199
Index
References to figures and other non-textual materials are in italics. American spellings are used.
Abscess, 38, 168 Accidents see Trauma Acetazolamide see Diamox
Acetylcysteine (Ilube), 190, 196 Aciclovir see Zovirax ointment Adenovirus (keratoconjunctivitis), 52,
53
Afferent pupillary defect (APD) basic examination, 7–8 dysthyroid eye disease, 53 eyelid infection, 149
orbital hematoma, 122 painful eye, 66
AION (anterior ischemic optic neuropathy), 74–5
Allergy
drops for, 188, 195 eyelid irritation, 144, 145 red eye, 14, 16, 45, 50
Alomide (lodoxamide), 188, 195 Alphagan drops, 50, 189, 195 Altitudinal field loss patterns, 10 Amblyopia (toxic or nutritional),
103–4
Amethocaine (local anesthetic), 191, 197
chemical injury, 112 contact lenses
lost, 37
overwear/poor hygiene, 49 keratoconjunctivitis, 52
red eye, 37, 46, 48, 49, 52 welding/grinding/flash burn
injuries, 48
Amitriptyline, neuralgia treatment, 70 Anesthesia, 197
corneal, 149, 150
local see Amethocaine (local anesthetic); Benoxinate (local
anesthetic); Lignocaine (local anesthetic); Proxymetacaine (local anesthetic)
Aneurysm, cerebral, 66, 68, 109 Ankylosing spondylitis, 19 Antazoline sulfate (allergy drops), 50,
145, 188
Anterior chamber, 22, 48
Anterior ischemic optic neuropathy (AION), 74–5
Antibiotic drops see Chloramphenicol drops; Exocin (antibiotic drops); Fucithalmic drops/ointment); Genticin drops, 186
Antibiotics, 193–4 Antivirals, 194
APD (afferent pupillary defect) see Afferent pupillary defect (APD)
Argon laser, 184 Arterial occlusion, 74
Arteriosclerotic blockage, 74 Arteritis, temporal, 64, 67, 74–5, 78 Arthritis, 62
Artificial Tears, 190, 193, 196 Astigmatism, 175
Atopy (red eye), 59 Atropine
allergies, 50 glaucoma surgery, 192 illustrated, 191
pupil dilation, 190, 196
retinal detachment surgery, 193 ulcers, contact-lens-related, 40
Aureomycin (antibiotic ointment), 187, 194
Bacterial ulcers (corneal), 38 Basal cell carcinoma, 160, 161
200 Index
Basic examination see Examination, basic
Benoxinate (local anesthetic), 191, 197 chemical injury, 112
contact lenses lost, 37
overwear/poor hygiene, 49 keratoconjunctivitis, viral, 52 red eye, 37, 46, 48, 49, 52 welding/grinding/flash burn
injuries, 48
Beta Blockers see Betagan glaucoma drops; Betoptic glaucoma drops; Timoptol/timolol (beta blocker)
Betagan glaucoma drops, 189 Betamethasone sodium phosphate see
Betnesol (steroid drops) Betaxolol glaucoma drops, 189 Betnesol (steroid drops), 188, 194
allergies, 50 cataract surgery, 192
dacryocystorhinostomy, 193 glaucoma treatment, 41 squint surgery, 193
tumors (eye surface), 164 uveitis, 35
Betoptic glaucoma drops, 189, 190 Bitemporal hemianopia (visual field
loss patterns), 10 Blepharitis
features, 60 hygiene, 144
lid examination, 47 management, 61, 143–4 referral/follow up, 61, 145 ulcers, 38, 39, 40, 45 watering eye, 132, 133
Blepharospasm, 46 Blunt injuries, 114–20
see also Sharp and penetrating injuries
cornea, 118
double vision, 114, 116 examination, 116 external globe, 118 eye movements, 118 fluorescein, 118 fundus, 119–20
globe rupture, 114 hematoma, 119
orbital, 114, 116 hyphema, 114, 115, 119 iris, 119
lens, 119 management, 120 orbital rim, 115
orbital root, 117 pupil, distorted, 119
subconjuctival hemorrhage, 118 visual acuity, 118
Brimonidine tartrate see Alphagan drops
BRVO (branch retinal vein occlusion), 81, 82, 83
C-reactive protein, 70, 75 Canaliculus, inferior, 159 Cancer
see also Tumors
basal cell carcinoma, 160, 161 diffuse cell basal cell carcinoma, 161 features of malignancy, 153 malignant melanoma, 162, 163
choroidal, 166–7
sebaceous cell carcinoma, 153, 162 secondary metastases, 167 squamous cell carcinoma, 161, 162
Carbamazepine (neuralgia treatment), 70
Carotico-cavernous fistula, 54, 55 Cataracts
complications following surgery, 172–4
immediate (0-2 days), 172 early (2-7 days), 172–3 late (7 days+), 173 management, 173–4
double vision, 111 examination/management, 94 features, 94
illustrated, 95 macula edema, 102
posterior capsule thickening following cataract surgery, 93,
94 red eye, 23
red reflex, 8 referral/follow up, 94 surgery, 170–4
complications, 172–4 drops, 192
extracapsular lens extraction, 172 following, 101–2, 184–5 phacoemulsification, 170, 171,
172 sutures, 173
Cefuroxime drops, 39, 129 Cellulitis (periorbital/orbital)
blepharitis, 145
diffuse infection, 147, 148 painful eye, 65
red eye, 17, 18, 55
Index 201
Central retina, 8
Central retinal artery occlusion, 76–8 associations, 76 examination/management, 76–7 features, 76
referral/follow up, 77
Central retinal vein occlusion (CRVO), 81, 82, 83
Cerebrovascular accident (CVA), 104–5 CF (Count Fingers) test, 2
Chalazion infected, 146, 154
tumors on eyelid, 153–6, 154 management/referral, 153–4 meibomian cyst, 154
Chemical injury features, 112 management, 112–13 pitfalls, 113–14
red eye, 13, 45 referral/follow up, 113
Chemosis, 21, 53, 164 Children
corneal abrasions, 27 diplopia (double vision), 110 eyelids
benign lesions, 154 infection, 149
