Ординатура / Офтальмология / Учебные материалы / Manual of Eye Emergencies Diagnosis and Management Webb Kanski 2004

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

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

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

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

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

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

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)

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

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