pregnant or breast feeding? Tetracycline works very well in fighting off the infection. I need you to take this four times a day for a total of 10 days I hour before eating or two hours after eating. There are some dietary restrictions. Remember not to take in any dairy products such as milk with the medication. There is also increased sensitivity to sunlight. So remember to put on sun block whenever you are outdoors. It's important you come back for your follow-up appointments. ORBITAL CELLULITIS
“I am just recovering from a dental infection and now I'm having problems with my eyes. They're very painful. I can't even open or move them.”
11 There is serious infection of your eye which is very dangerous. I need you in the hospital
immediately! CONJUNCTIVA PINGUECULA
12 You may even notice this yourself when you look in the mirror. The white part of your eyes
has a patch of yellowish overgrowth. We call this pinguecula. It is due to over exposure to UV rays. It's normal. Just like how our skin changes color when exposed to too much UV radiation, the skin of your eyes does the same thing. So it's important that you protect your eyes and get UV protection in your glasses.
SLK (SUPERIOR UMBIC KERATOCONJUNCTIVITIS)
13 This is an inflammatory condition affecting your superior conjunctiva and cornea due to
thyroid disease. The medication may cause some stinging on instillation. I need to refer you to an internist for a thyroid work-up. Please come back in a week for follow-up. EPISCLERITS
“2 days ago, I woke up and found the white part of my eye turned red. It feel ?hot?.”
14 There is an inflammation of the outer tissue of your eye. It's sometimes caused by stress. It
should be gone in 1-3 weeks. Cold compresses QID for 15 minutes plus artificial team such as Refresh Tears QID should speed recovery. If you need to give presentations and want to relieve the redness, you can use eye drops call vasoconstrictors. But please use It sparingly because excessive use makes it worse. SCLERITIS
15 There is an inflammation of the front part of your eye, which could become very serious. You
must take your meds. This is usually related to systemic diseases. Should resolve in 2-3 months. But I need you to go to the internist for a systemic work-up. Please come back in 2 days for your follow-up appointment so I can monitor your condition closely. CONJUNCTIVITIS
HYPERACUTE BACTERIAL CONJUNCTIVITIS
“I wake-up and my lids are stuck together. My eyes are so red and painful.”
16 The cause of inflammation is sexually transmitted disease. There is also a severe bacterial
infection present in your eye. The systemic and ocular drugs are to kill the bacteria and hourly irrigation will wash out the bacteria from your eye. I strongly recommend that you and your sexual partner seek medical care for this venereal disease. ACUTE BACTERIAL CONJUNCTIVITIS
“I woke-up this morning and can~ open my eye. My lids are stuck together. There is this green-yellowish discharge. My eye is beefy red and painful.”
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17 You have a bacterial infection in your eye. The toxins produced by the bacteria cling to your
lids at night causing your lids to stick together in the morning. The warm compresses QID for 20 minutes improve blood circulation in the lids and help cleanse the deposits around lids. Water irrigation washes bacteria out of your eyes. Hand washing and quarantine from school (work) are to prevent further spreading. Remember to take your eye drop medication. I want to see you back in 2 days for a follow-up. CHRONIC BACTERIAL CONJUNCTIVITIS
18 There is a bacterial infection in your eye and this is due to poor lid hygiene. You must take
your medication and do lid hygiene. This lid disease can recur if not treated. So I need you to do lid scrubs TID and apply the Ab. Ophthal. gtt. QID during the day and apply this ung. QHS. Come back in 3 days so I can see how well you are responding to this treatment. GPC (GIANT PAPILLARY CONJUNCTIVITIS)
19 You have a reaction due to poor contact lens hygiene and contact lens over wear. You
shouldn?t be wearing your contacts until this resolves. Cold compresses and AT QID will help relieve your symptoms. I want to see you back in 7 days. We need to refit you with new contacts to something that's healthier for your eyes. EKC (EPIDEMIC KERATOCONJUNCTIVITIS) “My eye is red and there's watery discharge.”
20 It is a viral infection also known as 'pink eye' that must run its course. My recommendations
will make you feel more comfortable and speed up the progress. Use AT QID and cool compresses to relieve the irritation. Wear sunglasses when you go outside since you are more sensitive to sunglasses. Beware of its very contagious nature. Come back in a week for a follow-up.
