PC2Exam1part3

Viral and Bacterial Sinusitis

• Nasal congestion, facial pain/pressure, postnasal drip, purulent nasal discharge, headache, cough, and fever are all signs and symptoms
• Physical exam involves inspecting the nose for redness, swelling, and discharge
• Tenderness can be elicited from percussion of the sinuses
• Transillumination may show opacity in the sinuses
• Severe headache, high fever, or altered mental status may indicate complications like an abscess
• Clinical diagnosis, imaging (CT scan) is suspected if complications or chronic symptoms
• Viral infections are treated with supportive care like decongestants, nasal saline, and rest
• Bacterial infections are treated with antibiotics, such as amoxicillin-clavulanate
• Encourage fluid intake, proper nasal hygiene, and avoidance of irritants in patient education
• Referral to an ENT specialist is needed if symptoms persist for >12 weeks or complications arise
• Follow up if symptoms worsen or persist beyond 7-10 days

Hearing Loss

• Decreased ability to hear, difficulty understanding speech, and tinnitus are signs and symptoms
• Physical exam includes otoscopic examination for ear canal obstruction and tuning fork tests (Weber, Rinne) and audiometry
• Sudden hearing loss, associated with vertigo or neurological deficits, may indicate a serious condition like acoustic neuroma
• Audiometry and tympanometry are used for diagnostics
• Treatment is based on the etiology such as removing obstructions for conductive loss
• Hearing aids or cochlear implants may be needed for sensorineural
• Avoid loud noises and protect ears from damage in patient education
• Referral to an audiologist or ENT if sudden or progressive hearing loss is noted
• Regular follow-up is important to monitor progress and audiological function

Allergic Rhinitis

• Sneezing, nasal congestion, watery eyes, itchy nose, and throat are signs and symptoms
• Physical exam reveals pale, boggy nasal mucosa, clear nasal discharge, and conjunctival injection
• Severe, unrelenting symptoms or complications like sinusitis or asthma exacerbations are red flags
• Clinical diagnosis is based on history and symptoms while skin testing is used for allergens
• Antihistamines, intranasal corticosteroids, decongestants, and allergen avoidance are treatments
• Encourage environmental controls such as air purifiers, avoiding allergens, and using nasal saline in patient education
• Referral to an allergist if symptoms are severe or not controlled with standard treatments
• Follow-up in 1-3 months to assess treatment efficacy and adjust if necessary

Impacted Cerumen

• Ear fullness, decreased hearing, discomfort, and itching are signs and symptoms
• Physical exam involves inspecting ear canal with an otoscope, where impacted wax may be visible
• Pain or drainage could suggest an infection, such as otitis externa and are considered red flags
• Clinical diagnosis is done through an otoscopic exam
• Cerumen removal using warm water irrigation or cerumenolytic agents (e.g., carbamide peroxide) are treatment options
• Advise against using cotton swabs in the ear canal for patient education
• Referral to ENT is warranted if cerumen impaction is recurrent or if there are complications

Epistaxis (Nosebleed)

• Bleeding from the nostrils, often sudden and profuse is a sign and symptom
• Physical exam includes visual inspection of the nasal cavity for bleeding sites and checking for signs of systemic bleeding disorders
• Recurrent or severe epistaxis may signal bleeding disorders, such as thrombocytopenia or clotting factor deficiencies which are red flags
• Usually clinical; labs if a bleeding disorder is suspected
• Direct pressure, nasal decongestants, or cauterize the site if persistent for treatment.
• Avoid picking the nose, and use humidifiers to prevent dryness for patient education
• Referral to an ENT specialist for persistent cases or if packing is required
• Follow up if bleeding recurs or is difficult to control

