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

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

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

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