Red eye resident survival guide (pediatrics): Difference between revisions

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*'''Carotid–cavernous sinus fistula'''
*'''Carotid–cavernous sinus fistula'''


===Common Causes<ref name="pmid285301802">Frings A, Geerling G, Schargus M (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28530180 Red Eye: A Guide for Non-specialists.] ''Dtsch Arztebl Int'' 114 (17):302-312. [http://dx.doi.org/10.3238/arztebl.2017.0302 DOI:10.3238/arztebl.2017.0302] PMID: [https://pubmed.gov/: 28530180 : 28530180]</ref><ref name="pmid27304768">Pflipsen M, Massaquoi M, Wolf S (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=27304768 Evaluation of the Painful Eye.] ''Am Fam Physician'' 93 (12):991-8. PMID: [https://pubmed.gov/PMID: 27304768 PMID: 27304768]</ref><ref name="pmid24852155">Wong MM, Anninger W (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24852155 The pediatric red eye.] ''Pediatr Clin North Am'' 61 (3):591-606. [http://dx.doi.org/10.1016/j.pcl.2014.03.011 DOI:10.1016/j.pcl.2014.03.011] PMID: [https://pubmed.gov/PMID: 24852155 PMID: 24852155]</ref><ref name="pmid16564769">Wirbelauer C (2006) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16564769 Management of the red eye for the primary care physician.] ''Am J Med'' 119 (4):302-6. [http://dx.doi.org/10.1016/j.amjmed.2005.07.065 DOI:10.1016/j.amjmed.2005.07.065] PMID: [https://pubmed.gov/PMID: 16564769 PMID: 16564769]</ref>===
===Common Causes<ref name="pmid285301802">Frings A, Geerling G, Schargus M (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28530180 Red Eye: A Guide for Non-specialists.] ''Dtsch Arztebl Int'' 114 (17):302-312. [http://dx.doi.org/10.3238/arztebl.2017.0302 DOI:10.3238/arztebl.2017.0302] PMID: [https://pubmed.gov/: 28530180 : 28530180]</ref><ref name="pmid27304768">Pflipsen M, Massaquoi M, Wolf S (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=27304768 Evaluation of the Painful Eye.] ''Am Fam Physician'' 93 (12):991-8. PMID: [https://pubmed.gov/PMID: 27304768 PMID: 27304768]</ref><ref name="pmid24852155">Wong MM, Anninger W (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24852155 The pediatric red eye.] ''Pediatr Clin North Am'' 61 (3):591-606. [http://dx.doi.org/10.1016/j.pcl.2014.03.011 DOI:10.1016/j.pcl.2014.03.011] PMID: [https://pubmed.gov/PMID: 24852155 PMID: 24852155]</ref><ref name="pmid16564769">Wirbelauer C (2006) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16564769 Management of the red eye for the primary care physician.] ''Am J Med'' 119 (4):302-6. [http://dx.doi.org/10.1016/j.amjmed.2005.07.065 DOI:10.1016/j.amjmed.2005.07.065] PMID: [https://pubmed.gov/PMID: 16564769 PMID: 16564769]</ref><ref name="IsmailAdel2020">{{cite journal|last1=Ismail|first1=M.|last2=Adel|first2=A.|title=Prediction of
α
-decay chains and cluster radioactivity of
121300–304
and
122302–306
isotopes using the double-folding potential|journal=Physical Review C|volume=101|issue=2|year=2020|issn=2469-9985|doi=10.1103/PhysRevC.101.024607}}</ref>===


==== infectious<ref name="Høvding2008">{{cite journal|last1=Høvding|first1=Gunnar|title=Acute bacterial conjunctivitis|journal=Acta Ophthalmologica|volume=86|issue=1|year=2008|pages=5–17|issn=1755375X|doi=10.1111/j.1600-0420.2007.01006.x}}</ref>====
==== infectious<ref name="Høvding2008">{{cite journal|last1=Høvding|first1=Gunnar|title=Acute bacterial conjunctivitis|journal=Acta Ophthalmologica|volume=86|issue=1|year=2008|pages=5–17|issn=1755375X|doi=10.1111/j.1600-0420.2007.01006.x}}</ref>====

