Eye complaints

One of my classmates did an EM rotation down in the South and shared this humorous and straightforward breakdown of eye complaints.  While there’s an overwhelming number of conditions that manifest in the eye, there are only two drop-what-you’re-doing “true emergencies” that I’ve learned while on my ophthalmology rotation.

1.  Retrobulbar hematoma

2.  Globe rupture

Next are a couple of the broad categories of eye complaints.  It’s not perfect by any means and obviously there’s more to it than this, but it’s a good starting point in generating a DDx.

Painful eye:

(Next step: Apply topical anesthetic)

Pain decreases –> Corneal abrasion, corneal ulcer, foreign body, conjunctivitis

Pain unaffected –> Iritis/uveitis, glaucoma

Can’t see:

No pain –> CRAO, CRVO, retinal detachment, CVA

Pain –> Glaucoma, globe rupture, orbital fx, brian hemorrhage, traumatic iritis

Looks funny:

Subconjunctival hemorrhage

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