A 22-year-old male presents to the emergency department after being struck in the right eye with a metal fragment from a grinder. The patient complains of severe eye pain and vision loss. On examination, you note a teardrop-shaped pupil. Which of the following is the most appropriate immediate nursing intervention?
Apply a firm pressure patch to the affected eye to control bleeding.
Irrigate the eye with normal saline to remove any remaining debris.
Protect the eye with a rigid shield and obtain an urgent ophthalmology consultation.
Measure intraocular pressure to assess the extent of the injury.
The patient's presentation with a penetrating mechanism of injury, severe pain, vision loss, and a teardrop-shaped pupil is highly indicative of a globe rupture, which is a true ocular emergency. The most critical initial intervention is to protect the injured eye from further damage by applying a rigid shield, such as a Fox shield or a makeshift shield from a paper cup. Any form of pressure on the globe, including applying a pressure patch or performing tonometry, is contraindicated as it can cause further extrusion of intraocular contents. Irrigation is also avoided in cases of obvious rupture. An urgent ophthalmology consultation is essential for definitive surgical repair.
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BCEN CEN
Maxillofacial and Ocular Emergencies
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