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On Day of Presentation, OD
Case History:
This is a 72-year old male who presents as a "drop in" patient c/o of red eye right eye for the past 3 days. He reports no trauma, acute pain, photophobia or sudden loss of vision. He denies any recent history of coughing, sneezing or vigorous rubbing of this eye. This is his first visit with the me. His medical history appears to be unremarkable and apparently non-contributory.
My physical examination reveals that the entrance vision with current ophthalmic correction was OD 20/25 and OS 20/25. Both corneas were intact as were each crystalline lens and iris. A CTA was used determine the depth of the hemorrhage. It apparently was mobile with the CTA. The anterior chambers are formed and quiet without any cells, flare or blood cells. Gonioscopy shows a normal trabecular meshwork and there were no signs of rubeosis irides.
The IOPs by App were OD 17 and OS 18. Dilated fundus examination was unremarkable.
Questions:
1. What additional testing is needed?
2. What are the differential diagnoses?
3. How would you manage this patient
What Dr. Hom Says
"A dramatic example of the extent of the
subconjunctival hemorrhage aggravated by the looseness of the bulbar
conjunctiva rather than a significantly more severe episode.
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