Red eye resident survival guide: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Line 83: Line 83:
** Topical steroids
** Topical steroids
** [[Ascorbate]]
** [[Ascorbate]]
|}
* '''Other causes'''
{| class="wikitable" border="1"
!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| Foreign body}} !!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF|  Conjunctivits}} !! style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| Blepharitis}} !! style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| Scleritis}}
|-
|
* Foreign body removal emergently<ref name="pmid17344985">{{cite journal| author=Macedo Filho ET, Lago A, Duarte K, Liang SJ, Lima AL, Freitas Dd| title=Superficial corneal foreign body: laboratory and epidemiologic aspects. | journal=Arq Bras Oftalmol | year= 2005 | volume= 68 | issue= 6 | pages= 821-3 | pmid=17344985 | doi=10.1590/s0004-27492005000600019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17344985  }} </ref>
* Pain control ([[cycloplegic]] eye drops or topical [[tetracaine]])
* Antibiotics ([[anti-pseudomonas]] coverage)
|
* Bacterial<ref name="pmid30214351">{{cite journal| author=Putnam CM| title=Diagnosis and management of blepharitis: an optometrist's perspective. | journal=Clin Optom (Auckl) | year= 2016 | volume= 8 | issue=  | pages= 71-78 | pmid=30214351 | doi=10.2147/OPTO.S84795 | pmc=6095371 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30214351  }} </ref>
** [[Chloramphenicol]] 0.5% eye drops, [[Gentamicin]] 0.3% eye drops, [[Tetracycline]] 1% eye ointment<ref name="pmid17491982">{{cite journal| author=Wood M| title=Conjunctivitis: diagnosis and management. | journal=Community Eye Health | year= 1999 | volume= 12 | issue= 30 | pages= 19-20 | pmid=17491982 | doi= | pmc=1706007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17491982  }} </ref>
* Viral
** Self-limiting just cold compresses to relieve discomfort
* Allergic
** [[Antihistamines]] (eye drops or orally), Steroid eye drops can be added by [[cromolyn sodium]] 4% eye drops and [[lodoxamide]] 0.1% eye drops
|
* Bacterial
** Topical antibiotic, corticosteroid
* [[HSV]]
** Topical ganciclovir or Oral acyclovir or valacyclovir if nonresolving
|
* First line
** Topical corticosteroid eyedrops ([[Prednisolone]] acetate 1.0%)
** Oral NSAIDs ([[Ibuprofen]] 600 mg)
* Second line
** Oral corticosteroids
*** Prescribed when oral NSAID treatment fails
|}
|}


Revision as of 19:56, 1 August 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyed Arash Javadmoosavi, MD[2]

Overview

Red eye is an essential sign of eye inflammation. Although it is usually benign and can be managed by primary care physician, It is important to distinguish between benign and sight-threatening diagnoses. Its most common cause is conjunctivitis. However, the other common causes are subconjunctival hemorrhage, blepharitis, scleritis, corneal abrasion, glaucoma and foreign body. Red eye can be concomitant photophobia, eye discharge, pain, itiching and visual changes.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[1]

Common Causes

Diagnosis

Shown below is an algorithm summarizing the diagnosis of red eye.[3][2]

{{
 
 
 
 
 
 
 
Patients with red eye
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mild or no pain with mild blurring or normal vision
 
 
 
 
 
 
 
Moderate to severe pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Local
 
Diffuse
 
 
 
 
 
Vesicular rash, Corneal ulcer, Iritis, Acute angle gluacoma, Chemical burn, Traumatic eye injury
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Discharge
 
 
 
 
 
Emergency Ophthalmology referral
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
No
 
 
 
 
 
Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Intermittent
 
 
 
Continuous
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Dry eye
 
Watery or Serous
 
 
Mucopurulent to Purulent
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ItichingClamydial Conjunctivitis
 
Acute bacterial conjunctivitis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mild to non
 
 
 
Moderate to severe
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Viral Conjunctivitis
 
 
 
Allergic Conjunctivitis
 
 
 
 

Treatment

The management of the red eye will depend on the underlying cause.

  • Life-threatening causes
AACG Endophthalmitis Necrotizing Scleritis Herpetic keratitis Chemical injury
  • Other causes
Foreign body Conjunctivits Blepharitis Scleritis
  • Bacterial
    • Topical antibiotic, corticosteroid
  • HSV
    • Topical ganciclovir or Oral acyclovir or valacyclovir if nonresolving
  • First line
  • Second line
    • Oral corticosteroids
      • Prescribed when oral NSAID treatment fails

Do's

  • Using artificial tears in patients with dry eye.
  • Protection against UV rays.
  • Observe hygiene protocols.

Don'ts

  • Avoid wearing contact lenses.
  • Avoid using sharp equipment specially in children.

References

  1. ↑ Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M (2017). "Differentiating Urgent and Emergent Causes of Acute Red Eye for the Emergency Physician". West J Emerg Med. 18 (3): 509–517. doi:10.5811/westjem.2016.12.31798. PMC 5391903. PMID 28435504.
  2. ↑ 2.0 2.1 Cronau H, Kankanala RR, Mauger T (2010). "Diagnosis and management of red eye in primary care". Am Fam Physician. 81 (2): 137–44. PMID 20082509.
  3. ↑ Noble J, Lloyd JC (2011). "The red eye". CMAJ. 183 (1): 81. doi:10.1503/cmaj.090379. PMC 3017259. PMID 20921253.
  4. ↑ Murray D (2018). "Emergency management: angle-closure glaucoma". Community Eye Health. 31 (103): 64. PMC 6253313. PMID 30487684.
  5. ↑ Novosad BD, Callegan MC (2010). "Severe bacterial endophthalmitis: towards improving clinical outcomes". Expert Rev Ophthalmol. 5 (5): 689–698. doi:10.1586/eop.10.52. PMC 3092298. PMID 21572565.
  6. ↑ Lawuyi LE, Gurbaxani A (2016). "Refractory necrotizing scleritis successfully treated with adalimumab". J Ophthalmic Inflamm Infect. 6 (1): 37. doi:10.1186/s12348-016-0107-y. PMC 5059540. PMID 27734292.
  7. ↑ Singh P, Tyagi M, Kumar Y, Gupta KK, Sharma PD (2013). "Ocular chemical injuries and their management". Oman J Ophthalmol. 6 (2): 83–6. doi:10.4103/0974-620X.116624. PMC 3779420. PMID 24082664.
  8. ↑ Macedo Filho ET, Lago A, Duarte K, Liang SJ, Lima AL, Freitas Dd (2005). "Superficial corneal foreign body: laboratory and epidemiologic aspects". Arq Bras Oftalmol. 68 (6): 821–3. doi:10.1590/s0004-27492005000600019. PMID 17344985.
  9. ↑ Putnam CM (2016). "Diagnosis and management of blepharitis: an optometrist's perspective". Clin Optom (Auckl). 8: 71–78. doi:10.2147/OPTO.S84795. PMC 6095371. PMID 30214351.
  10. ↑ Wood M (1999). "Conjunctivitis: diagnosis and management". Community Eye Health. 12 (30): 19–20. PMC 1706007. PMID 17491982.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Red_eye_resident_survival_guide&oldid=1646059"