St. Luke's Rural Family Medicine Residency - Miners, 34 S Railroad St, Tamaqua, PA 18252.
FP Essent. 2022 Aug;519:11-18.
In primary care practices and emergency departments, approximately 2% to 3% of visits are related to eye conditions. The most common diagnoses are corneal abrasion, corneal foreign body, conjunctivitis, external hordeolum (stye), and subconjunctival hemorrhage. This section addresses hordeolum, chalazion, conjunctivitis, corneal abrasion, and corneal foreign body. A thorough history and physical examination are crucial for patients with these conditions, and frequently are sufficient for diagnosis. Conservative therapies are first-line treatments for hordeolum and chalazion, including application of warm compresses, eyelid scrubs, and eyelid massage. Conjunctivitis is the most common etiology of red eye and has infectious and noninfectious causes. Bacterial conjunctivitis typically resolves in 1 to 2 weeks, but can be managed with topical antibiotic solutions or ointments. Viral conjunctivitis management involves frequent handwashing and use of cool compresses and artificial tears. Corneal abrasion is the most common eye injury seen in emergency departments, and corneal foreign body is the second most common. Topical antibiotics and cycloplegics are mainstay therapies for corneal abrasion, with consideration of topical nonsteroidal anti-inflammatory drugs for pain management. Follow-up visits are recommended for select patients. Management of corneal foreign body requires prompt removal of the object, pain management, consideration of prophylactic antibiotics, and follow-up when appropriate.
在初级保健诊所和急诊部门，大约 2%至 3%的就诊与眼部状况有关。最常见的诊断包括角膜擦伤、角膜异物、结膜炎、外麦粒肿（霰粒肿）和结膜下出血。本节介绍麦粒肿、霰粒肿、结膜炎、角膜擦伤和角膜异物。对于这些疾病的患者，详细的病史和体格检查至关重要，通常足以做出诊断。对于麦粒肿和霰粒肿，包括热敷、眼睑擦洗和眼睑按摩在内的保守治疗是一线治疗方法。结膜炎是眼红最常见的病因，有感染性和非感染性原因。细菌性结膜炎通常在 1 至 2 周内痊愈，但可以通过局部抗生素溶液或眼膏进行治疗。病毒性结膜炎的治疗包括经常洗手和使用冷敷和人工泪液。角膜擦伤是急诊室最常见的眼部损伤，角膜异物是第二常见的。对于角膜擦伤，局部抗生素和睫状肌麻痹剂是主要的治疗方法，对于疼痛管理，可以考虑局部非甾体抗炎药。建议对某些患者进行随访。角膜异物的处理需要迅速取出异物、疼痛管理、考虑预防性抗生素治疗，并在适当情况下进行随访。