Revision as of 14:51, 5 August 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Eman Alademi, M.D.[2]

Red eye resident survival guide (pediatrics) Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

Red eye is defined as a symptom of red eye as the major clinical finding. A detailed history, baseline ophthalmological tests, and accompanying manifestations can narrow down the differential diagnosis. The duration and laterality of symptoms (uni- vs. bilateral) and the intensity of pain are the main criteria allowing the differentiation of non-critical changes that can be cared for by a general practitioner from diseases calling for elective referral to an ophthalmologist and eye emergencies requiring urgent ophthalmic surgery.[1][2]

Red eye is one of the most common ophthalmologic conditions in the primary care setting. Inflammation of almost any part of the eye, including the lacrimal glands and eyelids, or faulty tear film can lead to red eye. Primary care physicians often effectively manage red eye, although knowing when to refer patients to an ophthalmologist is crucial.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.[3]

  • globe ruptures or perforations
  • intraocular infections
  • Carotid–cavernous sinus fistula

Common Causes[4][5][6][7][8]

infectious[9]

  • Bacterial conjunctivitis
  • Viral conjunctivitis
  • Iritis/iridocyclitis
  • Anterior uveitis
  • Posterior uveitis (choroiditis)
  • Endophthalmitis
  • Dacrocystitis

noninfectious

  • Acute angle-closure glaucoma
  • Disorders of the ocular adnexa(Hordeolum-Eyelid malposition)
  • Eyelid malposition
  • Intraocular disorders
  • Scleritis/Episcleritis
  • Photokeratitis
  • Corneal erosion/ulceration
  • Subconjunctival hemorrhage
  • Allergic conjunctivitis
  • Non-infectious (kerato-)conjunctivitis
  • Contact lens
  • blunt or penetrating trauma
  • foreign bodies
  • Chemical conjunctivitis
  • Blepharitis
  • Hordeola

FIRE: Focused Initial Rapid Evaluation

Complete Diagnostic Approach

localised, diffused and perikeratic injection. [10]

Shown below is an algorithm summarizing the diagnosis of [[red eye]] according the the [ Nelson Essentials of Pediatrics .] guidelines. [11]

Age Group Common Etiology
Neonates* < 24 hrs Chemical conjunctivitis
< 1 week Neisseria gonorrhea
1-2 wks Chlamydia trachomatis
Infants and Toddlers Without otitis Haemolphilus. influenzae, Streptococcus pneumoniae
With otitis H. influenzae
School Age Children 1-5 years Herpes simplex virusVaricella-zoster
School Age Children and Adolescents Viral conjunctivitisAllergic conjunctivtis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[Red eye ]] according the the [American family physician ] guidelines.

Good hygiene, such as meticulous hand washing, is important in decreasing the spread of acute viral conjunctivitis.[12][13]

Any ophthalmic antibiotic may be considered for the treatment of acute bacterial conjunctivitis because they have similar cure rates.[14] [15]

Mild allergic conjunctivitis may be treated with an over-the-counter antihistamine/vasoconstrictor agent, or with a more effective second-generation topical histamine H1 receptor antagonist.[16]

[17]Anti-inflammatory agents (e.g., topical cyclosporine [Restasis]), topical corticosteroids, and systemic omega-3 fatty acids are appropriate therapies for moderate dry eye.

Patients with chronic blepharitis who do not respond adequately to eyelid hygiene and topical antibiotics may benefit from an oral tetracycline or doxycycline.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.


