Red eye (by symptoms): Difference between revisions
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CAUSTIC CONTAMINATION | ==CAUSTIC CONTAMINATION== | ||
-caustic keratoconjunctivitis** | -caustic keratoconjunctivitis** | ||
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...alkaline exp requires min 4L over 40min | ...alkaline exp requires min 4L over 40min | ||
==PROPTOSIS or EXT SWELLING== | |||
PROPTOSIS or EXT SWELLING | |||
-blepharitis | -blepharitis | ||
[warm compresses 15min 4x/day, scrub w/ mild shampoo BID, outpt optho] | [warm compresses 15min 4x/day, scrub w/ mild shampoo BID, outpt optho] | ||
-chalazion | -chalazion | ||
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[warm compress 15min 4xday, massage, optho if fails] | [warm compress 15min 4xday, massage, optho if fails] | ||
-dacrocystitis:inflammation lower eyelid near punctum | -dacrocystitis:inflammation lower eyelid near punctum | ||
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[oral analgesia, abx, optho] | [oral analgesia, abx, optho] | ||
-inflam pseudotumor: retrobulbar inflamm | -inflam pseudotumor: retrobulbar inflamm | ||
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[iop, systemic w/u, CT, steroids and optho] | [iop, systemic w/u, CT, steroids and optho] | ||
-peri/orbital cellulitis*: orbital w/ systemic sx | -peri/orbital cellulitis*: orbital w/ systemic sx | ||
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-retrobulbar abscess/emphysema/hematoma** | -retrobulbar abscess/emphysema/hematoma** | ||
[iop, abx, correct coagulopathy, admit] | [iop, abx, correct coagulopathy, admit] | ||
-orbital tumor* | -orbital tumor* | ||
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==SEVERE PAIN or FB SENSATION== | |||
SEVERE PAIN or FB SENSATION | |||
-keratitis* | -keratitis* | ||
[r/o penetration, tetanus, topical abx, optho referral] | [r/o penetration, tetanus, topical abx, optho referral] | ||
-keratoconjunctivitis | -keratoconjunctivitis | ||
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[optho recs] | [optho recs] | ||
-acute angle-closure glaucoma** | -acute angle-closure glaucoma** | ||
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[iop, timolol, apraclonidine, prednisolone, pilocarpine, mannitol 2g/kg IV] | [iop, timolol, apraclonidine, prednisolone, pilocarpine, mannitol 2g/kg IV] | ||
-hyphema* | -hyphema* | ||
[r/o rupture, head elevation, optho] | [r/o rupture, head elevation, optho] | ||
-endophthalmitis* | -endophthalmitis* | ||
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==FOCAL REDNESS or BULBAR CONJUNCTIVA== | |||
FOCAL REDNESS or BULBAR CONJUNCTIVA | |||
-inflamed pterygium | -inflamed pterygium | ||
[naphazoline/ketorolac drops, outpt referral] | [naphazoline/ketorolac drops, outpt referral] | ||
-scleral penetration** | -scleral penetration** | ||
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[pain relief, antiemetic, tetanus, admit optho] | [pain relief, antiemetic, tetanus, admit optho] | ||
-subconjunctival hemorrhage | -subconjunctival hemorrhage | ||
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==PURULENT DISCHARGE== | |||
PURULENT DISCHARGE | |||
-bacterial conjunctivitis* | -bacterial conjunctivitis* | ||
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==ITCHING SENSATION== | |||
ITCHING SENSATION | |||
-allergic conjunctivitis | -allergic conjunctivitis | ||
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==TOPICAL MEDS or COSMETICS== | |||
TOPICAL MEDS or COSMETICS | |||
-contact dermatoconjunctivitis | -contact dermatoconjunctivitis | ||
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==IF NONE OF ABOVE: (consider)== | |||
IF NONE OF ABOVE: (consider) | |||
-Chlamydia conjunctivitis | -Chlamydia conjunctivitis | ||
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-viral conjunctivitis | -viral conjunctivitis | ||
[naphazoline or ketorolac drops] | [naphazoline or ketorolac drops] | ||
==Source== | ==Source== | ||
Adapted from Pani | Adapted from Pani | ||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
Revision as of 21:24, 14 July 2011
CAUSTIC CONTAMINATION
-caustic keratoconjunctivitis**
[anesth/irrigation until ph 7/optho]
...alkaline exp requires min 4L over 40min
PROPTOSIS or EXT SWELLING
-blepharitis
[warm compresses 15min 4x/day, scrub w/ mild shampoo BID, outpt optho]
-chalazion
-stye (hordeolum)
[warm compress 15min 4xday, massage, optho if fails]
-dacrocystitis:inflammation lower eyelid near punctum
[oral analgesia, abx, optho]
-inflam pseudotumor: retrobulbar inflamm
[iop, systemic w/u, CT, steroids and optho]
-peri/orbital cellulitis*: orbital w/ systemic sx
[CTX/Vanco, cx, CT, admit]
-retrobulbar abscess/emphysema/hematoma**
[iop, abx, correct coagulopathy, admit]
-orbital tumor*
[iop, ct, optho]
SEVERE PAIN or FB SENSATION
-keratitis*
[r/o penetration, tetanus, topical abx, optho referral]
-keratoconjunctivitis
-epi/scleritis
-anterior uveitis*
[optho recs]
-acute angle-closure glaucoma**
[iop, timolol, apraclonidine, prednisolone, pilocarpine, mannitol 2g/kg IV]
-hyphema*
[r/o rupture, head elevation, optho]
-endophthalmitis*
[CTX, vanco; admit to optho]
FOCAL REDNESS or BULBAR CONJUNCTIVA
-inflamed pterygium
[naphazoline/ketorolac drops, outpt referral]
-scleral penetration**
[pain relief, antiemetic, tetanus, admit optho]
-subconjunctival hemorrhage
[hx re coagulopathy, reassure will resolve 2-3 wks]
PURULENT DISCHARGE
-bacterial conjunctivitis*
[peds: polymyxin B + trimethoprim ointment 10Ds OU]
[adults: sulfacetamide or gent; cipro if pseudomonas; drops 10D OU]
ITCHING SENSATION
-allergic conjunctivitis
[naphazoline drops, oral antihistamines, outpt optho]
TOPICAL MEDS or COSMETICS
-contact dermatoconjunctivitis
-toxic conjunctivitis
[irrigate, naphazoline drops, outpt for tx failure]
IF NONE OF ABOVE: (consider)
-Chlamydia conjunctivitis
[PO erythromycin x 14D; CTX for gonorrhea]
-viral conjunctivitis
[naphazoline or ketorolac drops]
Source
Adapted from Pani