watering eye, 132, 138 Chiselling, injury from, 129–31 Chlamydia, 51, 59, 194
Chloramphenicol drops, 186, 187, 193 see also Chloramphenicol ointment allergies, 50
cataract surgery, 192 conjunctivitis, 51, 52, 56 dacryocystorhinostomy (DCR), 193 laser refractive surgery, 193
squint surgery, 193 styes, 157
Chloramphenicol ointment
see also Chloramphenicol drops blepharitis, 61
chemical injury, 113 contact lenses
allergic reactions, 50 cleaning solution, accidental
instillation, 140 lost, 37, 142 overwear, 36, 49, 140 ulcers, caused by, 40
corneal abrasion, 26, 27
corneal foreign body, removal, 29, 30
entropion, 152 eyelids, chalazion, 153 illustrated, 187
papilloma/skin tags, 158 squint surgery, 193 styes, 157
subtarsal foreign body, 31 tumors (eye surface), 164 welding/grinding/flash burn
injuries, 48
Chloromycetin (antibiotic drops), 186, 187
Chlortetracyline hydrochloride ointment (Aureomycin), 187, 194
Choroidal melanoma, 166–7 Choroidal nevus (tumors), 166 Ciloxan drops (ciprofloxacin), 186, 187,
194 conjunctivitis, 52
’Cobwebs’ (floaters, flashes), 106–7 Cold compresses (allergy), 145 Color perception, 46, 47 Conjunctiva
examination, 6, 47
fornix, conjunctival, 21, 37, 141 laceration, 126
pedunculated papilloma involving,
159
red eye, 16, 21, 37, 55, 59, 62 sharp/penetrating injuries, 128,
129 swollen, 145
Conjunctival chemosis, 164 Conjunctival lesions/cysts, 162, 163,
164, 165 Conjunctivitis
see also Keratoconjunctivitis bacterial, 52
features, 51, 56 management, 51–2, 56 pitfalls, 54
red eye, 13, 14, 45, 46, 51–2, 56–7 referral/follow up, 52, 56–7 visual acuity, 46
Contact lenses
acute problems, 139 allergic reaction, 50 broken, 36
chronic problems, 139 cleaning solution, accidental
instillation, 140 hygiene, poor, 19 intolerance to wear, 141 lost, 36–8, 141–2
management of disorders, 49 overwear
features, 35, 139 management, 35–6, 139–40 red eye, 19, 35–6, 45, 49
202 Index
Contact lenses contd problems, 139–42
red eye, 19, 35–8, 39, 45, 49–50, 62 referral/follow up, 49–50 removal, 36, 139, 140, 145
ulcers, connected to, 39, 139 Cornea
basic examination, 6–7 blunt injuries, 118 chemical burn, 113 painful eye, 66
red eye, 21–2, 47, 56, 60, 63 sharp/penetrating injuries, 128
Corneal abrasions, 13, 15, 19, 24–7 examination/management, 25–7 pitfalls, 27
red reflex, 8 referral/follow up, 27
subtarsal foreign body, containing,
21
Corneal abscess, 38 Corneal anesthesia, 149, 150
Corneal foreign body, 13, 14, 18 features, 27–8
management, 28–30 metallic, 28
needle, removal with, 29, 30 penetrating, 28
pitfalls, 31–2 referral/follow up, 30–1
Corneal sensation, checking, 109 Corneal ulcer, 17, 38–41
bacterial, 38
blepharitis associated with, 45 dendritic see Dendritic ulcers features, 38
management, 38–40 marginal, 40 pitfalls, 41
Cosopt (glaucoma drops), 189
CRVO (central retinal vein occlusion), 81, 82, 83
CT scans
blunt injuries, 117 eyelid infection, 149 hammering injuries, 131 tumors, 168
CVA (cerebrovascular accident), 104–5 Cyclopentolate drops
see also Mydrilate (cyclopentolate drops)
chemical injury, 113 contact lenses
overwear, 36, 49, 139
solution, accidental instillation, 140
corneal abrasions, 26
corneal foreign body, removal with needle, 29
keratoconjunctivitis, 52 pupil dilation, 190 pupillary spasm, 21 subtarsal foreign body, 31
ulcers, contact-lens-related, 40 uveitis, 35 welding/grinding/flash burn
injuries, 48 Cyst of Moll, 159, 160 Cysts
conjunctival, 162, 163, 164, 165 features, 153
meibomian, 154
removal of contents, 155–7, 158 sebaceous, 160
Dacryocystitis, 168, 169 Dacryocystorhinostomy (DCR)
(watering eye surgery), 135, 193 Dendritic ulcers, 38, 40, 56
keratoconjunctivitis, 52, 53 Dendritiform ulcers (shingles), 150 Dexamethasone see Maxidex (steroid
drops)
Dextran (Tears Naturelle), 190 Diabetes
laser treatment, 184
maculopathy, diabetic, 81, 92, 100–1 painful eye, 65, 70–1
red eye, 55
retinopathy, diabetic, 70, 100–1, 103 Diamox, 196
central retinal artery occlusion, 76 glaucoma treatment, 41, 189 illustrated, 190
Diffuse cell basal cell carcinoma, 161 Diplopia (double vision)
basic examination, 5–6 blunt injuries, 114, 116 children, 110
corneal sensation, checking, 109 in diabetes, 70
examination, 109
eyelid infection, 148, 149 history, taking, 109 horizontal, 6, 7
main causes, 107–8 management and referral, 110 nerve palsy with/without pupil
involvement, 110 orbital bruising and, 123 painful eye, 66 proptosis, 111
retina, 109
Index 203
squint surgery, 180
thyroid eye disease, 109, 111 traumatic, 110
vertical, 6, 116
Disciform (macular) hemorrhage, 83–4 Dorzolamide (glaucoma drops), 189 Double patching technique
see also Patching technique contact lens overwear, 36 corneal abrasion, 26, 27 corneal foreign body, 30
Double vision see Diplopia (double vision)
Drilling, injury from, 18 Dry eye
and red eye, 45, 63 watering, 132, 135
Dysthyroid eye disease, 46 features, 53 management, 53–4 pitfalls, 48 referral/follow up, 54
Ectropion
eyelid infections, 150–1 surgery, 174
