TREATMENTModerate and severe con-
tusions 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 treat-
ment, but sulfonamide therapy helps to prevent
. 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
are advisable. Treat with
sulfonamides or tetracycline systemically for
3 weeks. Instill tetracycline drops in oil to
supplement the systemic tetracycline.
l 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
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.