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GPH News Winter 2015

A&E stands for Accident & Emergency but we need to be experts on Anything & Everything! Suspected foreign bodies in the eye are a common presentation to GP clinics and Emergency Departments. Small metallic particles embedded on the surface of the eye (cornea) are frequently seen in metal workers and weekend warriors. Patients will present with an irritated, red and watery eye and typically describe the sensation of something stuck in the eye. If a foreign body has been present for a prolonged period, the patient will have severe irritation with looking at light (photophobia). GPH news 13 (or what we do in the Emergency Department) revealED Foreign body in the eye Dr Kakule Masinda Abraham is continuing his post graduate training in Obstetrics & Gynaecology as a fulltime resident at the Mbarara University in Uganda. Greenslopes Private Hospital is proud to be able to continue providing funding towards Dr Abraham’s training so he is better equipped to serve the communities of Kasese District, Uganda. Dr Abraham recently sent us an update on his studies and the practical experience he is getting on a daily basis attending to patients at Mbarara Regional Referral and Teaching Hospital constructed in the premises of the University. As a first Year Resident working under the supervisions of Senior Consultants and Professors, Dr Abraham’s responsibilities include admitting pregnant mothers and gynaecological patient, triaging them according to urgency of the sickness and required intervention, doing ward rounds and sometimes teaching the undergraduates, nursing students during ward rounds and presenting reports at various levels: staffs morning meeting, during ward rounds and hand over. Dr Abraham was the sixth child to illiterate farmers, born in North Kivu, Democratic Republic of Congo in 1976. With great foresight his mother ensured he received a good education and as a result of his achievements was sent him to the Faculty of Medicine in Goma, DR Congo. Studies were disrupted by wars in DR Congo, and then volcano Nyirangongo in Goma erupted in 2002 with lava destroying Goma where he lived. Despite these interruptions, Dr Abraham completed the Bachelor of Medicine & Bachelor of Surgery in 2007 and in May 2009, he was selected to assume the role of missionary medical officer to work in St Paul’s Health Centre IV in the Kasese District, western Uganda. As an active member of his community in the Kasese District, he has implemented several health projects. Dr Abraham is married with two children (Sephorah and Jack). In the ED • Manage the pain – a few drops of topical local anaesthetic • Check and document corrected visual acuity (on an eye chart) • A full eye examination including eversion of the lid • Remove FB using a wet cotton bud or blunted needle • Remove rust ring with dental burr or needle • Review every 24 hours until rust ring removed and corneal abrasion fully healed • Consider Chlorsig eye drops for a few days Tips of the trade • Don’t forget to document visual acuity • Penetrating foreign bodies are very rare but must always be excluded • Most ophthalmoscopes have a blue light for fluorescein examinations • A bent tip to a 25G needle is a great removal tool • Rust rings are easier to remove after 24 hours – bring them back the next day • Eye pads are not necessary and may slow down healing • Consider dilating the pupil for 24hrs if severe photophobia (Tropicamide) Greenslopes supports post graduate training of Ugandan doctor Back row far left: Dr Kakule Masinda Abraham


GPH News Winter 2015
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