Ophthalmology

A

• Acute Angle-Closure Glaucoma — Emergency Management

  Sudden painful red eye with halos and vision loss; treat immediately with topical and systemic agents to lower IOP; definitive therapy is laser peripheral iridotomy.
• Acute Angle-Closure Glaucoma — Emergent IOP Reduction

  Severe eye pain with halos and nausea; emergent therapy to lower IOP with topical and systemic agents followed by definitive laser iridotomy.
• Acute Angle-Closure Glaucoma — IOP-Lowering Sequence and Definitive Iridotomy

  Severe ocular pain, halos, N/V, and mid-dilated fixed pupil with corneal edema. Begin ED IOP-lowering sequence (topical β-blocker + α-agonist + carbonic anhydrase inhibitor + hyperosmotic agent) and topical pilocarpine once IOP decreased; arrange urgent laser peripheral iridotomy.
• Acute Angle-Closure Glaucoma — IOP-Lowering Sequence and Laser Iridotomy

  Painful red eye with halos, mid-dilated pupil, corneal edema, and high IOP. Lower pressure with sequential topical and systemic therapy and arrange urgent laser peripheral iridotomy in both eyes when appropriate.
• Acute Angle-Closure Glaucoma — Pressure-Lowering Regimen and Laser Iridotomy

  Severe eye pain, halos, headache, and nausea with mid-dilated fixed pupil and corneal edema. Start immediate pressure-lowering regimen (topical beta-blocker, alpha-agonist, carbonic anhydrase inhibitor; systemic acetazolamide ± hyperosmotic agent), then pilocarpine once IOP lowered; arrange urgent laser iridotomy.
• Acute Anterior Uveitis - Initial Management

  Pain, photophobia, and ciliary flush with anterior chamber cells require cycloplegic and topical steroid guided by ophthalmology and evaluation for systemic associations.
• Amblyopia — Screening and Treatment

  Early detection and treatment improve outcomes. Screen at ages 3–5 with visual acuity or instrument‑based screening; treat with refractive correction plus patching or atropine penalization.

B

• Bacterial Keratitis Corneal Ulcer - Treatment

  Painful red eye with corneal infiltrate and epithelial defect needs urgent ophthalmology, culture for severe or central ulcers, and intensive topical antibiotics.
• Blepharitis — Diagnosis & Lid Hygiene

  Chronic eyelid margin inflammation (anterior staph vs posterior meibomian gland dysfunction). Mainstay is lid hygiene and warm compresses; add topical antibiotics or azithromycin/doxycycline for refractory cases.

C

• Cataract — Indications for Surgery & Preop Assessment

  Offer cataract surgery when visual function limits daily activities; perform targeted preop assessment including IOL calculations and macular screening; plan for IFIS and anticoagulation management.
• Central Retinal Artery Occlusion - Emergency Care

  Sudden painless monocular vision loss is an ocular stroke. Activate stroke pathway, assess time last seen normal, control risk factors, and coordinate emergent ophthalmology and stroke services.
• Central Retinal Artery Occlusion — ED Actions

  Sudden painless monocular vision loss is an ocular stroke; activate stroke pathway, control risk factors, and urgently involve ophthalmology; consider IOP-lowering measures and hyperbaric oxygen per protocol.
• Central Retinal Artery Occlusion — Hyperacute Actions

  Sudden painless monocular vision loss is an ocular stroke; activate stroke pathway, consider immediate ocular massage and IOP lowering while arranging urgent ophthalmology and vascular evaluation.
• Central Retinal Artery Occlusion — Stroke Pathway, IOP Lowering, and Secondary Prevention

  Sudden, painless monocular vision loss. Treat as an ocular stroke: activate stroke pathway, exclude giant cell arteritis in older patients, consider time-sensitive thrombolysis protocols per center, lower IOP, and start secondary prevention after vascular workup.
• Chalazion & Hordeolum — Treatment

  Acute hordeolum is infectious; chalazion is sterile granuloma. Warm compresses are first‑line; incision and curettage or steroid injection for persistent chalazia; antibiotics for external hordeola or preseptal cellulitis.
• Chemical Eye Injury - Immediate Irrigation

  Begin copious irrigation immediately with any available isotonic solution, check pH until neutral, remove particulate matter, and arrange urgent ophthalmology.

