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Ophthalmic Emergency Manual
Muawyah D Al Bdour, Mohammed A Abu Ameerh
CHAPTER 1:
Eyelids/Lacrimal System
EYELID LACERATION
Symptoms
Clinical Evaluation
Imaging Studies
Treatment
Surgical Care
CANALICULAR LACERATION
Diagnosis
Indications for Repair
Urgency of Repair
Pattern of Canalicular Disease (Table 1.1)
Anesthesia
PRESEPTAL CELLULITIS
Symptoms
Signs
Etiology
Differential Diagnosis (Table 1.2)
Workup
Treatment
Follow-up
CONTACT DERMATITIS
Symptoms
Signs
Treatment
PERIORBITAL BURNS
ACUTE INFECTIOUS DACRYOADENITIS
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
Follow-up
DACRYOCYSTITIS
Frequency
Mortality/Morbidity
Race
Sex
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
Follow-up
CHAPTER 2:
Cornea/Conjunctiva
CHEMICAL BURNS
Acids Injury
Alkali Injury
Emergency Treatment
A. Mild-to-Moderate Burns
Signs
Workup
Treatment During and After Irrigation
Follow-up
B. Severe Burns
Signs
Workup
Follow-up
C. Eye Exposure to Super Glue
Treatment
THERMAL KERATOPATHY
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
Follow-up
INFECTIOUS CORNEAL ULCERS
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Culture Procedure Equipment
Procedure
Media
Routine
Optional
Slides
Routine
Optional
Treatment of Bacterial Ulcers
Follow-up
CORNEAL GRAFT REJECTION
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
Follow-up
CORNEAL ABRASIONS
Clinical Examination
Treatment
CORNEAL FOREIGN BODIES
Symptoms
Signs
Treatment
Procedures
Medical Care
Follow-up
BACTERIAL CONJUNCTIVITIS
Symptoms and Signs
Workup
Treatment
Follow-up
SUBCONJUNCTIVAL HEMORRHAGE
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
Follow-up
NEONATAL CONJUNCTIVITIS (OPHTHALMIA NEONATORUM)
Symptoms
Signs
Etiology
Chlamydial Conjunctivitis
Treatment
Gonococcal Conjunctivitis
Treatment
Chemical Conjunctivitis
Differential Diagnosis
Prevention
Workup
Prognosis
Complications
CONJUNCTIVAL LACERATIONS
Symptoms
Signs
Workup
Treatment
Follow-up
CHAPTER 3:
Orbit
ORBITAL CELLULITIS
Symptoms
Signs
Etiology
Workup
Treatment
Follow-up
ORBITAL FLOOR FRACTURES
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
ORBITAL HEMORRHAGE
Signs and Symptoms
Pathophysiology of Visual Loss
Differential Diagnosis
Workup
Management
Follow-up
CAVERNOUS SINUS THROMBOSIS (CST)
Symptoms
Signs
Investigations
Treatment
CHAPTER 4:
Glaucoma
PRIMARY ACUTE ANGLE-CLOSURE GLAUCOMA (PAACG)
Symptoms
Signs
Treatment
Definitive Treatment
PHACOMORPHIC GLAUCOMA
Signs
Treatment
MALIGNANT GLAUCOMA (AQUEOUS MISDIRECTION SYNDROME)
Definition
Symptoms
Signs
Differential Diagnosis
Treatment
FLAT/SHALLOW ANTERIOR CHAMBER AFTER FILTRATION SURGERY
Workup
Etiology for Postoperative Flat Anterior Chamber
Wound Leak (Bleb vs Flap Leaks)
Excessive Filtration (Trabeculectomy)
Choroidal Detachment
Pupil Block due to Non-patent PI
Malignant Glaucoma
Mature Lens
CHAPTER 5:
Retina/Choroid
CENTRAL RETINAL ARTERY OCCLUSION (CRAO)
Mortality/Morbidity
Age
Symptoms
Signs
Etiology
Differential Diagnosis
Treatment
Workup
Follow-up
BRANCH RETINAL ARTERY OCCLUSION (BRAO)
Mortality/Morbidity
Symptoms
Signs
Etiology
Workup
Treatment
Follow-up
CENTRAL RETINAL VEIN OCCLUSION (CRVO)
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Ocular
Comment
Systemic
Treatment
BRANCH RETINAL VEIN OCCLUSION (BRVO)
