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Eye Issues-Differential diagnosis
Chapter 70
32
Medical
Graduate
01/25/2017

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Term
Ocular burning; eyelid margins red with scalingerythema, ecchymosis, edema of affected area
Definition
Blepharitis
Term
Severe pain; nausea, vomiting; halos around lights; photophobia; cornea cloudy with variable decrease in vision; conjunctival hyperemia; pupil mid-dilated and fixed; firm globe; shallow anterior chamber
Definition
Angle-Closure Glaucoma
Term
Nontender in chronic lesions; localized erythema, edema of eyelids. Type of eyelid lesion.
Definition
Chalazion
Term
In this type of ocular cellulitis, Vision usually not affected; localized tenderness, erythema, edema; fever sometimes present
Definition
Preseptal
Term
This type of ocular cellulitis causes Chronic tearing; eyelash crusting; localized tenderness; circumscribed erythema, edema in the inferior medial canthal area; may be able to express purulent material from the nasolacrimal duct
Definition
Dacrocystitis
Term
Localized tenderness, erythema, edema of eyelids; internal lesions pointing to external or internal eyelid surface; external lesions pointing to eyelid margin
Definition
Hardeolum
Term
Localized tenderness sometimes present; erythema, ecchymosis, edema of affected area. Treatment includes cold compresses and possible CT scan if fracture is suspected.
Definition
Soft tissue Hemorrhage
Term
Pain; conjunctival hyperemia, chemosis; corneal haze, decreased visual acuity. Treatment includes immediate copious irrigation and emergent ophthalmologist referral.
Definition
Chemical Exposure
Term
Pruritus; conjunctival hyperemia, chemosis; watery or stringy discharge. Treatment includes cold compresses, avoidance of triggers, and topical and/or systemic medications
Definition
Allergic conjunctivitis
Term
Photophobia with blepharospasm; mucopurulent discharge with eyelash mattering; edema, hyperemia; preauricular adenopathy only with hyper acute disorder. Treatment includes topical antibiotics and in some cases systemic antibiotics
Definition
Bacterial conjunctivitis (Systemic antibiotics for gonococcal or chlamydial cause)
Term
Acute onset often associated with systemic illness; photophobia or foreign body sensation; preauricular adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal lesion present with herpes simplex; periocular lesions present with_____ ______ _____.
Definition
Viral conjunctivitis; Herpes Zoster opthalmicus
Term
Foreign body sensation with intense pain; photophobia; conjunctival hyperemia; may have decreased visual acuity; ulcers usually seen as white or opaque corneal lesion; immediate prior history of trauma common with abrasion but not erosion. Which type would require immediate referral?
Definition
Corneal foreign body, abrasion or ulcer; Corneal ulcer
Term
Sandy, gritty, foreign body sensation; burning; pruritus; conjunctival hyperemia; decreased visual acuity
Definition
Dry Eye
Term
Mild to severe pain; circumscribed erythema of affected sclera; vision unaffected. Usually self-limited. Refer to ophthalmologist
Definition
Episcleritis or scleritis
Term
Microscopic or visible blood layering in anterior chamber usually after blunt trauma; often associated with other ocular symptoms. Urgent referral to ophthalmologist.
Definition
Hyphema
Term
Pain; photophobia; conjunctival hyperemia; pupil constriction; may have epiphora but no mucopurulent discharge. Urgent opth referral
Definition
Iritis or uveitis
Term
Pain, photophobia; conjunctival hyperemia; corneal cloudiness with stromal involvement
Definition
Keratitis
Term
Ocular irritation or pain when inflamed; dry eye symptoms; fleshy lesion medial on conjunctiva; with pterygium, lesion extending onto cornea. Use ocular lubricants, topical NSAIDS
Definition
Pinguecula and pyerygium.
Term
No subjective symptoms; bright red spot of blood visible under overlying conjunctiva; remainder of conjunctiva white. Give reassurance as no treatment is necessary.
Definition
Subconjunctival Hemorrhage
Term
Are the following associated with sudden or gradual vision loss?:

• Acute angle-closure glaucoma • Central retinal vessel occlusion • Hyphema or other trauma • Endophthalmitis • Iritis or uveitis • Migraine • Optic neuritis • Retinal hemorrhage (macular area) • Stroke • Vitreous hemorrhage • Corneal ulcer • Giant cell arteritis (temporal arteritis)
Definition
Sudden
Term
• Cataracts • Corneal opacities • Primary open-angle glaucoma • Iritis or uveitis* • Macular degeneration* • Pituitary tumor* • Retinal detachment* • Vitreous opacities
Definition
Gradual
Term
a transient, unilateral episode of vision loss. This condition is typically caused by small embolic plaques that transiently occlude retinal circulation. An embolic workup is typically warranted.
Definition
Amaurosis
Term
Warped or distorted central vision
Definition
Metamorphosia
Term
Accounts for 48% of world blindness according to WHO
Definition
Cataracts
Term
Eye wall trauma includes damage to which structures?
Definition
The sclera and cornea.
Term
A closed globe injury is defined as:
Definition
non full-thickness wound of the eye wall.
Term
An eye contusion is defined as:
Definition
Non full-thickness wound of the eye wall.
Term
A lamellar laceration of the eye is defined as:
Definition
Partial-thickness wound of the eye wall
Term
A rupture injury of the eye is defined as:
Definition
Full-thickness wound of the eye wall caused by a blunt object.
Term
An eye laceration is defined as:
Definition
Full thickness wound of the eye wall caused by a sharp object.
Term
Penetrating injury of the eye is defined as:
Definition
Entrance wound. If more than one wound is present, each must have been caused by a different agent.
Term
A perforating injury of the eye is defined as:
Definition
Having entrance and exit wounds. Both wounds are caused by the same agent.
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