TREATMENTModerate and severe contusions should be referred to an ophthalmologist. Any injury causing hyphema involves the danger of secondary hemorrhage that may result in irreversible glaucoma. Patients with hyphema should be placed on bed rest for 6 to 7 days with both eyes bandaged.
Lacerations involving the lid margins should be referred to an ophthalmologist. Lacerations involving the conjunctival need not be sutured. Instill antibiotics to prevent infection. Corneal or scleral lacerations should be lightly bandaged and covered with a metal shield. Instruct the patient to avoid squeezing his or her eyes together and to remain quiet. Pressure exerted may result in extrusion of the intraocular contents. In all lacerations involving the eye, transfer the patient to an ophthalmologist.
This is an inflammation of the thin mucous membrane lining the inner portions of the eyelids and anterior surface of the eyeballs. The inflammation may be acute or chronic and can be due to chemical irritation, allergy, bacterial or viral infection, and fungal or parasitic infection.
Bacterial ConjunctivitisIt produces a purulent discharge, photophobia, and reddening of the eyelids and conjunctival. The eyelids may burn, itch, or hurt, and often there is marked edema. The discharge repeatedly turns mucopurulent and may seal the eyelids at night. The condition usually lasts about 10 days.
TREATMENTThere is no specific treatment, but sulfonamide therapy helps to prevent secondary infection.
Viral ConjunctivitisBlennorrhea is also called inclusion conjunctivitis. It is a venereal infection resulting from nongonorrheal cervicitis and urethritis that can be spread to the eyes during and after intercourse. In the past this form was also spread during swimming and was known as swimming pool conjunctivitis. Adequate chlorination of swimming pools has eliminated this mode of transportation.
SYMPTOMSThere is usually a copious watery discharge with scanty exudate, occasional fever, and malaise as well as lacrimation, photophobia, sensations of sand or grit in the eye, and burning in the eyelid margins.
TREATMENTIsolation techniques, such as separate towels, are advisable. Treat with sulfonamides or tetracycline systemically for 3 weeks. Instill tetracycline drops in oil to supplement the systemic tetracycline.
Allergic ConjunctivitisThis is commonly and most frequently associated with hay fever.
SYMPTOMSThere is usually tearing, itching, redness, and a thin stringy discharge.
TREATMENTCorticosteroid therapy is usually effective.
A sty is a common abscess formation at the eyelid margin due to staphylococcus.
SYMPTOMSThere is usually pain, redness, swelling, and an area of tenderness on the upper or lower eyelid. The intensity of the pain is related to the amount of swelling. The abscess tends to localize within a few days. The patient sometimes complains of photophobia, lacrimation, and a feeling of fullness or foreign body sensation.
TREATMENTApply warm compresses. When the abscess focuses to a point, it will normally rupture spontaneously. An I&D may be performed if necessary. Irrigate the eye with warm saline and apply local antibiotics or sulfonamides.
This a a superficial corneal ulcer caused by the herpes simplex virus. It is almost always unilateral and may affect any age group. It is characterized by superficial branching gray lesions of the cornea, resembling the veins in a leaf.
TREATMENTTransfer the patient to an ophthalmologist as soon as possible for removal of the ulcers.
This is an acute inflammation of the iris. When the ciliary body is involved, as it usually is, the condition is known as iridocyclitis.