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By R. Dargoth. Wright Institute.

Gerstenbluth RE cheap biaxin 500mg with amex, Spirnak JP, Elder JS: Sports participation and using protective eyewear, participating in sports high grade renal injuries in children. McAleer IM, Kaplan GW, Lo Sasso BE: Renal and testis injuries BASICS OF THE EYE EXAMINATION in team sports. Nattiv A, Puffer JC, Green GA: Lifestyle and health risks of col- HISTORY legiate athletes: A multi-center study. Sagalowsky AI, Peters PC: Genitourinary Trauma, in Walsh PC, The history should include a detailed description of Retik, AB, Vaughan ED, Jr, et al (eds. It is also crit- EPIDEMIOLOGY ical to perform a thorough examination, and not solely focus on the obvious area of involvement. CHAPTER 28 OPHTHALMOLOGY 163 Pupils: Using a bright light source, check to ensure Lacerations suspected of involving the lacrimal pupils are round, symmetric, and reactive. Conjunctiva and sclera: Here pay close attention One of the most common sports-related eye injuries for signs that suggest a ruptured globe, including (Zagelbaum, 1997), accounting for 33% of all eye lacerations, 360° subconjuctival hemorrhage, or injuries seen in Major League Baseball and 12% of extruding pigment (uveal tissue) or gel (vitreous these seen in the National Basketball Association humor). Cornea: Assess for clarity, then apply fluorescein to identify epithelial defects or foreign bodies. Anterior chamber: Ensure the chamber is well- Sharp pain, photophobia, foreign body sensation, and formed, comparing to unaffected side. EXAMINATION Fundoscopic examination: This should be performed Check visual acuity. Then apply fluorescein stain, in all cases of eye trauma, paying special attention to preferably with topical anesthetic and assess using a the red reflex. The pain should improve with the subtle clue to the presence of significant pathology. Any epithelial staining confirms Other: Although slit-lamp examination is ideal for all the diagnosis. As Flip upper and lower lid to search for foreign body, if such, it is often deferred for more serious cases that suspected from mechanism.

Early separation of the polyurethane film may occur before complete healing has occurred best biaxin 500 mg. In this case, the dressing should then be removed and petrolatum-based fine mesh gauze or Mepitel applied until re-epithelialization has occurred, which is generally complete in few days. Biobrane is particularly useful in donor sites on the trunk (front or back). It is placed in a circular fashion and covered with petrolatum-impregnated fine-mesh gauze. After 2 days it can be exposed and separates from the wound when complete re-epithe- lialization has occurred. Patient may bathe with Biobrane in place, but it should be dried afterwards. A good alternative to Biobrane is Acticoat, a specially tailored fine-mesh gauze impregnated with nanocrystalline silver nitrate. Acticoat is ap- plied in direct contact with the wound and dressed with a standard dressing. Antimicrobial properties of Acticoat remain active for a minimum of 3 days. Small donor sites in infants and small children can be managed successfully with Opsite or Tegaderm dress- ings with or without calcium alginate. A protective head dressing is necessary to avoid trauma to the polyurethane film. Extensive scalp donor sites are best managed with the application of Biobrane. It is virtually painless and can be exposed on the second postoperative day, allowing good hygiene.