Foreign Body in the Ear

• Pain, fullness, decreased hearing, or drainage are signs and symptoms
• Inspect with an otoscope to identify foreign objects is part of the physical exam
• Avoid attempting removal without proper equipment if a foreign body is deeply embedded or causing significant pain and is considered a red flag
• Diagnostics include visual inspection with an otoscope
• Removal under proper technique is recommended to avoid injury to the ear canal.
• Advise caution with inserting objects into the ear canal in patient education
• Referral to ENT is warranted if the object cannot be removed or complications arise
• Follow-up if there are any signs of infection or if symptoms persists

Periorbital Cellulitis

• Redness, swelling, and warmth around the eyes, with or without fever are signs and symptoms
• Physical exam involves inspection for swelling, redness, and tenderness around the eyelids and check for any ocular involvement
• Proptosis, visual changes, or pain with eye movement are red flags and suggest orbital cellulitis, which requires urgent treatment

Eustachian Tube Dysfunction

• Ear fullness, muffled hearing, popping sounds in the ears, and discomfort are signs and symptoms
• Physical exam may show a normal tympanic membrane, a pneumatic otoscopy can show limited mobility
• Severe pain, fever, or hearing loss are red flags and might indicate acute otitis media or infection
• Diagnosis is usually clinical, audiometry or tympanometry can be used for further evaluation
• Decongestants, nasal steroids, or autoinflation are used for mild cases in treatment
• Avoid sudden pressure changes (e.g., in air travel) in patient education
• Referral to ENT is needed if symptoms persist for over 3 months or if complications arise
• Follow-up in 4-6 weeks to reassess

Nasopharyngitis

• Runny nose, cough, sore throat, mild fever, red throat, nasal congestion, clear nasal discharge are signs and symptoms
• Severe fever, difficulty breathing, or altered mental status are considered red flags
• Clinical diagnosis is used for diagnostics
• Treatment is symptomatic: fluids, analgesics, saline nasal spray
• Patient education includes rest, hydration, and over-the-counter remedies for symptom relief
• Referral is warranted if symptoms persist >10 days or complications arise
• Follow-up if symptoms worsen or persist.

Otitis Media with Effusion (OME)

• Ear fullness, muffled hearing, no pain or fever are signs and symptoms
• Physical exam using otoscopic exam shows a dull, retracted tympanic membrane with fluid behind it
• Pain or fever suggests acute otitis media and is considered a red flag
• Otoscopic examination is used in diagnostics
• Observation if mild is treatment
• Tympanostomy tubes are used for recurrent cases
• Patient education includes encouraging fluid intake and avoid irritants
• ENT if recurrent or persistent should be referred
• Follow up in 3-6 months if symptoms persist

Pharyngitis/Tonsillitis

• Sore throat, fever, and difficulty swallowing are signs and symptoms
• Physical exam reveals red, swollen tonsils with or without exudate and anterior cervical lymphadenopathy
• Difficulty breathing, drooling, or muffled voice suggests peritonsillar abscess are red flags
• Rapid strep test or throat culture or needed for diagnostics
• Antibiotics if group A streptococcus confirmed for treatment
• Patient education include rest, hydration, and complete the full course of antibiotics
• ENT if symptoms persist or for recurrent tonsillitis is needed for referral
• Follow-up if symptoms persist or worsen

Otitis Externa

• Ear pain, itching, and discharge from the ear are signs and symptoms
• Physical exam reveals tenderness on manipulation of the auricle, otoscopic findings of edema and discharge
• Severe pain, fever, or hearing loss may indicate deeper infection are considered red flags
• Clinical diagnosis is used in diagnostics
• Treatment include topical antibiotics --ciprofloxacin and analgesics
• Keep ears dry and avoid inserting objects into the ear for patient education
• ENT if symptoms persist or there are complications like cellulitis is needed for referral
• Follow-up within a week if symptoms do not resolve