watering eye, 132, 133, 134 Emollient cream, shingles, 149 Endophthalmitis, 17, 18, 173 Entropion
and eyelid infections, 151–2 red eye, 14, 15, 33–4, 43 surgery, 174
Episcleritis, 42 features, 41, 58 management, 43, 58
mild discomfort in, 22, 24 pitfalls, 43 referral/follow up, 43, 59 scleral injection, 24
Erythema (eyelids), 133, 147 ESR, checking, 68, 70
Euthyroid patients see Dysthyroid eye disease; Thyroid disease
Examination, basic conjunctiva, 6 cornea, 6–7
external appearance, 1–2 eye movements, 5–6 face, lids and orbit, 1 fundus (retina), 8, 9 pupils, 7–8
red reflex, 8 sclera, 6
visual acuity, 2–5 visual fields, 10–12
Exocin (antibiotic drops), 186, 194 allergies, 50
cataract surgery, 192 conjunctivitis, 52
External globe, 118
Extracapsular lens extraction, cataract surgery, 172
Extraocular muscles, direction of action, 6
Eye
external appearance, 1–2 illustrated, 1
Eye movements
basic examination, 5–6 blunt injuries, 118 eyelid infection, 148 painful eye, 66 migraine, 68
Eye surface tumors, 162–5 conjunctival lesions/cysts, 162, 163,
164, 165
red, painful and irritable lesions, 165 Eyelashes, ingrowing, 14, 15, 33–4
eyelid infection, 151–2 Eyelids
cysts, 65
diffuse infection, 147–9 edema, 44
erythema of margin, 133, 147 examination, 19, 20, 47, 65 hygiene, 61, 144
infection, 146–52 diffuse, 147–9 ectropion, 150–1 entropion, 151–2
ingrowing lashes, 151–2 localized, 146–7 shingles, 149–50
irritation see Allergy; Blepharitis lacerations, 124, 125, 128 localized infection, 146–7
styes, 65, 146 tumors, 153–62
ulcers associated with, 38
5HT antagonist, migraine treatment, (Imigran), 68
Flash burn injuries, 48–9 Flashes, 106–7
’Flies’, (floaters, cobwebs), 106–7 Floaters, 81, 106–7
Fluorescein,
anesthetic drops, 191, 192 Fluorescein staining, 191, 197
blepharitis, 61, 144 blunt injuries, 118
204 Index
Fluorescein staining contd chemical injury, 113 conjunctivitis, 51, 56 contact lens
cleaning solution, accidental instillation, 140
intolerance to wear, 141 lost, 37
overwear, 35, 49, 139 corneal abrasion, 13, 15, 25 corneal foreign body, 28 dry eye, 63
dysthyroid eye disease, 54 ectropion, 151
entropion, 151 episcleritis, 43, 58 hyphema, 124 keratoconjunctivitis, 52
lateral canthotomy procedure, 122 painful eye, 66
tumors, eye surface, 165 watering eye, 133, 134 welding/grinding/flash burn
injuries, 48 Fluoromethalone (FML), 188, 195 Footballs, injuries caused by, 115 Fracture, ’blow-out’, 116, 121, 123 Froben (anti-inflammatory agent),
episcleritis, 43, 58 Fucithalmic drops/ointment, 186,
194 allergies, 50 blepharitis, 144 conjunctivitis, 52 illustrated, 187
Fundus
basic examination, 8, 9 blunt injuries, 119–20 occipital infarct, 79 painful eye, 66
red eye, 24, 48, 56, 60 Fusidic acid see Fucithalmic drops/ointment
Ganda, (glaucoma drops), 196 Garamycin see Genticin (gentamicin)
drops
Gardening injuries, 127, 129 Gelonet (vaseline gauze), 174 GelTears (lubricant), 190
ectropion, 151 illustrated, 191 keratoconjunctivitis, 52
Genticin (gentamicin) drops, 186, 194 conjunctivitis, 52
contact lenses
allergic reaction, 50 ulcers, 40
Glass injuries, 125, 127, 129 Glasses see Spectacles Glaucoma
acute, 41, 95 chronic, 95–8 congenital, 132, 138 drops for, 189, 195–6 examination, 98 features, 95
laser treatment, 184 management, referral and follow
up, 98
optic disc in, 96, 97 painful eye, 66 red eye, 22, 41
surgery (trabeculectomy), 181 basic steps, 180 complications, 181
drops, 192 management, 182
Globe rupture, 17, 114, 118 suspected, 120
Grinding, injury from, 18, 45, 48–9 GTN (for use in central retinal artery
occlusion), 76
Hammering, injury from, 18, 129–31 Hayfever see Allergies
Head injury, 46 Headaches
see also Migraine painful eye, 65 vision loss, 73
Hematoma
blunt injuries, 114, 116, 119, 121 orbital, 114, 116
Hemorrhage
see also Subconjunctival hemorrhage; Vitreous hemorrhage
intraocular, 128 macular, 83–4 periorbital, 123 retinal, 81 subarachnoid, 69 submacular, 98
Herpes zoster ophthalmicus (HZO), 43, 44
Herpes simplex infection (primary), 148
History taking, basic examination, 1 HM (Hand Movements vision), 2 Homatropine hydrobromide, 190, 196 Homonymous hemianopia (visual
field loss patterns), 10
Index 205
Hydrocortisone (temporal arteritis treatment), 75
Hydrops (corneal), 92 Hydroxyethylcellulose (Artificial
Tears), 190, 193 Hyper-thyroidism, 59
Hypermetropia (long sightedness), 175 Hypertension
painful eye, 65 red eye, 55 vision loss, 73, 81
Hyphema
blunt injuries, 114, 115, 118, 119 examination/management, 124 pitfall, 124
red eye, 22, 24 referral, 124
sharp/penetrating injuries, 128 total, 123
Hypopyon (anterior chamber) anterior chamber, 22
red eye, 17, 18, 22, 24 surgery, previous, 17, 18
Hypromellose drops, 63, 135, 190, 196 HZO (herpes zoster ophthalmicus), 43,
44
Ilube ointment, 190, 196 Imigran (migraine treatment), 68 Infection
eyelids, 146–52 diffuse, 147–9 ectropion, 150–1 entropion, 151–2
ingrowing lashes, 151–2 localized, 146–7 shingles, 149–50
