Ophthalmology
Aims For The Week
Perform a slit lamp examination
Implement a stepwise approach for corneal foreign body removal
Perform a comprehensive eye examination
Discuss the differential diagnoses of a patient presenting with a red eye
Describe the causes of painless loss of vision
Discuss the anatomy of the eye
Differentiate between orbital and periorbital cellulitis
Explain the use of opthalmological medications for common ED eye presentations
Describe the signs and management of orbital trauma
Discuss the management of chemical burns to the eye
The Basics
Presentations to the emergency department with eye complaints are not uncommon, but many junior doctors, depending on previous exposure, have limited experience in ophthalmology. To bring you up to speed, check out these resources outlining the basics of eye anatomy, innervation, and examination.
Check out this video and our own guide demonstrating the use of a slit lamp.
This guide describes several of the drugs you might use during your examination.
The Red Eye
The bulk of our opthalmological presentations consists of corneal abrasions, conjunctivitis and ocular foreign bodies, with chemical exposure to the eye a little less common. Do you feel confident removing foreign bodies? Also take a look at our summary of chemical exposure.
Also see our teaching on the red painful eye, and ocular trauma.
Sudden Visual Loss
Can you list the differential diagnoses for painless visual loss? Although relatively less common than the red eye, this is often in the FRCEM exam!
Emergency Procedures
There are few emergency procedures related to ophthalmology in the emergency department, but lateral cathotomy to relieve pressure from orbital compartment syndrome is one of them. If you think the procedure is needed first discuss with your consultant and contact ophthalmology immediately. Watch this useful video by EM:RAP (youtube sign in required for this one!), and have a look at our St Mungo's guide over on the Skills & Drills section.
