Evaluation of the Red Eye - Holgren Flashcards
Identify this condition and describe the treatment:
pt reports - burning, gritty sensation that gets worse in the evenings
Dry Eyes
common with aging, F >M, often worse when reading
exposure: Bell’s palsy, Thyroid eye disease, scarred or malpositioned lids
may be associated with: rheumatological disorders, Stevens-Johnson, systemic meds
tx: artificial tears, lubricating ointment, punctal plug, Restasis, lid taping
Identify this condition and describe the treatment:
red, swollen lids and skin
normal: vision, pupils, occular motility, conjunctiva
Anterior (preseptal) cellultis
cause: trauma, URI, sinusitis, otitis
tx: cool compresses, systemic antibiotics
hospitalize if a child < 3
Identify this condition and describe the treatment:
spontaneous blood red eye, with normal vision, no pain and no discharge
Subconjunctival Hemorrhage
tx: resolves in 2-3 weeks on own
Identify this condition and describe the treatment:
localized or diffuse redness, deep red, pain
pt: history of RA
Episcleritis/Scleritis
scleritis - deep red, pain, can be vision threatening
idiopathic may have rheumatologic/autoimmune associations
tx: refer to ophthalmologist
Identify this condition and describe the treatment:
red eye, watery discharge, foreign body sensation, dendrite branching
Viral Keratitis
cause: Herpes Simplex Virus (type 1)
refer: STAT
Identify this condition and describe the treatment:
thick, red lid margins with crusting, some loss of eye lashes
Blepharitis
staphylococcal, seborrheic (meibomian gland dysfunction)
tx: warm compress, lid hygiene, topical antibiotics ung (ointment), oral antibiotics
Identify this condition and describe the treatment:
watery discharge with stringy mucus, itching
pt is an asthmatic
Allergic Conjunctivitis
ITENSE ITCHING
hx: allergy, ashtma, atopic/allergic disease
tx: topical antihistamines, mast cell stablizers
Causes of this condition
hint: pt was born at 0730
Neonatal Conjunctivitis
Staph, strep, h.flu
N. gonorrhea - refer to ophthalmologist, systemic antibiotics and topical
Chlamydial - topical and oral erythromycin
Identify this condition and describe the treatment:
pain, tearing, foriegn body sensation, photophobia, blurred vision
fluroscein exam:
Corneal Abrasion
tx: cycloplegic drops, oral analgesics with codiene; topical antibiotics; pressure patch 24 hours
refer: if not healed in 24-48 hours
Identify this condition and describe the treatment:
red, painful decreased vision with purulent discharge
Bacterial Keratitis
refer STAT
Identify this condition and describe the treatment:
pt was at work in a lab and got something in his eye
Chemical Injury
tx: immediate irrigation for 15 minutes, further irrigate until pH is normal
Alkali causes more damage
refer: STAT
Identify this condition and describe treatment:
localized or diffuse lid cellulitis, tenderness
Hordeola/chalazia
inflammed lid glands due to obstructed orifces
tx: warm compress, topical antibiotic ung (ointment)
Identify this condition and describe the treatment:
severe eye pain, blurred vision, halos around lights, nausea and vomiting
exam: mid-dilated pupil, redness, cloudy cornea, hard eye
Acute Glaucoma
cause: dim lights, drugs, emotional stress
refer: STAT
Identify this condition and describe the treatment:
purulent discharge
Bacterial Conjunctivitis
cause: Staph, Steph, Hemophilus Influenzae
tx: warm compress, topical antibiotics, fluroquinolones
if Neisseria gonorrhea systemic antibiotics and hyperpurulent discharge
Identify this condition and describe the treatment:
circumcorneal redness, pain, photophobia, decreased vision, small pupil
Iritis/Uveitis
idiopathic, infectious, sarcoidosis, autoimmune disorders, trauma
refer
Identify this condition and describe the treatment:
watery, serous discharge, tender preauricular nodes
Viral Conjunctivitis
cause: Adenoviral, highly contagious
tx: no effective therapy (will clear in 1-2 weeks)
refer: pain, decreased vision, photophobia
Identify this condition and describe the treatment:
swollen, red lids and conjuncitva; proptosis; impaired occular motility and painful movement; decreased vision; afferent pupillary defect; optic disc edema
Posterior (orbital) cellulitis
tx: hospitalization, CT scan, blood cultures IV antibiotic
often a fungal infection in immunocompromised
can lead to cavernous sinus thrombosis, meningitis
Vision Threatening Red Eye Disorders
these need to be refered to ophthalmologist ASP!
orbital cellulitis
scleritis
chemical injuries
corneal infection
hyphema
iritis
acute glaucoma
Identify this condition and describe the treatment:
inflamamtion and irritation
pt has job exposure to sun, wind and dust
Pinguecula (top photo)/Pterygium (bottom photo)
tx: artifical tears, topical NSAIDs
refer: severe inflammation, or if pterygium is actively growing
Identify this condition and describe the treatment:
pt recieved a blow to the face, reports decreased vision and pain
Hyphema
blood in anterior chamber
refer STAT
Identify this condition and describe the treatment:
tearing and discharge
Nasolacrimal Duct Obstruction
infected tear sac (Dacryocystitis)
Congenital tx: daily massage, antibiotics if infected, refer if no resolution 6-8 months
Aquired tx: systemic antibiotics if infected, refer if chronic
