O'Keefe Kelly, Temple Sarah
Program Director, Professor of Clinical Sciences, Florida State University College of Medicine Emergency Medicine Residency, Tallahassee, FL; Sarasota Memorial Hospital, Sarasota, FL
Assistant Professor of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL
Emerg Med Pract. 2020 Apr;22(4):1-28. Epub 2020 Apr 1.
Patients present to the ED with visual disturbances that may be painful or painless and may include loss of visual acuity, field cuts, diplopia, and headache. A detailed history and complete ocular examination are essential to obtaining the correct diagnosis and offering expedited treatment and referral. This review discusses the differential diagnosis for patients experiencing abnormal vision from a nontraumatic or minimally traumatic etiology, and reviews diagnostic and treatment strategies from an evidence-based perspective, including point-of-care ocular ultrasound. Management of the needs of special populations, such as patients with sickle cell disease, HIV, and those with a ventriculo-peritoneal shunt, is reviewed.
患者因视觉障碍前往急诊科，这些视觉障碍可能伴有疼痛或无痛，可能包括视力丧失、视野缺损、复视和头痛。详细的病史和全面的眼部检查对于获得正确诊断以及提供快速治疗和转诊至关重要。本综述讨论了非创伤性或轻度创伤性病因导致视力异常患者的鉴别诊断，并从循证医学角度回顾了诊断和治疗策略，包括即时床旁眼部超声检查。还综述了特殊人群（如镰状细胞病患者、艾滋病毒感染者以及脑室-腹腔分流患者）的需求管理。