intraocular, 17
surgery complications, 175, 182 viral
painful eye, 65 red eye, 45
Influenza, red eye, 45
Infraorbital nerve paresthesia, 122 Internal ocular tumors, 165–7 Intraocular hemorrhage, 128 Intraocular infection, 17 Intraocular pressure (IOP), 76 Iris, tumors on, 165–6
Iritis, 14, 16 shingles, 150
Ischemic pain, 71
Keratoconjunctivitis
features, 52
management, 52 red eye, 45, 52–3
referral/follow up, 53 Keratoconus, 92, 175 Keratosis (solar/seborrheic),
159–60
Lacri-Lube ointment, 190, 196 dry eye, 63, 135 dysthyroid eye disease, 54 ectropion, 151
Lacrimal punctum
cannula insertion, 134–5, 137 dilation, 134, 137
drying and closure, 133 stenosis, 132, 136
Lacrimal sac lesions, 168–9 Lansoprazole
dysthyroid eye disease, 54 temporal arteritis treatment, 75
Laser (excimer) refractive surgery, 175–8
contraindications, 178 drops, 193
LASIK (laser-assisted in situ keratomileusis), 175–6
PRK (photo refractive keratectomy), 175, 176–8
Laser treatment, 184–5 Argon laser, 184
cataract surgery, following, 184–5 diabetics, 184
focal laser, 184 glaucoma, 184
laser (excimer) refractive, 175–8, 193
YAG laser, 94, 101, 184 LASIK (laser-assisted in situ
keratomileusis), 175–6 Latanoprost see Xalatan
(latanoprost)
Lateral canthotomy procedure, orbital hematoma, 122
Levobunolol hydrochloride (glaucoma drops), 189
Lidocaine hydrochloride, 191 Lids see eyelids
Light sparks, 106–7 Lignocaine, 191 Liquifilm Tears, 190, 196 Long sightedness, 175
Lubricant drops see Artificial tears; GelTears (lubricant); Hypromellose drops; Liquifilm Tears; Tears Naturelle; Viscotears (lubricant)
206 Index
Lubricant ointment see Ilube; Lacri-Lube
Lymphoma, 163
Macula edema, 102
Macular degeneration (age-related) examination, 98–9
features, 98
management, referral and follow up, 99–100
submacular hemorrhage, 98 Macular hemorrhage, 83–4 Maculopathy
age-related, 81 diabetic, 81, 92, 100–1
Magnapen (antibiotic) ’blow-out’ fracture, suspected,
123 dacryocystorhinostomy, 193 eyelid infection, 149 painful eye, 67
penetrating injury, 129 tumors, 169
Malignant melanoma, 162, 163 choroidal, 166–7
Maxidex (steroid drops), 188, 194 cataract surgery, 192 glaucoma treatment, 41 uveitis, 35
Maxolon (antiemetic) glaucoma treatment, 41 migraine treatment, 68
Meibomian gland, 65
Melanoma see Malignant melanoma Melanosis, conjunctival, 163 Migraine
associations, 90 examination/management, 91 features, 90
painful eye, 68–9 pitfall, 69 referral, 91 vision loss, 81
MRI scan
eyelid infection, 149 hammering injuries, 131 tumors, 168
Mucocele, watering eye, 133, 136 Myasthenia gravis, 111 Mydriacyl (pupil dilator), 190 Mydriasis, traumatic, 122 Mydrilate (cyclopentolate drops)
contact lens overwear, 139 glaucoma surgery, 192 keratoconjunctivitis, 52 pupil dilation, 190, 196
retinal detachment surgery, 193 uveitis, 35
Myopia (short sightedness), 175
Nasolacrimal duct,
failure of canalization (children), 132, 138
Nasolacrimal system, blockage (adults), 132, 134
Nausea treatments see Maxolon (antiemetic); Stemetil (antiemetic)
Nedocromil sodium, 50, 188 Neomycin, laser refractive surgery, 193 Nerve palsy (3rd)
double vision, 109, 110 failure to treat, 111 painful eye, 66, 68 Neuralgia, 69–70
shingles, 150
Neuropathology, visual fields, 10 Normal vision, 3
painful eye, 64–5
NPL (No Perception of Light), 2, 120
Oculoplastic surgery, 174–5
Ofloxacin see Exocin (antibiotic drops) Olopatadine drops (allergies), 50, 145,
188
ON (optic neuritis) see Optic neuritis (ON)
Opacity (prolapsed tissue), 120, 176 Opatanol eye drops (olopatadine), allergies, 50, 145, 188
Operations see Surgery Ophthalmoscope, 8 Optic disc, 8
glaucoma in, 96, 97
Optic nerve damage, APD (afferent pupillary defect), 7
Optic nerve infarction, 74–5 Optic neuritis (ON)
APD (afferent pupillary defect), 7 associations, 89
examination, 89 features, 88–9 management, 89–90 partial vision loss, 88–90 pitfalls, 90 referral/follow up, 90
Opticrom (sodium cromoglicate), 188, 195
Orbit tissues, examination, 20 Orbital bruising, 123
Orbital hematoma, 114, 116
Index 207
lateral canthotomy procedure, 122 no view of eye, 121
with view of eye, 122 Orbital rim, 114, 115 Orbital root, 117 Orbital tumors, 167–9
Otrivine-Antistin eye drops (allergies), 50, 145, 188
Oxybuprocaine hydrochloride see Benoxinate (local anesthetic)
Painful eye, 64–72
see also Red eye; Watering eye arteritis, temporal, 64, 67 diabetes, 65, 70–1 examination, 65–6
ischemic pain, 71 location of pain, 64 migraine, 68–9 neuralgia, 69–70
normal appearance and vision, 64–5 periocular pain, 64
sinusitis, 65, 67–8
spectacles, incorrect/absent, 71–2 Pan retinal photocoagulation (PRP),
184, 185 Papillitis, 97
Papilloma/skin tags, 157, 158, 159 Particles, high-volocity, 125 Patching technique
chemical injury, 113
contact lens overwear, 36, 140 corneal abrasion, 26, 27 corneal foreign body, 30
cyst removal, 158 welding/grinding/flash burn
injuries, 48 Pedunculated papilloma, 159 Penetrating injuries, 18, 120
see also Sharp and penetrating injuries
