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Here are the Top 10 essential emergency cases not to miss on duty. Keep calm and save some eyes! =)
1. A-AION / N-AION
- Differentiate arteritic from non-arteritic form based on history, lab tests (CRP, ESR, Tc), age
2. Retrobulbar Hematoma
- Clinical diagnosis! Compartment syndrome!
- Canthotomy and cantholysis
3. Central Retinal Artery Occlusion
- Rule out giant cell arteritis
- Refer to Stroke Unit
4. Endophthalmitis
- What’s the aetiology?
- Antibiotics + pars plana vitrectomy (ppV)
5. Retinal Detachment
- Is the macula on or off? Examine both eyes!
- Bed rest and head positioning on the side of the detachment
6. Orbital Cellulitis
- Differentiate preseptal vs. postseptal based on clinical presentation and/or contrast-enhanced CT
- Oral/intravenous antibiotics
7. Open Globe Injury
- Is Seidel’s test positive?
- High-resolution CT
- Decision on surgical or conservative treatment
8. Acute Angle-Closure Glaucoma
- Gonioscopy with indentation
- Medical treatment
- Iridotomy
9. Infectious Keratitis
- History, duration of symptoms? Contact lens use?
- Differential diagnosis (bacterial, fungal, Acanthamoeba).
- Corneal Swab
- Consider hospital admission
10. Chemical Injuries / Burns
- Rinse immediately! Measure pH!
- Double evert eyelids in cases of lime/plaster exposure
- Consider hospital admission