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
Follow-up
POSTERIOR VITREOUS DETACHMENT (PVD)
Symptoms
Signs
Differential Diagnosis
Treatment
Follow-up
RETINAL DETACHMENT (RD)
A. Rhegmatogenous RD (RRD)
Symptoms
Signs
B. Exudative RD (ERD)
Symptoms
Signs
Etiology
C. Tractional RD (TRD)
Symptoms
Signs
Etiology
Differential Diagnosis of RD
Treatment/Follow-up
VITREOUS HEMORRHAGE (VH)
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
CENTRAL SEROUS CHORIORETINOPATHY (CSCR)
Natural Course
Gender
Symptoms
Signs
Risk Factors
Differential Diagnosis
Investigations
Treatment
Prognosis
COMMOTIO RETINAE (BERLIN'S EDEMA)
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
Follow-up
TRAUMATIC CHOROIDAL RUPTURE
Symptoms
Signs
Differential Diagnosis
Follow-up
CHAPTER 6:
Uveitis/Endophthalmitis
POSTOPERATIVE UVEITIS
Workup
POSTOPERATIVE INFECTIOUS ENDOPHTHALMITIS
Acute Endophthalmitis
Symptoms
Signs
Organisms
Differential Diagnosis
Workup
Treatment
Follow-up
Delayed-Onset Endophthalmitis
Symptoms
Signs
Etiology/Organisms
Workup
Treatment
ENDOGENOUS ENDOPHTHALMITIS
Symptoms
Etiology
Differential Diagnosis
Investigations
Treatment
TRAUMATIC ENDOPHTHALMITIS
Symptoms and Signs
Organisms
Differential Diagnosis
Workup
Treatment
SYMPATHETIC OPHTHALMIA (SO)
Symptoms
Signs
Differential Diagnosis
Treatment
Follow-up
PHACOANAPHYLACTIC ENDOPHTHALMITIS
Definition
Symptoms
Signs
Workup
Treatment
Follow-up
TRAUMATIC IRITIS
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
CHAPTER 7:
Neuro-ophthalmology
PAPILLEDEMA
Symptoms
Signs
Causes of Increased ICP
Differential Diagnosis
Workup
Treatment
OPTIC NEURITIS (ON)
Optic Neuritis in Children
Etiology of ON
Gender
Age
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
Follow-up
ARTERITIC ISCHEMIC OPTIC NEUROPATHY (AION) [GIANT CELL ARTERITIS (GCA)]
Symptoms
Signs
Differential Diagnosis
Workup
Treatment
Follow-up
NONARTERITIC ISCHEMIC OPTIC NEUROPATHY (NAION)
Symptoms
Signs
Etiology
Differential Diagnosis
Workup
Treatment
DIPLOPIA
Clinical
Physical Examination
Workup
Treatment
Surgical Care
Consultations
TRAUMATIC OPTIC NEUROPATHY
Symptoms
Signs
Etiology
Workup
Treatment
Follow-up
OCULOMOTOR NERVE PALSY
Symptoms/Signs
Etiology
Workup
Differential Diagnosis
Medical Care
Follow-up
TROCHLEAR NERVE PALSY
Etiology
Pathophysiology
Congenital
Acquired
Clinical
Indications for Treatment
Treatment
Medical Therapy
Surgical Therapy
ABDUCENS NERVE PALSY
History
Physical
Causes
Laboratory Studies
Imaging Studies
Medical Care
CORTICAL BLINDNESS
Symptoms
Signs
Etiology
Workup
Treatment
NONPHYSIOLOGIC VISUAL LOSS
Symptoms
Signs
Differential Diagnosis
Workup
This is a Diagnosis of Exclusion
Patients Claiming no Light Perception
Patients Claiming Hand-Motion to no Light Perception
Patients Claiming 6/12 to 6/120 Vision
Children
Treatment
Follow-up
AMAUROSIS FUGAX
Symptoms and Signs
Pathophysiology
Work-up
Treatment
Follow-up
Clinical Pearls
CHAPTER 8:
General Ophthalmic Problems
BLIND AND PAINFUL EYE
Possible Causes of Eye Pain
Workup
Treatment
Follow-up
THE EYE IN COMA PATIENTS
Neuro-ophthalmological Examination
Ophthalmoscopy
Pupils
Evaluation of Ocular Motility
Nystagmus in Coma
Care for the Cornea
EYE IN PREGNANCY
Physiologic Ocular Changes Occurring During Pregnancy
Changes in Refractive Error
Cornea
Intraocular Pressure
Visual Field Changes