Periocular pain, 64 Periorbital bruising, 117 Periorbital hemorrhage, 123
Periorbital tissues, examination, 20, 55
Periorbital tumors, 167–9 Periorbital/orbital tumors, 167–9 Peripheral iridotomy (PI), 184 Peripheral retina, 8 Phacoemulsification (cataract surgery),
170, 171, 172 Phenylephrine hydrochloride, 190 Photophobia
contact lens overwear, 140 red eye, 18, 21, 31, 35
Photopsia (flashes or sparks of light), 106–7
PI (peripheral iridotomy), 184 Pilocarpine (glaucoma treatment), 41,
50, 189, 195 Pinhole, 2, 5
Polyacrylic acid see GelTears (lubricant); Viscotears (lubricant)
Polymyalgia rheumatica, vision loss, 73
Polyvinyl alcohol, 188, 189, 190 Posterior vitreous detachment (PVD)
floaters, 106 photopsia, 106
vitreous hemorrhage, 84
Pred Forte (steroid drops), 188, 194 cataract surgery, 192
dysthyroid eye disease, 54 glaucoma treatment, 41 illustrated, 188
uveitis, 35
Prednisolone acetate see Pred Forte (steroid drops)
Prednisolone sodium phosphate see Predsol (steroid drops)
Predsol (steroid drops), 188, 189, 195 hyphema, 124
laser refractive surgery, 193 tumors (eye-surface), 164
PRK (photo refractive keratectomy), 175, 176–8
Propine, 50, 195 Proptosis, 111, 167–8
Proxymetacaine (local anesthetic), 191, 197
basic examination, 2 chemical injury, 112 contact lenses
lost, 37
overwear/poor hygiene, 49 corneal abrasions, 25
corneal foreign bodies, 28 Cyst of Moll, 159 illustrated, 192
keratoconjunctivitis, viral, 52
red eye, 25, 28, 31, 37, 46, 48, 49, 52 subtarsal foreign body, 31
tumors (eye surface), 164 watering eye, 134 welding/grinding/flash burn
injuries, 48
PRP (pan retinal photocoagulation), 184, 185
Pseudomonas, 194
Pterygium, 164
Ptosis, sudden onset, 66
208 Index
Pupils
afferent pupillary defect (APD) see Afferent pupillary defect (APD)
blunt injuries, 119 dilated, 67
treatment for, 190, 196 distorted, 119, 127, 128 examination, 7, 47, 66 and iris, 119
and nerve palsy (3rd), 110 painful eye, 66
red eye, 21, 47, 56, 60 small (miosis), 195
PVD (posterior vitreous detachment) see Posterior vitreous detachment (PVD)
Ranitidine, 54, 75
Rapitil (nedocromil sodium) drops, allergies, 50, 188, 195
RD (retinal detachment) see Retinal detachment (RD)
Reading glasses, 4, 72, 175 Red eye, 13–63
see also Painful eye; Watering eye acute onset, 17–62
allergy, 14, 16 bilateral, 45–55, 59–63
blepharitis see Blepharitis carotico-cavernous fistula, 54–5 chronic, 62–3
chronic, unilateral and bilateral, 62–3
conjunctivitis, 13, 14, 51–2, 56–7 contact lenses, 19, 35–8, 39, 45,
49–50, 62
corneal abrasion, 13, 15, 19, 21, 24–7 corneal foreign body, 13, 14, 18,
27–31
corneal ulcer, 17, 38–41 disease categories, 13–17
dysthyroid eye disease, 45, 46, 53–4 episcleritis/scleritis, 41–3, 42, 58–9 glaucoma, 41
ingrowing lashes/entropion, 14, 15, 33–4
onset, 13 painful, 17–55 painless, 55–62
shingles, 43–5, 150
subconjunctival hemorrhage, 14, 16, 17, 55, 57–8
subtarsal foreign body (STFB), 31, 32 trauma, 17, 19, 55
unilateral, 17–45, 55–9, 62–3 uveitis see uveitis (red eye)
viral keratoconjunctivitis, 52–3 welding/ grinding/ flash burn
injuries, 48–9 Red reflex, 7, 8
lens, sharp/penetrating injury to, 128
Retina
see also fundus (retina) central, 8
double vision, 109 peripheral, 8 tumors, 166–7
Retinal detachment (RD) associations, 86 examination/management, 86–7 features, 86
photopsia, 106, 107 pitfall, 88 referral/follow up, 87–8 surgery, 183
basic steps, 182 complications, 182 drops, 193 management, 182–4
vision loss, 86–8 Retinal hemorrhages, 81 Retinoblastoma, 8, 167
Retinopathy(diabetic patients), 70, 100–1, 103
Rimexolone (Vexol), 188 Rosacea, 38
Safety goggles, 130 Sclera/scleritis, 22, 24, 42, 56, 58–9,
60 examination, 6, 48 features, 41 management, 43
referral/follow up, 43 Sebaceous cell carcinoma, 153, 162 Sebaceous cyst, 160
Sessile papilloma, 159
Sharp and penetrating injuries, 120,
126
see also Blunt injuries examination, 128–9 gardening, 127, 129
glass injuries, 125, 127, 129 questions, asking, 127 thrown objects, 127, 129 usual causes, 125, 127 x-ray, 128
Shingles, 43–5, 65
eyelid infections, 149–50 Short sightedness (myopia), 175
Shuttlecocks, injuries caused by, 115
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eyelid infections, 147 |
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Surgery, 170–85 |
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Slit lamp |
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see also Surgery complications |
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basic examination, 11, 12 |
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cataract, 170–4 |
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cataracts, 94 |
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complications, 172–4 |
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conjunctivitis, 51, 59 |
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drops, 192 |
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lost contact lenses, 37, 141 |
