Glaucoma 9.1 Primary Open Angle Glaucoma Symptoms Usually asymptomatic until the later stages. Symptoms may include visual field defects. Tunnel vision and loss of central fixation typically do not occur…

General Ophthalmic Problems 13.1 Acquired Cataract Symptoms Slowly progressive visual loss or blurring, usually over months to years, affecting one or both eyes. Glare, especially in bright sun or from…

Cornea 4.1 Superficial Punctate Keratopathy Symptoms Pain, photophobia, red eye, foreign body sensation, mildly decreased vision. Signs (See Figure 4.1.1.) Critical. Pinpoint corneal epithelial defects that stain with fluorescein. May…

Pediatrics 8.1 Leukocoria Definition A white pupillary reflex (see Figure 8.1.1). Etiology Retinoblastoma: A malignant tumor of the retina that appears as a white, nodular mass that breaks through the…

Conjunctiva/Sclera/Iris/External Disease 5.1 Acute Conjunctivitis Symptoms “Red eye” (conjunctival hyperemia), discharge, eyelids sticking or crusting (worse upon awakening from sleep), foreign body sensation, <4-week duration of symptoms (otherwise, SEE 5.2,…

Orbit 7.1 Orbital Disease This section provides a framework to evaluate a variety of orbital disorders. Symptoms Eyelid swelling, bulging eye(s), and double vision are common. Pain, decreased visual acuity,…

Eyelid 6.1 Ptosis Symptoms Drooping upper eyelid, visual loss often worse with reading and at night. Concerning associated symptoms include diplopia, headache, and neck pain. Signs (See Figure 6.1.1.) Critical….

Trauma 3.1 Chemical Burn Treatment should be instituted IMMEDIATELY, even before testing vision, unless an open globe is suspected. NOTE: This includes alkali (e.g., lye, cements, plasters, airbag powder, bleach,…

Differential Diagnosis of Ocular Signs Anterior Chamber/Anterior Chamber Angle Hyphema Traumatic, iatrogenic (e.g., intraocular surgery or laser), iris neovascularization, herpes simplex or zoster iridocyclitis, blood dyscrasia or clotting disorder (e.g.,…

Differential Diagnosis of Ocular Symptoms Burning More Common. Blepharitis, meibomitis, dry eye syndrome, conjunctivitis (infectious, allergic, mechanical, chemical). Less Common. Corneal defects (usually marked by fluorescein staining of the cornea),…