0071643192.pdf

HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

SYMPTOMS/EXAM

■ Pain, redness, and photophobia, subepithelial corneal infiltrates may

cause decreased visual acuity.

■ Tender preauricular nodes

■ Superficial punctate corneal lesions

■ Fibrinous membrane in some cases

■ Extremely contagious

■ Lasts 7–21 days

TREATMENT

■ Diligent hand washing

■ Artificial tears

■ Cold compresses

■ Ophthalmology may give topical steroids for membranous conjunctivitis.

■ Topical antibiotics to prevent bacterial superinfection

Allergic Conjunctivitis

■ Usuallyrecurrent

■ Results from allergen exposure, often pollen →hypersensitivity reaction in

the conjunctiva.

■ History of atopy, eczema, asthma

SYMPTOMS/EXAM

■ Itching

■ Conjunctival injection and edema (chemosis) (see Figure 14.32)

■ Discharge (watery, clear, or white)

TREATMENT

■ Topical antihistamine

■ Mast cell stabilizer (cromolyn, pemirolast)

■ Antibiotics if superinfection

■ Oral antihistamine may be helpful if associated nasal symptoms present

■ Cool compresses

■ Avoid contact lenses.

Corneal Abrasion and Foreign Bodies

SYMPTOMS/EXAM

■ Pain, foreign body sensation, redness

■ Decreased visual acuity if central abrasion

■ Fluorescein staining of epithelial defect (see Figure 14.33)

DIAGNOSIS

■ Careful slit lamp examination

■ To check for foreign bodies, remember to evert the eyelids (see

Figure 14.34).

■ CT scan may be useful if suspect penetrating injury (high velocity/energy

event).