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extracapsular lens extraction, |
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Smoking, 65, 73 |
172 |
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Snellen chart, 2 |
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following, 101–2, 184–5 |
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Sno Phenicol (antibiotic drops), 186 |
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phacoemulsification, 170, 171, |
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Sodium cromoglicate, 188 |
172 |
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SOL (space-occupying lesion), 104–5 |
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sutures, 173 |
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Spectacles |
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laser (excimer) refractive, 175–8 |
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incorrect/absent, 65, 71–2 |
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drops, 193 |
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old, 65, 102–3 |
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laser-assisted in situ |
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reading glasses, 4, 72, 175 |
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keratomileusis (LASIK), 175–6 |
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visual acuity tests (VA), 2 |
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photo refractive keratectomy |
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reading chart, 4 |
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(PRK), 175, 176–8 |
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Squamous cell carcinoma, 161, 162 |
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laser treatment, 184–5 |
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Squash balls, injuries caused by, 115 |
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cataract surgery, following, |
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Squint surgery, 179 |
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184–5 |
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basic steps, 178–9 |
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diabetics, 184 |
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complications, 180 |
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glaucoma, 184 |
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drops, 193 |
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laser (excimer) refractive, 175–8, |
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management, 180 |
193 |
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Stemetil (antiemetic), glaucoma |
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oculoplastic/trauma, 174–5 |
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treatment, 41 |
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previous, red eye, 17, 18, 19 |
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Steristrips, entropion, 34, 151 |
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retinal detachment, 183 |
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Steroid drops, 194–5 |
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basic steps, 182 |
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allergies, 50 |
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complications, 182 |
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episcleritis, 43 |
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drops, 193 |
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uveitis, 35 |
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management, 182–4 |
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Steroids, oral, temporal arteritis |
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squint, 179 |
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treatment, 75 |
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basic steps, 178–9 |
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STFB (subtarsal foreign body) see |
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complications, 180 |
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Subtarsal foreign body (STFB) |
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drops, 193 |
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Styes, 65, 146, 147, 154, 156–7 |
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management, 180 |
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Subarachnoid hemorrhage, occipital |
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trabeculectomy (glaucoma), 181 |
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pain, 69 |
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basic steps, 180 |
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Subconjunctival hemorrhage |
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complications, 181 |