Epiglottitis

• Severe sore throat, fever, difficulty swallowing (dysphagia), drooling, stridor (high-pitched breathing sounds), and tripod positioning are signs and symptoms
• Physical examination inspection may reveal a swollen, inflamed epiglottis, laryngoscopy can confirm the diagnosis if necessary
• Respiratory distress, stridor, and inability to swallow are considered red flags and indicate potential airway compromise, which requires urgent intervention
• Direct visualization via laryngoscopy and neck x-rays showing a "thumbprint" sign are used for diagnostics
• Secure the airway using intubation or tracheostomy for treatment
• IV antibiotics which can include ceftriaxone and cefotaxime and corticosteroids for treatment
• Educate patients on the importance of seeking care for severe sore throats, especially in children for patient education
• Emergency referral for airway management and IV antibiotics is needed for referral
• Close monitoring in a hospital setting with follow-up if any residual issues arise

Acute Otitis Media (AOM)

• Ear pain (otalgia), fever, irritability, hearing loss, and tugging at the ear in infants are signs and symptoms
• Physical exam includes Otoscopic exam reveals a red, bulging tympanic membrane, effusion, and decreased tympanic membrane mobility
• Severe pain, high fever, or hearing loss indicate complications, like mastoiditis
• Clinical diagnosis is based on otoscopic findings. Tympanometry can assess middle ear function
• Amoxicillin or amoxicillin-clavulanate for bacterial infections are first-line treatment
• Acetaminophen or ibuprofen used manage pain
• Emphasize adherence to antibiotic regimens, proper ear care, and preventing recurrence by avoiding exposure to respiratory infections in patient education
• Referral to ENT if symptoms persist for more than 48-72 hours, or if complications like mastoiditis develop
• Follow-up in 1-2 weeks for persistent symptoms

Infectious Mononucleosis (Mono)

• Fever, sore throat, lymphadenopathy, fatigue, and splenomegaly are signs and symptoms
• Physical exam findings include enlarged tonsils with exudate, red throat, and swollen lymph nodes
• Difficult breathing, severe abdominal pain (splenic rupture), or jaundice are red flags
• Monospot test or EBV serology is used for diagnostics and a CBC may show atypical lymphocytes
• Supportive care: Rest, hydration, analgesics --acetaminophen, and avoiding strenuous activities, especially contact sports, to prevent splenic rupture
• Advise avoiding aspirin due to Reye's syndrome risk, and recommend rest to promote recovery
• Referral for complications, such as splenic rupture or severe tonsillar swelling may be required
• Follow-up if there is persistent fatigue or complications

Mastoiditis

• Postauricular pain, erythema, swelling behind the ear, fever, and protrusion of the auricle are signs and symptoms
• Physical exam will have tenderness over the mastoid, redness, and swelling behind the ear
• High fever, severe pain, inability to move the ear, or swelling of the mastoid process are red flags
• CT scan or MRI is used to confirm diagnosis and assess the extent of the infection
• IV antibiotics like ceftriaxone, cefotaxime and possibly surgical drainage are used for treatment
• Educate on completing antibiotics and avoiding recurrence for Patient Education
• Urgent referral to ENT for possible surgical intervention is needed for referral
• Follow-up in 48-72 hours to assess treatment response

Peritonsillar Abscess

• Severe sore throat, fever, difficulty swallowing, "hot potato" voice, and trismus are signs and symptoms
• Physical exam reveals asymmetric tonsils with visible pus/fluctuation and tender cervical lymphadenopathy
• Severe airway obstruction or difficulty breathing may require immediate attention and are red flags
• Diagnostics include needle aspiration or incision and drainage to confirm the abscess
• Treatment include IV antibiotics like penicillin and clindamycin and drainage of the abscess
• Emphasize the importance of completing the antibiotic regimen in patient education
• Referral to ENT for drainage and further management is needed for referral
• Follow-up in 48-72 hours to ensure resolution

Red Eye (Conjunctivitis)

