With more than 2 million visits annually to United States emergency departments, patients who have complaints involving the eye and its surrounding tissues are encountered frequently by the emergency physician. Eye complaints represent the full range of disease, from trivial (uncomplicated subconjunctival hemorrhage) to life-threatening (intracranial aneurysm). This issue attempts to provide a framework to approach patients who have eye complaints.
The issue begins with ‘‘Physical Exam of the Eye,’’ which reviews the anatomy of the eye, including its innervation and blood supply and suggests how to perform a rapid, yet thorough, physical exam of the eye. There is an article entitled ‘‘Ophthalmologic Procedures’’ that reviews commonly performed ophthalmologic procedures, such as measurement of visual acuity, tonometry, and slit lamp evaluation, and infrequently used procedures, such as paracentesis and lateral canthotomy, with a discussion of ocular ultrasound. The subsequent articles approach the patient who has eye complaints in one of two ways: a system-based approach and a problem-based approach. The system-based articles include ‘‘Ocular Infection and Inflammation,’’ which discusses topics from conjunctivitis to scleritis and orbital cellulitis. The next system-based article is entitiled ‘‘Trauma to the Globe and Orbit,’’ and is a comprehensive article that covers topics ranging from corneal abrasion to hyphema, ruptured globe, and retro-orbital hemorrhage. Another system-based article is ‘‘Neuro-Ophthalmology,’’ which presents a detailed discussion of the unique ocular findings seen in neurologic diseases, including afferent papillary defect, Argyll Robertson pupil, and Adie’s tonic pupil. The final system-based article is ‘‘Ophthalmologic Complications of Systemic Disease,’’ which covers topics ranging from diabetes to acquired immunodeficiency syndrome.
The first of the problem-based articles is ‘‘The Red Eye,’’ and it discusses the differential diagnosis and treatment of this very common emergency department presentation, which ranges from conjunctivitis to acute angle closure glaucoma. Another problem-based article is ‘‘Acute Visual Loss,’’ and it discusses central retinal artery occlusion, retinal detachment, and other causes of this condition that can be alarming for the physician and the patient. The next problem-based article is ‘‘Eye Exposures,’’ which attempts to guide the emergency physician in the management of conditions ranging from alkali exposures to biologic exposures to health care workers. The final problem-based article is entitled ‘‘The Painful Eye,’’ which discusses topics including uveitis and optic neuritis. There is a separate article entitled ‘‘Pediatric Ophthalmology in the Emergency Department’’ that provides guidelines for the evaluation and management of ocular complaints in children of various age groups. The final article, entitled ‘‘Conditions Requiring Emergency Ophthalmologic Consultation,’’ cuts through the myriad of ophthalmologic complaints that patients present with and presents those diagnoses, such as endophthalmitis and corneal ulceration, that require immediate attention by an ophthalmologist.
The issue begins with ‘‘Physical Exam of the Eye,’’ which reviews the anatomy of the eye, including its innervation and blood supply and suggests how to perform a rapid, yet thorough, physical exam of the eye. There is an article entitled ‘‘Ophthalmologic Procedures’’ that reviews commonly performed ophthalmologic procedures, such as measurement of visual acuity, tonometry, and slit lamp evaluation, and infrequently used procedures, such as paracentesis and lateral canthotomy, with a discussion of ocular ultrasound. The subsequent articles approach the patient who has eye complaints in one of two ways: a system-based approach and a problem-based approach. The system-based articles include ‘‘Ocular Infection and Inflammation,’’ which discusses topics from conjunctivitis to scleritis and orbital cellulitis. The next system-based article is entitiled ‘‘Trauma to the Globe and Orbit,’’ and is a comprehensive article that covers topics ranging from corneal abrasion to hyphema, ruptured globe, and retro-orbital hemorrhage. Another system-based article is ‘‘Neuro-Ophthalmology,’’ which presents a detailed discussion of the unique ocular findings seen in neurologic diseases, including afferent papillary defect, Argyll Robertson pupil, and Adie’s tonic pupil. The final system-based article is ‘‘Ophthalmologic Complications of Systemic Disease,’’ which covers topics ranging from diabetes to acquired immunodeficiency syndrome.
The first of the problem-based articles is ‘‘The Red Eye,’’ and it discusses the differential diagnosis and treatment of this very common emergency department presentation, which ranges from conjunctivitis to acute angle closure glaucoma. Another problem-based article is ‘‘Acute Visual Loss,’’ and it discusses central retinal artery occlusion, retinal detachment, and other causes of this condition that can be alarming for the physician and the patient. The next problem-based article is ‘‘Eye Exposures,’’ which attempts to guide the emergency physician in the management of conditions ranging from alkali exposures to biologic exposures to health care workers. The final problem-based article is entitled ‘‘The Painful Eye,’’ which discusses topics including uveitis and optic neuritis. There is a separate article entitled ‘‘Pediatric Ophthalmology in the Emergency Department’’ that provides guidelines for the evaluation and management of ocular complaints in children of various age groups. The final article, entitled ‘‘Conditions Requiring Emergency Ophthalmologic Consultation,’’ cuts through the myriad of ophthalmologic complaints that patients present with and presents those diagnoses, such as endophthalmitis and corneal ulceration, that require immediate attention by an ophthalmologist.