Eye Complaints
Summary: <br> Common Complaints<br> <br> <br> <br> * Red Eye* Decreased Vision* Trauma to the Eye<br> <br> <br> <br> Approach to a Vision Complaint<br> <br> <br> <br> * Step 1: Assess visual acuity* Visual acuity is the “vital sign of the eye”* Snellen eye chart is best* If patient unable to see chart…* Count fingers?* Able to see light?* Step 2: Examine the conjunctiva/cornea with fluorescein* How to apply fluorescein* Recline patient 45 degrees* Pull down on lower eyelid to create pocket* Place anesthetic eye drops in pocket (ex. tetracaine) * Wet the fluorescein strip with eye drops and apply to pocket* Have the patient blink to distribute the dye* Look under woods lamp for bright “uptake” areas that don’t move with blinking* These represent abrasions, ulcers, etc* This step is also a good opportunity to evert the eyelids and examine for foreign bodies if appropriate* Step 3: Examine the anterior chamber with slit lamp * “Cell and flare” (example <a href="https://timroot.com/cell-and-flare-in-the-eye-video/">HERE</a>)* Representative of iritis, uveitis* This is also a good opportunity to examine any other abnormal areas of the eye under magnification!!! * Step 4: Check intraocular pressure* Pressure >20mmHg (especially when unequal) is concerning for acute angle closure glaucoma* Multiple tools to measure pressure on market, ask somebody to show you how to use* Step 5: If appropriate, use ultrasound to evaluate posterior eye* Multiple things can be diagnosed with ultrasound of the eye* Retinal detachment* Optic neuritis* Papilledema* Foreign bodies<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Introduction to Slit Lamp <a href="https://www.youtube.com/watch?v=w9wMJ6job_0&t=62s">(YouTube)</a>* Cell and Flair <a href="https://timroot.com/cell-and-flare-in-the-eye-video/">(TimRoot.com)</a><br>