• Redness, irritation, tearing, discharge (watery or purulent), and a foreign body sensation are signs and symptoms
• Physical exam will reveal conjunctival injection like redness and discharge and to examine for corneal involvement
• Pain, photophobia, or vision changes may indicate keratitis or iritis and are considered to be red flags
• Fluorescein staining to evaluate for corneal ulcers
• Culture may be needed for bacterial infections in diagnostics
• Bacterial conjunctivitis can be managed with topical antibiotics like erythromycin and ciprofloxacin
• Viral conjunctivitis treated with symptomatic treatment, like cool compresses and artificial tears
• Advise on hygiene, like handwashing, not sharing towels, and avoiding contact lens use in patient education
• Referral to ophthalmology is needed if vision changes, severe pain, or suspected keratitis
• Follow-up if symptoms persist or worsen

Dental Abscess

• Severe toothache, gum swelling, fever, and possible pus drainage are signs and symptoms
• Swelling, redness, and tenderness in the gums, possible drainage of pus from the abscess are noted in a physical exam
• Fever, difficulty swallowing, or breathing difficulties could indicate a spreading infection and are red flags
• Diagnostics include x-rays to assess the extent of the infection
• Treatment includes drainage of the abscess and antibiotics like amoxicillin or clindamycin
• Possible root canal therapy or extraction may be needed
• Emphasize the importance of following up with a dentist for permanent resolution in Patient Education
• Referral to a dentist for definitive treatment may be needed
• Follow-up within 48-72 hours to ensure resolution of infection

Conjunctivitis (Pink Eye)

• Redness, itching, burning, discharge (watery or mucopurulent), and foreign body sensation are signs and symptoms
• Physical exam will reveal Conjunctival injection and discharge and aid differentiation between viral, bacterial, and allergic causes
• Pain, light sensitivity, or vision changes suggest keratitis or corneal involvement in Red Flags
• Clinical diagnosis with possible cultures for bacterial infections
• Viral conjunctivitis is managed with supportive care like cool compresses and artificial tears
• Bacterial conjunctivitis is managed with topical antibiotics
• Encourage hygiene practices via handwashing and avoiding contact lens use during infection in patient education
• Referral if there are complications, such as vision changes, or a corneal ulcer is suspected

Temporomandibular Joint (TMJ) Dysfunction

• Jaw pain, clicking or popping sounds, difficulty opening the mouth, and headaches are signs and symptoms
• Physical exam involves palpate the TMJ for tenderness and check for restricted jaw movement
• Severe pain, restricted jaw movement, or difficulty chewing may indicate more serious conditions and are considered red flags
• X-rays or MRI to is used to assess joint alignment or cartilage damage in diagnostics
• NSAIDs, jaw exercises, and a soft diet are treatment options and night guards may be recommended to prevent teeth grinding
• Advise relaxation techniques, posture correction, and avoiding excessive jaw movements in patient education
• Referral to a dentist or orthodontist for night guard therapy or further management
• Follow-up in a few weeks if symptoms persist or worsen

Blepharitis

• Red, swollen eyelids, crusting along the lashes, itching, and burning are signs and symptoms
• Physical exam finding will include eyelid inflammation with possible debris at the lash line
• If symptoms don't improve with basic treatment or if there is involvement of the cornea, further evaluation is necessary and this is considered a red flag
• Diagnosis is typically clinical, though culture may be performed for recurrent cases
• Warm compresses and lid scrubs and topical antibiotics like erythromycin may be used for bacterial involvement for treatment
• Patient education includes Emphasize regular eyelid hygiene and warm compresses
• Referral to ophthalmology symptoms do not improve with home management
• Follow-up in 1-2 weeks to assess symptom resolution

Hand-Foot-Mouth Disease

• Fever, vesicular rash on the hands, feet, and oral mucosa, and painful sores are signs and symptoms
• physical exam will reveal oral ulcers with a characteristic rash on hands and feet
• Severe pain or dehydration like inability to drink fluids may require hospitalization and are considered red flags
• Clinical diagnosis; PCR test for enterovirus if needed
• Patient is treated with Symptomatic care, like hydration, pain relief -acetaminophen, and oral analgesics for mouth sores
• Patient education includes advise good hygiene and isolation to prevent transmission
• Referral is rarely needed unless complications arise
• Follow-up if symptoms worsen or if dehydration occurs

