Materiały źródłowe

• #1 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html

  Red eye is the cardinal sign of ocular inflammation. The condition is usually benign and can be managed by primary care physicians. Conjunctivitis is the most common cause of red eye. Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis. Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes. Generally, viral and bacterial conjunctivitis are self-limiting conditions, and serious complications are rare. […] Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye. Referral is necessary when severe pain is not relieved with topical anesthetics; topical steroids are needed; or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections.

• #2 Red Eye: Background, Pathophysiology and Etiology, Epidemiology and Prognosis

  https://emedicine.medscape.com/article/1192122-overview

  Red eye is very common, and conjunctivitis is the most frequent cause. […] The prognosis depends on the cause of the red eye. For example, subconjunctival hemorrhage is a self-limited condition when not associated with systemic illness or significant trauma; thus, the prognosis is excellent. Complications also depend on the cause of the red eye.

• #3 Bacterial Conjunctivitis (Pink Eye): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1191730-overview

  The prognosis for complete recovery without sequelae is excellent in bacterial conjunctivitis, as long as the cornea is not involved. Most benign cases are treated with topical antibiotics or self-resolve. […] Bacterial conjunctivitis generally resolves within 1-2 weeks without treatment. Complications are expected to develop only in cases caused by extremely pathogenic bacteria, such as C trachomatis or N gonorrhoeae. […] Mortality in the setting of bacterial conjunctivitis is related to the failure to recognize and treat the underlying disease. Sepsis and meningitis caused by N gonorrhoeae can be life-threatening. […] Signs and symptoms of discomfort, mucopurulent ocular discharge, and conjunctival redness are common in benign cases and often lead to absence from work and school to minimize the risk of infection to others. Morbidity can be associated with misdiagnosis. Since many eye diseases cause the eye to be red, it is beneficial to have a solid clinical approach to differential diagnoses of the red eye, as well as an effective referral paradigm in the primary care setting. Diagnoses often missed by noneye-care providers (providers other than ophthalmologists and optometrists) include acute glaucoma; iritis; bacterial, fungal, and parasitic keratitis; corneal foreign bodies; conjunctival and tarsal foreign bodies; herpetic dendritic keratitis; scleritis; and subconjunctival hemorrhage, among others.

• #4 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html

  Red eye is one of the most common ophthalmologic conditions in the primary care setting. Inflammation of almost any part of the eye, including the lacrimal glands and eyelids, or faulty tear film can lead to red eye. Primary care physicians often effectively manage red eye, although knowing when to refer patients to an ophthalmologist is crucial. […] A thorough patient history and eye examination may provide clues to the etiology of red eye. […] The clinical presentation of viral conjunctivitis is usually mild with spontaneous remission after one to two weeks. […] Referral to an ophthalmologist is necessary if symptoms do not resolve after seven to 10 days or if there is corneal involvement. […] Hyperacute bacterial conjunctivitis is characterized by copious, purulent discharge; pain; and diminished vision loss. Patients need prompt ophthalmology referral for aggressive management.

• #5 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html

  Chronic bacterial conjunctivitis is characterized by signs and symptoms that persist for at least four weeks with frequent relapses. Patients with chronic bacterial conjunctivitis should be referred to an ophthalmologist. […] If the infection does not improve within one week of treatment, the patient should be referred to an ophthalmologist. […] Chlamydial conjunctivitis should be suspected in sexually active patients who have typical signs and symptoms and do not respond to standard antibacterial treatment. […] Ophthalmology referral is indicated if the patient needs topical steroid therapy or surgical procedures.

• #6

  https://bpac.org.nz/bpj/2013/august/redeye.aspx

  Most cases of red eye seen in general practice are likely to be conjunctivitis or a superficial corneal injury, however, red eye can also indicate a serious eye condition such as acute angle glaucoma, iritis, keratitis or scleritis. Features such as significant pain, photophobia, reduced visual acuity and a unilateral presentation are red flags that a sight-threatening condition may be present. […] In the absence of specialised eye examination equipment, such as a slit lamp, General Practitioners must rely on identifying these key features to know which patients require referral to an Ophthalmologist for further assessment. […] However, red eye can also be a feature of a more serious eye condition, in which a delay in treatment due to a missed diagnosis can result in permanent visual loss.

• #7

  https://bpac.org.nz/bpj/2013/august/redeye.aspx

  Refer urgently for an ophthalmological assessment if the patient is suspected to have acute angle closure glaucoma, iritis, scleritis, infectious/inflammatory keratitis or a penetrating eye injury. […] This is a medical emergency and the patient should be discussed with an Ophthalmologist immediately to determine initial management and arrange urgent assessment. […] Symptoms of raised intraocular pressure are deep eye pain (described as throbbing, drilling pain), redness, blurred vision (often with haloes around lights due to corneal oedema), headache, nausea and vomiting. […] Patients with suspected herpes simplex keratitis should be referred for ophthalmological assessment (or consider Optometrist triage if uncertain and the use of a slit lamp would assist in diagnosis). […] Key features are pain, photophobia and decreased vision. […] Ophthalmological assessment will confirm the diagnosis and exclude any possible infectious cause. […] Patients with an injury which has penetrated the eye should be referred immediately for an ophthalmological assessment.

• #8

  https://bpac.org.nz/bpj/2013/august/redeye.aspx

  In general, a patient with a unilateral presentation of a red eye suggests a more serious cause than a bilateral presentation. […] The patient history will usually identify a penetrating eye injury or chemical burn to the eye, but further assessment may be necessary in order to determine whether a patient presenting with red eye has any red flag features which suggests one of these sight-threatening conditions. […] Patients with the following features should be referred urgently (same day) for ophthalmological assessment: Severe eye pain, Severe photophobia, Marked redness of one eye, Reduced visual acuity (after correcting for refractive errors), Suspected penetrating eye injury, Worsening redness and pain occurring within one to two weeks of an intraocular procedure. […] If there is any suspicion of a serious cause then discussion with an Ophthalmologist is recommended.

• #9 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  If you have eye cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Stage is an important prognostic factor for eye cancer. A lower stage eye cancer has a better prognosis. […] The location of the eye cancer helps to predict a prognosis. […] A melanoma of the iris often has a better prognosis than a melanoma of the choroid or ciliary body. […] Cancer that has spread outside of the eye has a less favourable prognosis than cancer that hasnt spread outside of the eye.

• #10 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  Generally, a smaller eye tumour has a better prognosis than a larger tumour. […] People with small to medium-sized intraocular melanoma are also more likely to be able to see with the affected eye after treatment compared to people with larger tumours. […] Some changes to chromosomes are linked to a higher risk of the cancer spreading and a poorer prognosis. […] People whose tumours have certain gene mutations or too many copies (called overexpression) of certain genes tend to have a poorer outcome. […] Gene expression profiling can help predict the risk of cancer spreading in people with uveal melanoma, a type of intraocular melanoma. […] Younger people have a better prognosis than older people. […] Survival statistics for eye cancer are very general estimates and must be interpreted very carefully.

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