Week 3 Discussion Part I
Table 1
Red Eye
| Please complete the differential diagnosis table for cc: red eye | |||
| Clinical Findings | Diagnosis | Treatment/Management | |
| Ophthalmia neonatorum | |||
| Bacterial conjunctivitis | |||
| Viral conjunctivitis | |||
| Allergic conjunctivitis | |||
| Corneal abrasion, foreign body | |||
| Periorbital Cellulitis | |||
| Blepharitis | |||
| Hordeolum (Stye) | |||
| Chalazion | |||
Table 2
Abnormal Ophthalmologic Finings
| Complete the table | |||
| Strabismus | Amblyopia | Esotropia | |
| Description | |||
| Management/Treatment | |||
| Red Reflex | Light Reflex Test/Corneal Light Reflex/Hirschberg Test) | |
| Describe how to perform the procedure | ||
| What is an expected finding? | ||
| Screening for? |
Table 3
Dental Health
| Fill in the Blank |
| 1. When should a child’s first dental appointment occur? |
| 2. When do the first primary teeth erupt? |
| 3. A child usually has 6-8 primary teeth by _____ (what age?) |
| 4.A child has a complete set of 20 primary teeth, including second molars by ______(what age?) |
Table 4
Ear Pain
| Complete the table. | |||||
| Common Differentials | Description | Causative Agents | Clinical Findings | Treatment/ Management |
Prevention/ Education |
| Otitis Externa | |||||
| Acute Otitis Media (AOM) | |||||
| Otitis Media w/ Effusion | |||||
| List 5 other Differentials for er pain | Description | Clinical Findings | Management | ||
| 1. | |||||
| 2. | |||||
| 3. | |||||
| 4. | |||||
| 5. | |||||
Taylor is 7-year-old who is brought to the clinic by her aunt because she has had redness in her right eye for 3 days. Today when she woke up, her right eye was swollen, red, and tender. She denies fever.
- What should you ask Taylor about her eye?
- What type of exam(s) should be performed?
- What would be your management for this patient?
SOLUTION
✅ Taylor’s Case: Red Right Eye (7-Year-Old)
Questions to Ask Taylor About Her Eye:
-
When did the redness start?
-
Was there any injury or trauma to the eye?
-
Is there any discharge? If yes, what color is it?
-
Does the eye itch or feel gritty?
-
Is the vision blurry?
-
Is there any sensitivity to light?
-
Has she had any recent upper respiratory infection or allergies?
-
Does she wear contact lenses?
-
Has this happened before?
Exams to Perform:
-
Visual acuity test
-
Inspection of eye for discharge, swelling, conjunctival injection, and eyelid involvement
-
Eversion of eyelid to check for foreign bodies
-
Fluorescein stain with Wood’s lamp to rule out corneal abrasion
-
Palpation of periorbital area for tenderness or cellulitis
-
Ophthalmoscope exam for red reflex and internal eye structures
-
Pupil reaction test for photophobia or afferent pupillary defect
Likely Diagnosis:
Hordeolum (Stye) or Periorbital Cellulitis (differential).