D

• Diabetic Macular Edema — Anti‑VEGF Therapy

  Anti‑VEGF injections are first‑line for center‑involving DME; choice among aflibercept, ranibizumab, and bevacizumab depends on vision and cost; steroids for pseudophakic or non‑responders.
• Dry Eye Disease — Evaluation & Treatment

  Multifactorial disease of tear film and ocular surface. Stage severity; treat with lubricants, anti‑inflammatories (cyclosporine/lifitegrast), lid hygiene/MGD therapy, and punctal occlusion in select cases.

H

• Herpes Simplex Keratitis - Initial Therapy

  Dendritic epithelial lesions with decreased corneal sensation respond to topical or oral antiviral therapy and avoidance of topical steroid in epithelial disease.

K

• Keratoconus — Diagnosis & Cross‑Linking

  Progressive ectasia causing irregular astigmatism. Diagnose with topography/tomography; halt progression with corneal cross‑linking; use specialty contacts for vision; transplant if advanced.

O

• Ocular Migraine — Diagnosis & Counseling

  Visual aura phenomena (scintillations, scotomas) with or without headache. Differentiate from TIA/retinal ischemia; manage triggers and offer migraine prophylaxis when frequent.
• Open Globe Injury - Initial Management

  Suspect with peaked pupil, low intraocular pressure, or uveal prolapse. Place rigid shield, avoid pressure and drops, give IV antibiotics and tetanus as indicated, and get urgent ophthalmology.
• Open Globe Injury — Eye Shield, IV Antibiotics, and Emergent Repair

  Penetrating ocular trauma with peaked pupil, low IOP, or Seidel sign. Avoid any pressure on the eye, place a rigid shield (no patch), give antiemetics and analgesia, start broad IV antibiotics, update tetanus, obtain CT orbit (no tonometry/US), and take urgently to the OR for repair.
• Orbital Cellulitis - Initial Management

  Painful ophthalmoplegia, proptosis, or decreased vision suggests orbital involvement. Start IV antibiotics, obtain urgent imaging, and involve ophthalmology and otolaryngology.
• Orbital Cellulitis — IV Antibiotics, Imaging, and Surgical Drainage Criteria

  Painful ophthalmoplegia, proptosis, and vision changes with fever and sinusitis history suggest orbital cellulitis. Start broad IV antibiotics, obtain contrast CT/MRI of orbits/sinuses, and consult ENT/Ophthalmology for abscess drainage when vision threatened or lack of response to antibiotics.

P

• Postoperative Endophthalmitis - Urgent Management

  Painful red eye with decreased vision after intraocular surgery needs same day ophthalmology for vitreous tap and intravitreal antibiotics.
• Pterygium — Indications for Excision & Recurrence Prevention

  UV‑related fibrovascular growth onto the cornea. Excise when visually significant, symptomatic, or progressive; reduce recurrence with conjunctival autograft ± mitomycin C.

R

• Retinal Detachment - Urgent Referral

  Flashes, floaters, curtain over vision, or new field loss warrant same day ophthalmology to confirm and repair.
• Retinitis Pigmentosa — Diagnosis & Low‑Vision Support

  Inherited retinal degeneration causing night blindness and field loss. Provide genetic testing/counseling, manage complications (cataract, CME), and connect to low‑vision services; gene therapy for RPE65 mutations.

T

• Traumatic Hyphema - ED Care

  Manage with head elevation, eye shield, activity restriction, cycloplegic for comfort, and ophthalmology follow up; check for sickle cell disease in at risk patients.