Investigations
1st investigations to order
visual acuity
Test
No change in visual acuity with minor defects that occur outside of the visual axis. Substantial changes may occur if defects are within the visual axis or if there is associated corneal oedema.
Result
typically normal
fluorescein staining
Test
Examination with a cobalt blue slit lamp or ultraviolet lamp highlights areas of corneal abrasion. Fluorescein staining that seems to stream or change colour is suspicious for a penetrating globe injury.
Result
stains areas of exposed basement membrane
Investigations to consider
CT scan of head and orbits
Test
The imaging of choice in trauma to exclude foreign bodies and evaluate head trauma.
Should be considered for suspected penetrating injuries to the globe or concern for intraocular foreign bodies in the setting of significant trauma.
Thin section axial CT scan with multiplanar reformation is considered a good choice for evaluating orbital trauma and the presence of the intraocular and intraorbital foreign bodies.[17]
Result
typically normal; rules out presence of intraocular foreign body or perforation
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