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blunt injuries, 118 |
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drops, 192 |
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features, 57 |
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management, 182 |
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management, 57, 123 |
|
Surgery complications |
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pitfall, 57–8 |
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|
see also Surgery |
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red eye, 14, 16, 17, 55 |
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cataracts |
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referral/follow up, 57, 123 |
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immediate (0-2) days, 172 |
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sharp/penetrating injuries, 128 |
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early (2-7 days), 172–3 |
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Submacular hemorrhage, macular |
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late (7 days+), 173 |
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degeneration, 98 |
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management, 173–4 |
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Subnormal vision |
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laser-assisted in situ keratomileusis |
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|
see also Diplopia (double vision); |
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(LASIK), 176 |
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Vision |
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oculoplastic/trauma, 174 |
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basic examination, 4, 5 |
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photo refractive keractomy (PRK), |
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red eye, 20 |
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177–8 |
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Subtarsal foreign body (STFB), 31, |
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squint surgery, 180 |
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32 |
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trabeculectomy (glaucoma), 181 |
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corneal abrasions, 21 |
|
Sutures, cataract surgery, 173 |
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210 Index
Tears
artificial, 190, 193, 196 ectropion, effect on, 134
normal production/drainage, 135 Tears Naturelle, 190, 196
Temporal arteritis, 64, 67, 74–5, 78 TENS (transcutaneous nerve
stimulation), 70, 149 Tetracaine hydrochloride see
Amethocaine (local anesthetic) Tetracyline ointment, conjunctivitis, 51 Thermal burns, laser treatment, 184 Thrown objects, 127, 129
Thyroid eye disease
see also Dysthyroid eye disease diplopia (double vision), 109, 111 red eye, 45, 59, 62
Timoptol/timolol (beta blocker), 195 allergies, 50
glaucoma, 189 shingles, 44
Tonopen, 81
Trabeculectomy (glaucoma surgery),
181
basic steps, 180 complications, 181 drops, 192 management, 182
Transcutaneous nerve stimulation (TENS), 70, 149
Trauma, 112–31
blunt injuries, 114–20 chemicalinjury, 13, 45, 112–14 chiselling injuries, 129–31 double vision, 123
fracture, ’blow-out’, 116, 121, 123 gardening injuries, 127, 129 glass injuries, 125, 127, 129 globe rupture, 17, 114, 118, 120 hammering injuries, 129–31 hyphema, 123–4
lid lacerations, 124–5 orbital bruising, 123 orbital hematoma
no view of eye, 121 with view of eye, 122
penetrating/sharp injuries, 18, 120, 125, 126, 127–9
red eye, 17, 19, 55 subconjuctival hemorrhage, 123 surgery, 174–5
thrown objects, 127, 129 Traumatic mydriasis, 122
Trichiasis (ingrowing lashes), 14, 15, 33–4
eyelid infections, 151–2 Tropicamide, 105, 107, 190
Tumors
basal cell carcinoma, 160, 161 benign lesions, 153–60
chalazion, 153–8, 154 Cyst of Moll, 159, 160
incision and curettage, 155–7, 158 keratosis (solar/seborrheic),
159–60
papilloma/skin tags, 157, 158, 159 styes, 154, 156–7
chalazion, 153–8, 154
incision and curettage, 155–7, 158 conjunctival lesions/cysts, 162, 163,
164, 165
Cyst of Moll, 159, 160
diffuse cell basal cell carcinoma, 161 eye surface, 162–5
conjunctival lesions/cysts, 162,
163, 164, 165
red, painful and irritable lesions, 165
eyelids
benign lesions, 153–60 malignant lesions, 160–2
internal ocular iris, 165–6
retina/choroid, 166–7 iris, 165–6
keratosis (solar/seborrheic), 159–60 lacrimal sac lesions, 168–9 malignant lesions, 153, 160–2,
163
basal cell carcinoma, 160, 161 melanoma, 162, 163, 166–7 sebaceous cell carcinoma, 153,
162
squamous cell carcinoma, 161,
162
malignant melanoma, 162, 163, 166–7
management/referral, 163, 164 non-inflamed/non-tender mass, 169 non-pigmented lesions
eye surface, 164 iris, 166
papilloma/skin tags, 157, 158, 159 periorbital/orbital, 167–9 pigmented lesions
