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Minor Ophthalmic and Otic Disorders

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Differentiate between the various ophthalmic disorders based on patient-specific information.

  2. Choose an appropriate treatment regimen for an ophthalmic disorder.

  3. Discuss the product differences that direct the selection of ophthalmic medications.

  4. Assess when further treatment is required based on patient-specific information.

  5. Recommend an ophthalmic monitoring plan given patient-specific information, a diagnosis, and a treatment regimen.

  6. Educate patients about ophthalmic disease states and appropriate drug and nondrug therapies.

  7. Review common otic disorders and appropriate drug and nondrug therapies.

INTRODUCTION

This chapter provides an overview of common ophthalmic and otic disorders and their treatments. Image not available. Many ophthalmic disorders are benign or self-limited, but the clinician must be able to distinguish conditions that lead to serious morbidity, including blindness. Preserving both visual function and cosmetic appearance is the goal.1 The clinician must understand when referral is appropriate and the proper time frame for follow-up, based on the patient-specific condition. Health care professionals should also be aware of common otic disorders that may be encountered.

OCULAR INJURIES

Etiology and Epidemiology

Ophthalmic problems encompass 3% of all emergency department visits.2 Corneal abrasions are the most common eye injury in children. Scratches, objects, and aggressive eye rubbing may damage the cornea.3 Health care practitioners must know the proper treatment for ocular emergencies and the time frame for follow-up in order to prevent further morbidity (Table 62–1).

Table 62–1Ophthalmic Emergencies: Time to Follow-Up by Ophthalmologist

CORNEAL ABRASIONS

Treatment

Desired Outcomes

  • Complete healing of the corneal abrasion with no scarring or vision impairment

  • Prevent infection and pain

  • Prevent corneal loss or corneal transplant

General Approach to Treatment

The five layers of the cornea contain no blood vessels but are nourished by tears, oxygen, and aqueous humor. Minor corneal abrasions, also called corneal epithelial defects, heal quickly—typically within 24 hours.4 Moderate abrasions take 24 to 72 hours to heal. Deep abrasions may scar the cornea. This rarely results in sufficient visual impairment to require corneal transplant. Patients should be instructed not to rub the eye if a corneal abrasion is present. Do not use eye patches to ...

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