Update in office managementManagement of the Red Eye for the Primary Care Physician
Section snippets
Conjunctivitis
The causes to consider in patients with suspected acute conjunctivitis are allergic; bacterial (staphylococci, pneumococci, gonococci, haemophilus); viral (adenovirus, herpes viruses); and chlamydial. The most prominent signs are generalized conjunctival injection with gritty discomfort, mild photophobia, and variable discharge but no loss of visual acuity.
Allergic conjunctivitis usually presents with itching tearing, large cobblestone papillae under the upper lid, and conjunctival swelling
Subconjunctival Hematoma (Hyposphagma)
Two types of subconjunctival hematoma can be presented: spontaneous and traumatic. In spontaneous cases with no other subjective complaints, this may arise from coughing and straining or from atherosclerotic vessels, particularly in the elderly, and can be associated with hypertension or a bleeding diathesis (Figure 2). Check the blood pressure and reassure the patient that the blood will disperse within 2 weeks. No further treatment is needed.
In traumatic cases this may be the result of a
Dry Eye
The typical sign of common dry eye is a foreign body sensation, and the feeling can be exacerbated by dry air such as air conditioning. Dry eye is found in patients with Sjögren’s syndrome.
Artificial tear eyedrops can be used without prescription. If the symptoms persist, a consultation by an ophthalmologist is recommended.
Blepharitis
Blepharitis is a frequent chronic inflammation of the eyelid margin causing red, itchy, and crusted lids. Styes and chalazions can be associated.
In chronic cases, cleaning
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Approach to Red Eye for Primary Care Practitioners
2015, Primary Care - Clinics in Office PracticeCitation Excerpt :Redness of the eye is a sign of ocular inflammation, resulting from dilatation and/or rupture of blood vessels in the eye. Numerous conditions may result in redness of the eye, including conjunctivitis, blepharitis, canaliculitis, dacryocystitis, episcleritis, scleritis, uveitis, iritis, keratitis, orbital cellulitis, corneal injury, foreign body, chemical burn, subconjunctival hemorrhage, dry eye syndrome, and acute angle-closure glaucoma.1,2 The primary care provider is often the first clinician to encounter patients with eye complaints; it is reported that, among eye complaints prompting patients to present for medical care, the red eye is one of the most common.3,4
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