W. Va. Code R. § 85-20-32

Current through Register Vol. XLI, No. 45, November 8, 2024

Section 85-20-32 - Treatment Guidelines: Corneoscleral Lacerations

32.1. Corneoscleral lacerations are potentially severe injuries resulting from sharp objects making forceful contact with the globe.

32.2. The appropriate diagnostic criteria consists of:

a. A detailed examination by an ophthalmologist including visual acuity, slit lamp exam, intraocular pressure and dilated fundus exam.

b. CT scan of orbits may be required.

32.3. Appropriate treatment is as follows:

a. Small partial thickness lacerations:

1. Follow-up and/or patching; and

2. Bandage contact lens application and follow-up.

b. Full thickness corneal lacerations:

1. Bandage lens application;

2. Cyanoacrylate tissue adhesive and protective shield;

3. Surgical repair under general anesthesia and hospitalization;

4. Cycloplegic, steroid and antibiotic drops; and

5. Hospitalization: 0 - 7 days.

32.4. The estimated duration of care and anticipated outcome:

a. Partial thickness laceration: The injured worker should wear a protective shield for three to six weeks. Modified work may be done after several days. Normal visual function should be restored after six weeks.

b. Full thickness simple corneal lacerations: Treatment lasts from two to four months. Protective shield should be worn for six weeks. Return to full work after suture removal is normally in three to four months if vision is adequate for fusion.

c. Lacerations involving lens, uveal tissue and retina: Six months are normally required to achieve stability after which contact lens correction of the aphakic condition may allow good visual recovery.

W. Va. Code R. § 85-20-32