PCF (PHARYNGOCONJUNCTIVL FEVER)
21 It is a viral infection that must run its course. My recommendations (AT QID, cool
compresses QID, Vasoc, on-A QID) will help relieve symptoms. The condition is very contagious and re-infection is possible. Wash clothing and bedding frequently. Also, you should not go to school for the time being. If “ ” complains of pain, then take Tylenol. Come back in 2-3 days for your follow-up appointment. CHLAMYDIAL INCLUSION CONJUNCTVITIS
22 You have STD. You must inform your sexual partner of the need for treatment. As for
treatment, there are two options. One is expensive and the other is practical. Of course you pay your money's worth. You just have to take one pin only once. For the less expensive option, It works just as well. But it's not as convenient. You need to take the medication QID for a total of 3 weeks on top of following some dietary restrictions. Please come back in 2 weeks for your follow-up appointment. ALLERGIC CONJUNCTVITIS (TYPE Ⅰ) “ My eyes feel very itchy.”
23 You have hay fever causing your eye inflammation. Alternating Cool/warm compresses
QID for 20 minutes and AT& Vasocon-A QID will reduce itching and make you feel better. Come back in a week for your follow-up appointment. Next year, I want to see you back a month before your allergy starts so we can staff you off on a better medication to better treat your allergies.
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ALLERGIC CONJUNCTIVITIS (TYPE Ⅳ) “ My eyes bum and sting.”
24 Your condition is due to environmental conditions such as smog, the wind, and air
conditioning. You need to protect your eyes from these irritants or remove the irritants if possible. 50% of the symptoms relieved is considered successful. AT QID +cold compresses + Acular QID will help relieve your symptoms. VERNAL CONJUNCTIVITIS
25 You have allergic conjunctivitis. This is more common in spring and summer. Kids usually
grow out of it. It can last 4-10 years. The eye drops and cool compresses will make relieve inflammation and swelling to make your eyes feel more comfortable. Next year come in a few weeks prior to allergy season to begin a mast-cell stabilizer therapy. I want you to come back in 2 days for your foaow-up appointment. TOXIC KERATOCONJUNCTNITIS
26 You are having a toxic reaction to your eye drops (Make-up). Let's find out the cause so you
know to avoid using it next time. You shouldn't stop your glaucoma medications. But I will discuss with your doctor and see if we can change you're the medication. Come back in a week for your follow-up appointment. CORNEA PTERYGIUM
27 There is an overgrowth of tissue going onto the comea. Use of AT QlD will increase
comfort. Protect your eyes from the sun, dust and wind using UV sunglasses. Surgical removal is possible but it will grow back. CORNEAL ABRASION
28 Trauma to your eye scratched your cornea. I need to thoroughly exam your eyes to make
sure the there is no foreign body stuck inside and see how deep the cut is. There is no need for patching but I need to prescribe eye drops to prevent infection. I will prescribe a pain medication eye drop that you can use QID incase it gets too painful. I need to follow-up your condition everyday until it heals. FOREIGN BODY
29 Foreign matter has been embedded into the front part of your eye. Remember to wear safety
eyewear next time. PHLYCTENULOSIS
30 This is allergic hypersensitivity reaction to bacteria or their waste products. We need to
treat the underlying condition (staphylococcal blepharitis or TB). I need to refer you to your PCP for PPD test or chest X-ray to rule out TB. In the mean time, I need you to start this Ab. Therapy for a period of 2-4 weeks and do lid scrubs TID. Come back next week for your follow-up.
