Trauma and Community Eye Health
This domain tests ocular trauma management and population-level prevention of blindness. The exam connects individual injury care with public health programs.
Core trauma
- Open globe: shield, avoid pressure, give antibiotics and tetanus prophylaxis, and arrange primary repair.
- Corneal foreign body: remove under magnification, check for intraocular foreign body with CT or X-ray if risk exists.
- Hyphema: elevate the head, control IOP, avoid aspirin, and be cautious with acetazolamide in sickle cell disease.
- Blowout fracture: assess entrapment, diplopia, and restricted upgaze.
Community eye health
- Trachoma: use the SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement).
- Onchocerciasis: ivermectin-based control.
- Vitamin A deficiency: supplementation prevents xerophthalmia and measles-related blindness.
- Cataract remains the leading cause of reversible blindness globally; diabetic retinopathy screening is a growing priority.
- WHO blindness definition: visual acuity below 3/60 in the better eye or visual field below 10°.
Worked example
A factory worker has a metal foreign body on the cornea. Reasoning: remove it under magnification, then check for an intraocular foreign body if there is a history of high-speed injury. Prevention with goggles is the community-level lesson.
Traps
Do not patch an open globe. Do not overlook an intraocular foreign body after a high-speed injury.