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Wilderness Medical Society - snowmass 2005 (Page 207)

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Wilderness Medical Society - snowmass 2005
37
Chapter 9
WILDERNESS EYE PATHOLOGY

Recommendations are considered Category 1B by the WMS Panel of Expert Reviewers

I GENERAL INFORMATION
Management of ocular emergencies in the wilderness is made more difficult by three
factors: (1) the lack of diagnostic equipment such as a slit lamp; (2) the lack of specialty
consultation; and (3) limited medications with which to treat the disorders encountered.
Typical of many wilderness medical management issues, the diagnostic and therapeutic
approaches presented below are not necessarily to be used when professional referral is
readily available.
This guideline discusses sudden vision loss in a non-inflamed eye, orbital and
periorbital inflammation, and the acute red eye. The available medications and equipment
with which to treat these disorders will be assumed to be those in the recommended
wilderness ocular emergency kit shown below.

II. MEDICATIONS AND EQUIPMENT
The proposed management of ocular emergencies in the wilderness will require that the
medications and equipment shown below are available to the treating medical personnel:
Wilderness Eye Kit Medications
Gatifloxacin 0.3% drops or moxifloxacin 0.5% drops
Tetracaine 0.5% drops
Prednisolone acetate 1% drops
Gatifloxacin or moxifloxacin 400 mg tabs
Bacitracin ophthalmic ointment
Prednisone 20 mg tabs
Artificial
tears
Scopolamine 0.25% drops
Diclofenac
0.1%
drops
Pilocarpine
2%
drops
Wilderness Eye Kit Equipment
Penlight with cobalt blue filter
Fluorescein
strips
Cotton-tipped
applicators
Metal eye shield (or rig from suitable material)
Eye patches (or equal)
1-inch
tape
Wound closure strips (1/4 inch) (or make from wider tape)

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