HSK (HERPES SIMPLEX VIRUS KERATOCONJUNCTIVITIS)
31 You have a viral infection, it's caused by the same virus that you get cold sores from. I don't
want your,infection to spread so it is important that you take these medications. You must put a drop q2h nine times a day. I need to see you back everyday to see how you are responding to these drops. When I see improvement then we will taper the drops. HZO (HERPES ZOSTER OPHTHALMICUS)
32 Your condition is due to the reactivation of the chicken pox virus which lies dormant in your
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nerves. It may spread by inhalation to persons never infected before. To prevent scar, restrain from itching vesicles. I need to prescribe oral medication call Famciclovir for you to take right away TID for a period of 10 days. I will also prescribe some eye drops to calm the inflammation inside your eye. When it feels painful, do cool compresses and just in case, I will prescribe an oral medication for you to take BID if the cool compresses does not work. MARGINAL LIMBAL INFILTRATES
33 Your immune system is responding to the exotoxins produced by bacterial infections. There
are two steps we need to take in order to clear this infection. First we need to keep this infection under control. Second we need to clear all the ddstructive toxins that had already been produced. Do eyelid scrubs TID and also one drop of this AB (gentamicin or ciprofioxacin) eye gtt QID. The gtts. Kill the bacteria and helps wash the bacteria away from your lid margins. Come back tomorrow, the same time so I can see how you are responding to the eye gtts. I expect to see some signs of improvement in two days. CORNEAL ULCER
“ My eyes are extremely painful. I can't even put my contacts on.”
34 You have a severe bacterial infection that has caused an ulcer in your eye. You shouldn't be
wearing your contacts until this completely resolves. It is crucial that you stay compliant with the medication or else the infection spreads and severely affects your vision permanently. Also, you need to come in same time, everyday so we can monitor the healing process. The first medication I will prescribe is a top line antibiotic, Zymar / Vigamox that should keep things under control. You must obediently follow these directions: 1 gtt q30 min for the first 24 hrs. That means even when you sleep, set your alarm or have someone help you out to put your drops in. Another eye drop I will prescribe helps to improve comfort. Put l gtt of Scopolamine TID. Doing cool compresses helps as well. Once I see your eye responding well to the medications, then we need to add another type of eye drop to this regimen to minimize any scarring. RENCURRENT CORNEAL EROSION
35 The top layer of your cornea is loosely adhered to the other layers and in the morning your
eyelids pull off this top layer. SCL's will protect it from the lid. I will also prescribe an eye gtt to use QID and ung to use at night to reduce the swelling. FICH'S DSTROPHY
36 You have a hereditary condition that affects the front part of your eyes. This front part
consists of 5 layers: epithelium, bowman's, stroma, descemet's membrane and endothelial layer. The pump that keeps fluid out of these layers has broken down with age and causes your cornea to swell. The progression of your condition called Fuch's D is divided into 3 stages. You are now at the beginning stage. You don't feel anything but I see the signs while examining your eyes. As it progresses to the second stage, you will start to become more bothered by glare and expect your vision to drop 2-3 lines. In its last stage, we will need to see whether there is a need for corneal transplant. Right now, will prescribe an eye drop that helps to control the corneal swelling. But it may sting. I also recommend using a hair dryer to help dry out the surface. KERATOCONUS
37 You have a condition where the front part of your eye, called the cornea is getting thinner and
so it is bulging out. We don l know the cause but for now, glasses can still improve your
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vision. In the future, you need to be fitted with rigid contact lens to provide optimum correction. IRITIS/UVEITIS
TRAUMATIC IRITIS
38 You have an inflammation at the colored part of your eye, your iris. It was due to the
trauma you had. It is very important that you come back for subsequent follow-up exams. I will now prescribe eye drops that will calm the inflammation. The drops work very well. But make sure you remember to shake the bottle before you put it in your eye. It is a suspension, so you really need to shake it well. It is very important that you do not stop the medication yourself. If you stop it too early, it may worsen your condition and make it very difficult to treat afterwards. Do you have any questions? SYSTEMIC DISEASE ILNEITIS
39 You have an inflammation of the colored part of your eye. Our goal is to calm the
inflammation as well as decrease the pain. 1 gtt of homatropine QID, and I gtt of Prd Forte q3h. Come back tomorrow. Since this is the third time you've had this, I need to refer you for some testing to make sure it's not any systemic condition causing the inflammation. OCULAR ROSACEA
40 This is a non-contagious disorder of the oil glands and blood vessels near the skin surface.
It can be effectively treated with antibiotics, which should be taken one hour before meals or 2 hours alter. Be aware of sunlight sensitivity.
41 There is a break in a tissue layer in the back of your eye. We need to monitor this condition
for vessel growth, which can lead to bleeding and cause damage to the tissues of your eye, ultimately causing a decrease in vision.
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