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Grand Rounds 118-
February 2009 |
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©Richard
Hom
This is probably a more common situation here.
CC: Red OD
HPI A 60 year old woman presented 1 week ago from the
Emergency Department and noted a 5-day h/o red, irritated (but not
acutely painful) right eye. She is not photophobic nor does she
report mucopurulent discharge. There is no decrease in vision. She
was started on ciprofloxacin oph soln, 0.3%, QID and flurbiprofen,
0.03% QID, this eye. There is no itching or photophobia reported.
This is her first episode.
PMH - Unremarkable and non-contributory. The patient had a
physical examination to work in a public environment and does not
smoke, has a negative TB skin test and has no chronic medical
problems. No recent h/o trauma.
PHYSICAL : Current vision is OD 20/20 and OS 20/25+. PERRLA
Dia 2mm and reactivity of 3/4 in both. UL and LL' everted, without
any papillary hypertrophy noted. Corneal sensation seems normal and
there are no fluorescein retention in either cornea. Adequate TBUT.
Neither is the anterior chamber in either eye inflamed. Clean lid
margins.
Questions: Is it...
(1) Conjunctivitis, NOS
(2) Dry Eye Syndrome or Keratoconjunctivitis Sicca
(3) Episcleritis/Scleritis
(4) Other?
©Richard
Hom
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