References

  1. ↑ Frings A, Geerling G, Schargus M (2017) Red Eye: A Guide for Non-specialists. Dtsch Arztebl Int 114 (17):302-312. DOI:10.3238/arztebl.2017.0302 PMID: 28530180 : 28530180
  2. ↑ Cronau H, Kankanala RR, Mauger T (2010) Diagnosis and management of red eye in primary care. Am Fam Physician 81 (2):137-44. PMID: 20082509 PMID: 20082509
  3. ↑ Wirbelauer C (2006). "Management of the red eye for the primary care physician". Am J Med. 119 (4): 302–6. doi:10.1016/j.amjmed.2005.07.065. PMID 16564769 PMID: 16564769 Check |pmid= value (help).
  4. ↑ Frings A, Geerling G, Schargus M (2017) Red Eye: A Guide for Non-specialists. Dtsch Arztebl Int 114 (17):302-312. DOI:10.3238/arztebl.2017.0302 PMID: 28530180 : 28530180
  5. ↑ Pflipsen M, Massaquoi M, Wolf S (2016) Evaluation of the Painful Eye. Am Fam Physician 93 (12):991-8. PMID: 27304768 PMID: 27304768
  6. ↑ Wong MM, Anninger W (2014) The pediatric red eye. Pediatr Clin North Am 61 (3):591-606. DOI:10.1016/j.pcl.2014.03.011 PMID: 24852155 PMID: 24852155
  7. ↑ Wirbelauer C (2006) Management of the red eye for the primary care physician. Am J Med 119 (4):302-6. DOI:10.1016/j.amjmed.2005.07.065 PMID: 16564769 PMID: 16564769
  8. ↑ Ismail, M.; Adel, A. (2020). "Prediction of α -decay chains and cluster radioactivity of 121300–304 and 122302–306 isotopes using the double-folding potential". Physical Review C. 101 (2). doi:10.1103/PhysRevC.101.024607. ISSN 2469-9985. line feed character in |title= at position 15 (help)
  9. ↑ Høvding, Gunnar (2008). "Acute bacterial conjunctivitis". Acta Ophthalmologica. 86 (1): 5–17. doi:10.1111/j.1600-0420.2007.01006.x. ISSN 1755-375X.
  10. ↑ Sauer A, Speeg-Schatz C, Bourcier T (2008). "[Red eye in children]". Rev Prat. 58 (4): 353–7. PMID 18506971 PMID: 18506971 Check |pmid= value (help).
  11. ↑ Teoh DL, Reynolds S (2003) Diagnosis and management of pediatric conjunctivitis. Pediatr Emerg Care 19 (1):48-55. DOI:10.1097/00006565-200302000-00014 PMID: 12592117 PMID: 12592117
  12. ↑ Høvding G (2008). "Acute bacterial conjunctivitis". Acta Ophthalmol. 86 (1): 5–17. doi:10.1111/j.1600-0420.2007.01006.x. PMID 17970823 PMID: 17970823 Check |pmid= value (help).
  13. ↑ Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425 PMID: 10922425 Check |pmid= value (help).
  14. ↑ "Trimethoprim-polymyxin B sulphate ophthalmic ointment versus chloramphenicol ophthalmic ointment in the treatment of bacterial conjunctivitis--a review of four clinical studies. The Trimethoprim-Polymyxin B Sulphate Ophthalmic Ointment Study Group". J Antimicrob Chemother. 23 (2): 261–6. 1989. doi:10.1093/jac/23.2.261. PMID 2540136 PMID: 2540136 Check |pmid= value (help).
  15. ↑ Protzko E, Bowman L, Abelson M, Shapiro A, AzaSite Clinical Study Group (2007). "Phase 3 safety comparisons for 1.0% azithromycin in polymeric mucoadhesive eye drops versus 0.3% tobramycin eye drops for bacterial conjunctivitis". Invest Ophthalmol Vis Sci. 48 (8): 3425–9. doi:10.1167/iovs.06-1413. PMID 17652708 PMID: 17652708 Check |pmid= value (help).
  16. ↑ Varu DM, Rhee MK, Akpek EK, Amescua G, Farid M, Garcia-Ferrer FJ; et al. (2019). "Conjunctivitis Preferred Practice Pattern®". Ophthalmology. 126 (1): P94–P169. doi:10.1016/j.ophtha.2018.10.020. PMID 30366797 PMID: 30366797 Check |pmid= value (help).
  17. ↑ Akpek EK, Amescua G, Farid M, Garcia-Ferrer FJ, Lin A, Rhee MK; et al. (2019). "Dry Eye Syndrome Preferred Practice Pattern®". Ophthalmology. 126 (1): P286–P334. doi:10.1016/j.ophtha.2018.10.023. PMID 30366798 PMID: 30366798 Check |pmid= value (help).


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