Hordeolum (Stye)

• Painful, red, swollen eyelid with a localized bump, often near the lash line are signs and symptoms
• Physical exam you will find tenderness and erythema around the affected eyelash follicle
• If the stye does not resolve or worsens, it may be a chalazion or other deeper infection requiring drainage and are considered red flags
• Clinical diagnosis based on appearance and culture if it is recurrent or severe for diagnostics
• Treatment includes warm compresses and topical antibiotics like bacitracin or erythromycin
• In patient education you should emphasize Eyelid hygiene and avoiding squeezing the stye
• Referral if it doesn't resolve within a few days or if recurrent
• Follow-up in 1-2 weeks if symptoms persist

Thrush (Oral Candidiasis)

• White, cottage cheese-like lesions on the tongue, gums, and inner cheeks signs and symptoms
• Physical exam Lesions that can be scraped off, leaving a red, inflamed surface underneath
• If thrush is associated with pain or difficulty swallowing, further investigation for systemic infections and this is considered a red flag
• Clinical diagnosis or KOH preparation to confirm fungal elements during diangostics
• Treatment includes antifungal therapy like Nystatin or fluconazole
• Patient is educated about proper oral hygiene and complete the full course of antifungals
• Referral to a specialist if thrush recurs or is severe for referral
• Follow-up in 1-2 weeks if symptoms persist

Chalazion

• Painless, firm nodule on the eyelid, usually on the upper lid for signs and symptoms
• Physical Exam: Firm, round mass without redness or swelling
• If a chalazion is recurrent or very large, it may need surgical excision and are considered red flags
• Diagnostics includes clinical diagnosis and biopsy is rarely required unless malignancy is suspected
• Warm compresses and lid massages for treatment and if persistent, consider intralesional steroid injections or surgical excision
• Patient Education should advise warm compresses and patience as chalazia may take time to resolve.
• Referral to an ophthalmologist if no improvement after a few weeks is needed for referral
• Follow-up if the chalazion does not resolve after conservative management

Stomatitis

• Painful inflammation of the mucous membranes in the mouth, with lesions like ulcers or vesicles, erythema, and difficulty eating swallowing
• Physical Exam findings include Oral lesions on the inner cheeks, tongue, gums, or lips, often surrounded by erythema
• Red Flag includes if symptoms persist for more than 10 days or if there are signs of systemic involvement like fever and malaise, further evaluation for systemic infections may be required
• Clinical diagnosis based on the appearance of lesions is used in diagnostics
• Viral cultures or PCR tests --for herpes simplex virus or KOH prep --for fungal infections may be used if necessary
• Treatment includes Topical anesthetics e.g., lidocaine gel, antivirals like acyclovir for HSV, or antifungal treatments e.g., nystatin for oral thrush
• Patient education includes advise avoiding irritants like spicy foods and alcohol and maintaining good oral hygiene
• Emphasize the importance of rest and hydration.
• Referral to an oral specialist or ENT if symptoms persist beyond 10 days, are recurrent, or if systemic complications arise
• Follow-up in 1-2 weeks if no improvement or if additional symptoms develop

Ocular Foreign Body

• Sensation of something in the eye, redness, tearing, pain, and possibly decreased vision for a foreign body in the eye
• Physical exam includes inspection of the eye for visible foreign bodies by using a slit lamp or fluorescein stain to check for abrasions
• Red Flags include If the foreign body is not easily removed or if there is vision loss, trauma, or a significant corneal abrasion, the patient should be referred immediately for further evaluation
• Slit lamp examination or fluorescein staining is done to identify corneal abrasions and foreign bodies
• Removal of the foreign body using a sterile technique, such as irrigation or forceps --depending on size and location is used for treatment
• Antibiotic ointments e.g., erythromycin may be prescribed post-removal.
• Instruct patients to avoid rubbing the eye in patient education
• Advise wearing protective eyewear for high-risk activities.
• Referral to an ophthalmologist if the foreign body cannot be removed or if complications occur

