Tetanus prophylaxis following ocular injuries

Benson, William H.; Snyder, Irvin S.; Granus, Valerie; Odom, J. Vernon; Macsai, Marian S.

doi:10.1016/0736-4679(93)90626-i

Cited by 20 publications

(3 citation statements)

References 10 publications

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“…If tetanus primary vaccination or Td tetanus booster has not been given for the past 10 years, or if the wound is contaminated and the vaccination or booster has not been received for 5 years, Td tetanus booster vaccination should be considered. Tetanus immune globulin should be considered in contaminated wounds if there is no history of primary tetanus immunization [3]. Prompt and thorough cleaning and debridement of lacerations and wounds is also very important in preventing infections in general.…”

Section: Prehospital Care Of Ocular Injuriesmentioning

confidence: 99%

Ocular Trauma in Infancy and Childhood

Forbes¹,

Goldstein²

2020

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Trauma is an important cause of ocular morbidity in childhood with only strabismus ranking higher in frequency as an indication for eye surgery, and only amblyopia is responsible for more monocular vision loss. An estimated 2.4 million eye injuries occur annually in the United States, of which 95% are limited to the anterior segment. Children aged 11-15 years have a particularly high incidence of severe eye injury compared with other age groups, and most ocular trauma in younger children occurs during casual play, while older children usually sustain their injuries while participating in sports. The use of protective eyewear while participating in sports is

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Section: Prehospital Care Of Ocular Injuriesmentioning

confidence: 99%

Ocular Trauma in Infancy and Childhood

Forbes¹,

Goldstein²

2020

Albert and Jakobiec's Principles and Practice of Ophthalmology

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“…If unable, over-the-counter bacitracin and polymyxin B ophthalmic may be an acceptable alternative. Finally, although the risk of Clostridium tetani infection is low if the cornea is not perforated [17], this presents an opportunity to remember to update a patient's tetanus vaccination.…”

Section: Further Managementmentioning

confidence: 99%

Get Out of a Scrape! An Approach to Corneal Foreign Bodies and Abrasions for the Primary Care Physician

Squissato¹,

Brown

Baxter³

2015

Occup Med Health Aff

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Work-related injuries (WREIs) to the eye are common. Many are minor but, if not treated quickly, can lead to vision-threatening complications. Others are severe, but even with expert management sight can be lost. This article promotes an understanding of the physician's role in the prevention, assessment, and treatment of WREIs. By far the most common WREIs are corneal foreign bodies (CFBs) and abrasions, which this article primarily focuses on. Foreign bodies (FBs) visualized under slit lamp microscopy can be removed with a moistened cotton tip or bent 25-gauge needle followed by antibiotic and tetanus prophylaxis. Pain associated with corneal abrasions can interfere with daily functions including return to work. Adequate pain relief may be achieved using oral nonsteroidal antiinflammatories. Patching is not recommended because it does not improve comfort and may impair healing. Noncomplicated CFBs need only to be seen once by an ophthalmologist 4-6 days after the initial presentation.

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“…[28][29][30] Using a mouse model, Benson and colleagues 31 found that Clostridium tetani could not colonize the eye unless the cornea was perforated, and attributed this to the avascular nature of the cornea. British practice guidelines 32 and other authors 33 have since recommended using tetanus prophylaxis only for penetrating eye trauma and not for simple corneal abrasions.…”

Section: Therapeutic Agentsmentioning

confidence: 99%

Lack of consensus on corneal abrasion management: results of a national survey

Calder

Balasubramanian

Stiell

2004

CJEM

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Objectives: Our objective was to determine the practice patterns of Canadian emergency physicians with respect to the management of traumatic corneal abrasions. Methods: After developing our instrument and pilot testing it on a sample of emergency residents, we randomly surveyed 470 members of the Canadian Association of Emergency Physicians, using a modified Dillman technique. We distributed a pre-notification letter, an 18-item survey, and appropriate follow-up surveys to non-responders. Those members with an email address (n = 400) received a Web-based survey, and those without (n = 70) received a survey by post. The survey focused on the indications and utilization of analgesics (oral and topical), cycloplegics, eye patches and topical antibiotics. Results: Our response rate was 64% (301/470), and the median age of respondents was 38 years. Most (77.7%) were male, 71.8% were full-time emergency physicians, 76.5% were emergency medicine certified, and 64.4% practised in teaching hospitals. Pain management preferences (offered usually or always) included oral analgesics (82.1%), cycloplegics (65.1%) and topical nonsteroidal anti-inflammatory drugs (NSAIDs) (52.8%). Only 21.6% of respondents performed patching, and most (71.2%) prescribed topical antibiotics, particularly for contact lens wearers and patients with ocular foreign bodies. Two-thirds of the respondents provided tetanus toxoid if a foreign body was present, and 46.2% did so even if a foreign body was not present. Most respondents (88.0%) routinely arranged follow-up. Conclusions: This national survey of emergency physicians demonstrates a lack of consensus on the management of traumatic corneal abrasions. Further study is indicated to determine the optimal treatment, particularly regarding the use of topical NSAIDs. EM ADVANCES • INNOVATIONS EN MU

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Tetanus prophylaxis following ocular injuries

Cited by 20 publications

References 10 publications

Ocular Trauma in Infancy and Childhood

Ocular Trauma in Infancy and Childhood

Get Out of a Scrape! An Approach to Corneal Foreign Bodies and Abrasions for the Primary Care Physician

Lack of consensus on corneal abrasion management: results of a national survey

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