Management:
-
Warm compresses 4–6 times daily if it’s a hordeolum
-
Topical antibiotics (e.g., erythromycin ointment) if mild bacterial conjunctivitis
-
Oral antibiotics (e.g., Augmentin) if periorbital cellulitis is suspected
-
Refer to ophthalmology if not improving in 24–48 hours or if worsening
-
Educate on hand hygiene, avoid rubbing eyes, and avoid school until discharge clears
📘 Table 1: Differential Diagnosis of Red Eye
| Clinical Findings | Diagnosis | Treatment/Management |
|---|---|---|
| Redness in neonate within days of birth; purulent discharge | Ophthalmia Neonatorum | Depends on cause: erythromycin ointment prophylactically; systemic antibiotics for gonorrhea/chlamydia |
| Mucopurulent discharge, unilateral/bilateral, stuck eyelids | Bacterial Conjunctivitis | Topical antibiotics (e.g., polymyxin B/trimethoprim, erythromycin ointment) |
| Watery discharge, bilateral, preauricular node swelling | Viral Conjunctivitis | Supportive care, hand hygiene, cool compress |
| Itchy eyes, watery discharge, bilateral, allergic history | Allergic Conjunctivitis | Oral antihistamines, antihistamine eye drops (e.g., olopatadine), avoid allergens |
| Pain, foreign body sensation, fluorescein uptake | Corneal Abrasion/Foreign Body | Remove FB if present, topical antibiotic ointment, avoid contact lenses |
| Redness, eyelid swelling, tenderness, no vision changes | Periorbital Cellulitis | Oral antibiotics, warm compresses; refer if orbital cellulitis suspected |
| Red, itchy, scaly lid margins, crusting | Blepharitis | Lid hygiene, warm compresses, topical antibiotics if infected |
| Localized painful nodule on eyelid margin | Hordeolum (Stye) | Warm compresses, possible topical antibiotics |
| Firm, painless bump on eyelid (meibomian gland) | Chalazion | Warm compresses, ophthalmology referral if persistent |
📘 Table 2: Abnormal Ophthalmologic Findings
| Strabismus | Amblyopia | Esotropia | |
|---|---|---|---|
| Description | Misalignment of eyes | Decreased vision due to poor visual stimulation | Inward turning of one or both eyes |
| Management/Treatment | Refer to ophthalmology, patching, surgery | Patching stronger eye, corrective lenses | Eye patching, surgery, glasses |
Vision Screening Techniques
| Red Reflex | Corneal Light Reflex (Hirschberg Test) | |
|---|---|---|
| Procedure | Shine ophthalmoscope light into eyes from 12–18 inches | Shine light at eyes, observe light reflection location |
| Expected Finding | Equal red reflex in both eyes | Light reflection centered and symmetrical |
| Screening for | Cataracts, retinoblastoma | Strabismus, ocular misalignment |
🦷 Table 3: Dental Health
-
First dental appointment: By 12 months of age or within 6 months of first tooth eruption
-
First primary teeth eruption: Around 6 months
-
6–8 primary teeth by: 12 months of age
-
Complete set of 20 primary teeth by: 2.5 to 3 years of age
👂 Table 4: Ear Pain
Common Differentials
| Description | Causative Agents | Clinical Findings | Treatment/Management | Prevention/Education | |
|---|---|---|---|---|---|
| Otitis Externa | Infection of ear canal | Pseudomonas, S. aureus | Pain with ear tugging, canal edema, discharge | Antibiotic ear drops, avoid moisture | Keep ears dry, avoid trauma |
| Acute Otitis Media | Infection of middle ear | Viral, S. pneumoniae, H. influenzae | Fever, ear pain, bulging TM | Amoxicillin first-line | Vaccination, avoid smoke |
| Otitis Media w/Effusion | Fluid without infection | Post-infection | Hearing loss, fullness, no fever | Observation, possible ENT referral | Hearing screening, monitor speech delay |
5 Other Differentials for Ear Pain
| Description | Clinical Findings | Management | |
|---|---|---|---|
| 1. Foreign Body | Object in ear canal | Pain, hearing loss, visible object | Removal in office or ENT |
| 2. TM Perforation | Hole in eardrum | Sudden pain relief, drainage | Keep ear dry, ENT follow-up |
| 3. Mastoiditis | Infection of mastoid | Post-AOM, swelling behind ear | IV antibiotics, possible surgery |
| 4. Dental Abscess | Tooth infection referring pain | Tooth tenderness, swelling | Dental referral, antibiotics |
| 5. Temporomandibular Joint (TMJ) Dysfunction | Jaw-related pain | Clicking, pain on chewing | Rest jaw, warm compress, refer if persistent |
Place this order or similar order and get an amazing discount. USE Discount code “GET20” for 20% discount