Herpangina

• Sudden fever, sore throat, and small, painful vesicles or ulcers on the back of the throat, soft palate, or uvula are signs and symptoms
• Physical exam includes small white or grayish ulcers with a red halo on the soft palate and uvula
• If the patient develops difficulty swallowing, dehydration, or respiratory distress, referral is necessary red flags
• Clinical diagnosis based on symptoms and appearance is used for diagnostics
• Symptomatic treatment provided with pain relief --use acetaminophen for example, hydration, and avoiding irritants
• Oral analgesics, acetaminophen and antipyretics for fever can be used as well.
• Encourage hydration, rest, and good oral hygiene in patient education
• Referral if there are complications, such as dehydration, or if the patient has a weakened immune system
• Follow-up if symptoms worsen or if dehydration occurs

Iritis/Uveitis/Keratitis

• Eye pain, photophobia, redness, blurred vision, and excessive tearing are signs and symptoms
• Examination findings Physical exam findings: Conjunctival injection --particularly around the cornea, irregular pupil --in iritis, and possible corneal involvement in keratitis
• Severe pain, vision changes, and photophobia suggest an urgent need for referral are red flags
• Slit lamp exam for iritis, fluorescein staining for keratitis, and intraocular pressure measurement for uveitis is used in diagnostics
• Treatment includes Topical corticosteroids and cycloplegic agents --for iritis and antibiotic eye drops --for keratitis and systemic corticosteroids for uveitis if needed
• Advise avoiding eye strain in patient education
• Keep eyes covered in bright light, and attending follow-up exams promptly
• Urgent referral to ophthalmology for suspected iritis, uveitis, or keratitis, especially if there is visual disturbance is needed for referral
• Follow-up within 24-48 hours if the condition is severe or if there is suspicion of complications

Aphthous Ulcer (Canker Sores)

• Painful, shallow ulcers with a white or yellowish center and a red border, typically on the inner cheek or lips are signs and symptoms
• Physical exam shows Shallow, round ulcer with erythematous borders, often recurrent and self-limiting.
• Large ulcers, ulcers lasting more than 2 weeks, or associated with systemic symptoms --like fever and weight loss suggest a need for referral red flags
• Clinical diagnosis, though biopsy may be needed for persistent or severe cases to rule out underlying conditions like autoimmune disorders.
• Treatment includes Topical corticosteroids like triamcinolone, antiseptic mouth rinses, and pain relief with oral analgesics, such as benzocaine
• Recommend avoiding irritants like spicy foods and stress management in patient education
• Good oral hygiene can reduce frequency.
• Referral if the ulcers are unusually large, painful, or recurrent, or if an underlying condition such as Crohn's disease is suspected
• Follow-up if ulcers persist beyond 2 weeks or worsen

Acute Angle Closure Glaucoma

• Severe, sudden eye pain, headache, nausea/vomiting, blurred vision, and halos around lights are signs and symptoms
• Mid-dilated, non-reactive pupil, conjunctival redness, and possible corneal edema are noted on physical exam
• Immediate referral is necessary as this condition can result in permanent vision loss within hours without treatment for red flags
• Tonometry is used to measure intraocular pressure, gonioscopy to assess the angle of the anterior chamber
• Treatment with Immediate medical intervention with IV acetazolamide, topical beta-blockers, and hyperosmotic agents like mannitol
• Laser iridotomy or iridectomy is often required.
• Patient Education emphasize the urgency of seeking care if any of the symptoms develop
• Emergency referral to ophthalmology for management and possible surgical intervention is needed
• Urgent follow-up within 24 hours is needed to ensure IOP control

Corneal Abrasion

• