5th ed~~
	<references/>		<references/>

	[[category:ophtho]]		[[category:ophtho]]
	[[category:procedures]]		[[category:procedures]]

Mholtz at 10:54, 21 June 2015

2015-06-21T10:54:40Z

← Older revision		Revision as of 10:54, 21 June 2015
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	==Indications==		==Indications==
	*~~Globe~~ luxation		*Spontaneous or traumatic globe luxation

	==Contraindications==		==Contraindications==
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	*Failure to reduce (apply saline drops and non-contact eye shield)		*Failure to reduce (apply saline drops and non-contact eye shield)

	==~~After Care~~==		==Follow-Up==
	*Traumatic luxation requires emergent ophthalmology consult		*Traumatic luxation requires emergent ophthalmology consult
	*Spontaneous luxation with no visual impairment → f/u in 24-48 hours, avoid triggering maneuvers		*Spontaneous luxation with no visual impairment → f/u in 24-48 hours, avoid triggering maneuvers

Mholtz: updated background

2015-06-21T10:12:00Z

updated background

← Older revision		Revision as of 10:12, 21 June 2015
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	== Background ==		==Background==
	#Extreme proptosis which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation		*Extreme proptosis which permits lids to slip behind globe equator, obicularis oculi spasm sustains luxation
	#Early reduction indicated to relieve symptoms and minimize visual impairment		*Can be traumatic or spontaneous
			**In spontaneous globe luxation, extraocular muscles and optic nerve generally remain intact.<ref>Tok L, Tok OY, Argun TC, et al. Bilateral Traumatic Globe Luxation with Optic Nerve Transection. Case Reports in Ophthalmology. 2014;5(3):429-434. doi:10.1159/000370043.</ref>
			**In traumatic globe luxation, optic nerve avulsion is common (occurs in 38.2%)<ref>Amaral MB, Carvalho MF, Ferreira AB, Mesquita RA. Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review. J Maxillofac Oral Surg. 2015 Mar;14(Suppl 1):323-30.</ref>
			*Early reduction indicated to relieve symptoms and minimize visual impairment

	== ~~Indication~~ ==		==Indications==
	#Globe luxation		*Globe luxation

	== ~~Relative Contraindication~~ ==		==Contraindications==
	#Globe rupture		*Globe rupture (relative)

	== Procedure ==		==Procedure==
	#Perform rapid eye exam including acuity		*Perform rapid eye exam including visual acuity
	#If traumatic, consider imaging to r/o orbital deformity, retrobulbar hemorrhage, etc		*If traumatic, consider imaging to r/o orbital deformity, retrobulbar hemorrhage, etc
	#Place pt in recumbent position		*Place pt in recumbent position
	#Apply topical ocular anesthetic		*Apply topical ocular anesthetic (e.g. tetracaine)
	#When lashes are visible, have asst apply steady upward and outward traction to lids. If unable to grasp lashes, use lid retractor to apply countertraction		*When lashes are visible, have asst apply steady upward and outward traction to lids. If unable to grasp lashes, use lid retractor to apply countertraction
	#With gloved fingers, gently apply scleral pressure and manipulate back into orbit		*With gloved fingers, gently apply scleral pressure and manipulate back into orbit
	#Assess for and remove retained lashes to prevent corneal injury		*Assess for and remove retained lashes to prevent corneal injury
	#Repeat eye exam (acuity may not improve for days or longer)		*Repeat eye exam (acuity may not improve for days or longer)

	== Complications ==		==Complications==
	#Retained lashes		*Retained lashes
	#Failure to reduce (apply saline drops and non-contact eye shield)		*Failure to reduce (apply saline drops and non-contact eye shield)

	== After Care ==		==After Care==
	#Traumatic luxation requires emergent ophthalmology consult		*Traumatic luxation requires emergent ophthalmology consult
	#Spontaneous luxation with no visual impairment- f/u in 24-48 ~~hrs.~~ avoid triggering maneuvers		*Spontaneous luxation with no visual impairment → f/u in 24-48 hours, avoid triggering maneuvers

	== ~~Source~~ ==		==References==
	Roberts: Clinical Procedures in EM, 5th ed		Roberts: Clinical Procedures in EM, 5th ed
			<references/>

	[[category:ophtho]] [[category:procedures]]		[[category:ophtho]]
			[[category:procedures]]