eye surface, 162–3 iris, 165–6
proptosis, 167–8 pterygium, 164 retina/choroid, 166–7 retinoblastoma, 8, 167
sebaceous cell carcinoma, 153, 162 secondary metastases, 167 squamous cell carcinoma, 161, 162
Index 211
Upper respiratory tract infections, 147 keratoconjunctivitis, 45, 52
Uveitis acute, 23
anterior chamber, 14, 16, 22 examination, 22, 23 features, 35
painful eye, 66
and photophobia, 18, 21 pitfalls, 35
previous, 19
red eye, 14, 16, 18, 19, 21, 22, 23, 35 referral/follow up, 35
Valsalva maneuver, 55, 84 Vexol (rimexolone), 188 Viral infections, 45, 65 Viscotears (lubricant), 190
dry eye, 63, 135 keratoconjunctivitis, 52
Vision
acute partial loss, 80–91 branch retinal vein occlusion
(BRVO), 81, 82, 83
central retinal vein occlusion (CRVO), 81, 82, 83
macular hemorrhage, 83–4 migraine see Migraine myopic correction, 87 optic neuritis (ON), 88–90 retinal detachment, 86–8
vitreous hemorrhage, 84, 85, 86 acute total loss, 73–9
central retinal artery occlusion, 76–8
functional loss, 79–80 occipital infarct, 78–9 optic nerve infarction, 74–5 temporal arteritis, 75
blurred, glaucoma surgery, 182 central visual loss, 104–5 chronic loss, 91–104
amblyopia, toxic or nutritional, 103–4
cataracts see Cataracts diabetic
retinopathy/maculopathy, 81, 92, 100–1, 103
glaucoma, 95–8 hydrops, 92 keratonconus, 92
macular degeneration, agerelated, 98–100
spectacles, old, 65, 102–3 distorted, 91 documentation, 3–5
double see Diplopia (double vision) functional loss, 79–80 loss/reduction, 73–106
acute partial loss, 80–91 acute total loss, 73–9 central visual loss, 104–5 chronic loss, 91–104 eyelid infection, 149 functional loss, 79–80 profound loss, 84 transient loss, 105–6
normal, 3 profound loss, 84
subnormal see Subnormal vision transient loss, 105–6
Visual acuity (VA), 2–5 blunt injuries, 118 chart, 3
reading, 4 functional loss, 79 painful eye, 65 pinhole, 2, 5
red eye, 20, 46, 55, 59 sharp/penetrating injuries, 128
Visual fields examination, 10–12, 47 loss patterns, 10
hypertension related, 74 Visual symptoms, 73–111
see also Diplopia (double vision); Vision
astigmatism, 175
’cobwebs’ (floaters, flashes), 106 flashes, 106
floaters, 81, 106–7
hypermetropia (long sightedness), 175
loss/reduction in vision, 73–106 myopia, 175
Vitreous hemorrhage associations, 84 examination/management, 86 features, 84
flashes, floaters or cobwebs, 107 fundus, 8
partial vision loss, 84, 85, 86 pitfalls, 86
red reflex, 8 referral/follow up, 86 visual field loss patterns, 10
Voltarol (anti-inflammatory drops), episcleritis, 43, 58
Watering eye, 132–8
see also Painful eye; Red eye acute, 132
212 |
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Index |
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Watering eye contd |
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Xalatan (latanoprost) |
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adult management/referral, 132, |
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allergies, 50 |
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133–7 |
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glaucoma, 189, 195 |
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allergy, 144 |
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shingles, 44 |
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child management/referral, 132, 138 |
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Xylometazoline hydrochloride (allergy |
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chronic, 132–3 |
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drops), 50, 145, 188 |
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common causes, 133 |
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ectropion, 132, 133, 134 |
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examination, 133 |
|
YAG laser, 94, 101, 184 |
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main causes, 132 |
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management/referral, 133–5 |
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Welding, injury from, 18, 45, 48–9 |
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Zoton (lansoprazole), 54, 75 |
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White pupil reflex, 8 |
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Zovirax ointment, 187, 194 |
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Wound dehiscence, 174 |
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illustrated, 188 |
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keratoconjunctivitis, 52 |
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shingles, 44, 149 |
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X-rays |
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ulcers, contact-lens-related, 40 |
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hammering injuries, 131 |
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sharp and penetrating injuries, 128 |
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