Orbital and Preseptal Cellulitis

Nomenclature: The orbital septum defines the boundary between the orbital cavity and the skin covering the eye and orbit. Orbital cellulitis = post-septal cellulitis.  The preferred term is "orbital cellulitis." Preseptal cellulitis = peri-orbital cellulitis.  The preferred term is "preseptal cellulitis." Orbital cellulitis is a much more serious infection due to the limited space of… Continue reading Orbital and Preseptal Cellulitis

Eye Manifestations of Systemic Disease – Czarnecki

Lecture notes from presentation by Dr Scott Czarnecki, 04 January 2017: WHAT IS URGENT? Acute vision loss (<24h) Painful vision loss (<24h) Globe penetration (now) Flashes and floaters (<24h) Semi-urgent:  HSV conjunctivitis, zoster ophthalmicus (24-48h) Ptosis and blown pupil (now) Random ophtho pearls: For bacterial conjunctivitis, use Ocuflox or Polytrim.  Don't use tobra or gentamicin… Continue reading Eye Manifestations of Systemic Disease – Czarnecki

Things Specialists Wish Family Docs Would Stop (or Start) Doing

Compiled by Dr Alicia Adams during her PGY-2 rotations: Opthalmology If the eye doesn't hurt and there is no photophobia, the zoster/HSV is not affecting their eye Cardiology there should be no such thing as an outpatient troponin -- if you are worried enough to check it, they stay in office until you have the… Continue reading Things Specialists Wish Family Docs Would Stop (or Start) Doing

Acute Red Eye Physical Diagnosis

Best approaches to physical diagnosis of acute red eyeClinical Question:What signs or symptoms are indicative of serious eye disease in patients with red eye or a bacterial cause in patients with presumed conjunctivitis?Bottom Line:Eliciting photophobia via pupillary constriction and the presence of anisocoria (>1 mm) in patients with an acute red eye are the best predictors of serious eye disease… Continue reading Acute Red Eye Physical Diagnosis

Fluoroquinolones Slightly Increase Risk of Retinal Detachment

Studies conflict about FQ and retinal detachment risk. French study of n = 28,000 patients undergoing retinal detachment surgery over 3 years. Case-crossover design:  FQ use in 10 d prior to surgery vs control period (61-180 d prior to surgery). AOR 1.5 for retinal detachment in those who recently used FQ only individual FQ associated… Continue reading Fluoroquinolones Slightly Increase Risk of Retinal Detachment

Vision Loss in Older Adults

Cataracts Central loss, haziness, glare intol Surgery Macular degeneration Central; (+) Amsler grid Ocuvite, pts w smoking hx -> vit w beta-carotine Diabetic eye disease Fluctuating vision, flashers, floaters aflibercept, bevacizumab, ranibizumab, intravitreal steroids Glaucoma no sxs -> periph loss -> central loss various gtt to decrease IOP Aug 1, 2016 AFP