External Changes
Pathologic Ocular Changes During Pregnancy
Pregnancy-Induced Hypertension (Preeclampsia)
Central Serous Retinopathy
Retinal Detachment
Benign Intracranial Hypertension
Occlusive Vascular Disorders
Miscellaneous Disorders
Ptosis
Endogenous Candidal Endophthalmitis
Migraine
Effect of Pregnancy on Pre-existing Ocular Disorders
Diabetic Retinopathy
Purtscher's Retinopathy
Intracerebral and Other Tumors
Pituitary Adenomas
Meningiomas
Uveal Melanoma
Uveitis and Inflammatory Conditions
Vogt-Koyanagi-Harada Syndrome
Sarcoidosis, Ankylosing Spondylitis, and Juvenile Rheumatoid Arthritis
Toxoplasmosis
Miscellaneous Conditions
Graves Disease
Retinitis Pigmentosa
Multiple Sclerosis
High Myopia
Ophthalmic Medications in Pregnancy
Glaucoma Medications
Mydriatics
Corticosteroids
Antibiotics
Antivirals
Fluorescein
Topical Anesthetic
Summary
BELL'S PALSY
HYPHEMA
Signs
Workup
Management
For Nonhospitalized Patients
Follow-up
Nontraumatic (Spontaneous) and Postsurgical Hyphema
Symptoms
Etiology (of Spontaneous Hyphema or Microhyphema)
Workup
Treatment
RUPTURED GLOBE
Signs
Workup/Treatment
INTRAOCULAR FOREIGN BODIES (IOFBs)
Symptoms
Signs
Types of Foreign Bodies
Workup
Treatment
When IOFB is Anterior to the Iris Plane
Posterior Intraocular Foreign Body
External Approach
Internal Approach
INTRAORBITAL FOREIGN BODIES
Symptoms
Signs
Types of Foreign Bodies
Workup
Indications for Surgical Exploration and Attempted Extraction of Foreign Body
Treatment
Follow-up
THE BLIND CHILD
Workup
Treatment
THE RED EYE
Pathophysiology
Clinical Evaluation
History
Physical Examination
Causes
Workup
Laboratory Studies
Medical Care
Treatment
Appendices
MYDRIATIC AND CYCLOPLEGIC DROPS
PREPARING FORTIFIED TOPICAL ANTIBIOTICS
Fortified Tobramycin (or Gentamicin)
Fortified Cefazolin
Fortified Vancomycin
Fortified Bacitracin
Fortified Ceftazidime
DRUG GLOSSARY
Acetazolamide (Diamox)
Acyclovir (Zovirax)
Amikacin (Amikin)
Amoxicillin and Clavulanate (Augmentin)
Amphotericin B
Cefazolin (Ancef)
Cefotaxime (Claforan)
Ceftazidime (Ceptaz, Fortaz, Tazicef, Tazidime)
Chloral Hydrate
Ciprofloxacin (Cipro, Ciloxan)
Mannitol (Resectisol, Osmitrol)
Vancomycin (Vancocin, Vancoled, Lyphocin)
OCULAR DIAGNOSTIC TESTS
Tensilon Test
Fluorescein
Topical
Intravenous
Rose Bengal
Schirmer Test
Tear Break-Up Time
Dye Disappearance Test
Testing Corneal Sensation
Use
Technique
Forced Duction Test
Principle
Technique
Uses of the Forced Duction Test
SYSTEMIC DRUG-INDUCED OCULAR SIDE EFFECTS
OPHTHALMIC ABBREVIATIONS
SUTURE MATERIALS
Absorbable
Nonabsorbable
Silk
LOCAL INFILTRATION ANESTHESIA
Periocular/Peribulbar Administration
Intracameral Administration
ESTIMATING VISUAL LOSS
EYE DROPS, OCULAR SIDE EFFECTS AND CONTRAINDICATIONS
OCULAR MANIFESTATIONS OF SYSTEMIC DISEASES
Diseases of the Skin and Mucous Membranes
Collagen Diseases
Systemic Viral Infections
Systemic Bacterial Infections
Systemic Chlamydial and Protozoal Infections
Systemic Fungal Infections
Systemic Cestode and Nematode Infections
Chromosomal Disorders
Hematologic Diseases
Cardiovascular Diseases
Endocrine Diseases
Gastrointestinal and Nutritional Disorders
Metabolic Diseases
Musculoskeletal Diseases
Pulmonary Diseases
Renal Diseases
Neoplastic Diseases with Ocular Metastases
INDEX
TOC
Index
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