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Eye pain

  • Common ddx

    • eye strain, corneal abrasion, conjunctivitis, dry eyes, sinusitis, migraines
  • Serious ddx

    • orbital cellulitis
    • herpes zoster
    • glaucoma (halo vision, nonreactive pupil)
    • retinal detachment (vision flashes, floaters)
    • cavernous sinus thrombosis (headache, EOM defects)
    • optic neuritis (vision loss)
    • orbital fracture
  • Labs

    • fluorescein light if suspect corneal abrasion
    • CT if suspect orbital cellulitis
    • IOP if suspect glaucoma
    • culture if suspect bacterial conjunctivitis
  • Eyelid issues

    • chalazion, stye, hordeolum, periorbital cellulitis
  • Other ddx

    • uveitis, iritis, keratitis, scleritis, Sjogren syndrome, blepharitis, meibomitis, cluster headache, flu, Reiter syndrome, meningitis, Grave's disease, trachoma
  • HPI

    • onset
    • triggering event: trauma
    • location: front, back, unilateral vs bilateral
    • quality: sharp, dull, achy, pressure, photophobia
    • vision changes (blurry, halo, distortion, flashes, floaters, vision loss)
    • discharge
    • severity
    • aggravates, alleviates
  • ROS

    • fever, rash
    • headache, sinus pressure
    • chest pain, dyspnea
    • nausea, vomiting, diarrhea, abdominal pain
    • dysuria, GU discharge
    • paresthesia
    • arthralgia
  • PMH

    • IBD
    • chicken pox, shingles
    • recent infection
  • SH

    • eye strain
    • sick contacts with red eye
  • Px

    • vitals
    • gen impression
    • head: trauma, rash on forehead, sinus tenderness
    • eye: inspect (redness, vesicles, discharge), pupils (size, reactive to light), vision (grossly, card), EOM, funduscope
    • periorbital (edema, erythema, warmth, rash)
    • check eyelids for chalazion, stye, hordeolum
    • wood's light if suspect corneal abrasion
    • ENT
    • lymphadenopathy
    • cardio, pulm, abd

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.