Pediatric emergency medicine trisk 4031 4031

CHAPTER 123 ■ OPHTHALMIC EMERGENCIES
DEBORAH SCHONFELD, BRUCE M. SCHNALL

GOALS OF EMERGENCY CARE
A wide variety of pediatric ocular complaints are first seen by clinicians in the
emergency room. A number of acute disorders such as ocular infections and
exposures of a toxic nature require the immediate diagnostic workup and
management that is best carried out in the emergency department (ED). While
many problems can, and should be, managed by the ED clinician alone, others
may require immediate or expedited ophthalmologic evaluation. The ED clinician
must be capable of conducting an ophthalmic history and physical examination to
accurately assess ocular complaints. This chapter discusses the approach to
ophthalmic emergencies commonly seen in the ED. Ocular trauma (including
injuries to the globe, cornea, and eyelids) is discussed in Chapter 114 Ocular
Trauma . The approach to several other common eye complaints is outlined in the
related chapters mentioned below.
KEY POINTS
The pediatric eye examination can be challenging and often requires
an age-adjusted approach.
It is critical to distinguish periorbital cellulitis from the much more
serious orbital cellulitis.
Patient age and associated symptoms can often help the clinician
differentiate between different types of conjunctivitis.
Copious ocular irrigation immediately following caustic exposure to the
eye can be vision-saving.
RELATED CHAPTERS