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A 40-year-old sheet metal worker arrives in the ED on a Monday morning with a 2-day history of pain in her right eye, blurred vision and blepharospasm.
She is unsure whether there is something in her eye; she works close to others who are welding, grinding and using anti-corrosion chemicals.
You are working with a medical student who has seen the patient and taken a full history and examined the patient. The student could not identify an obvious abnormality and is keen to send the patient for an x-ray of the orbit.
Outline the circumstances where an x-ray of the orbit would be appropriate.
You decide to teach the medical student about corneal injuries and start with a discussion about pathophysiology.
Select the correct diagnosis for each pathophysiological process below.
Oxidisation and diffusion of iron into the corneal stroma
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Poor adhesion of corneal epithelium to basement membrane following injury
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Acute inflammatory response leading to superficial keratitis
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Corneal oedema and ischaemic necrosis
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You then discuss the potential differential diagnoses and their treatments with the medical student.
Select the appropriate method of removal for each eye problem.
Subtarsal foreign body
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Embedded corneal metallic foreign body
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Chemical splash
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CS spray exposure
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Corneal rust ring
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