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Chapter 029. Disorders of the Eye (Part 6)

Red or Painful Eye Corneal Abrasions These are seen best by placing a drop of fluorescein in the eye and looking with the slit lamp using a cobalt-blue light. A penlight with a blue filter will suffice if no slit lamp is available. Damage to the corneal epithelium is revealed by yellow fluorescence of the exposed basement membrane underlying the epithelium. It is important to check for foreign bodies. To search the conjunctival fornices, the lower lid should be pulled down and the upper lid everted. A foreign body can be removed with a moistened cotton-tipped applicator after placing a drop of. | Chapter 029. Disorders of the Eye Part 6 Red or Painful Eye Corneal Abrasions These are seen best by placing a drop of fluorescein in the eye and looking with the slit lamp using a cobalt-blue light. A penlight with a blue filter will suffice if no slit lamp is available. Damage to the corneal epithelium is revealed by yellow fluorescence of the exposed basement membrane underlying the epithelium. It is important to check for foreign bodies. To search the conjunctival fornices the lower lid should be pulled down and the upper lid everted. A foreign body can be removed with a moistened cotton-tipped applicator after placing a drop of topical anesthetic such as proparacaine in the eye. Alternatively it may be possible to flush the foreign body from the eye by irrigating copiously with saline or artificial tears. If the corneal epithelium has been abraded antibiotic ointment and a patch should be applied to the eye. A drop of an intermediate-acting cycloplegic such as cyclopentolate hydrochloride 1 helps to reduce pain by relaxing the ciliary body. The eye should be reexamined the next day. Minor abrasions may not require patching and cycloplegia. Subconjunctival Hemorrhage This results from rupture of small vessels bridging the potential space between the episclera and conjunctiva. Blood dissecting into this space can produce a spectacular red eye but vision is not affected and the hemorrhage resolves without treatment. Subconjunctival hemorrhage is usually spontaneous but can occur from blunt trauma eye rubbing or vigorous coughing. Occasionally it is a clue to an underlying bleeding disorder. Pinguecula This is a small raised conjunctival nodule at the temporal or nasal limbus. In adults such lesions are extremely common and have little significance unless they become inflamed pingueculitis . A pterygium resembles a pinguecula but has crossed the limbus to encroach upon the corneal surface. Removal is justified when symptoms of irritation or blurring develop but .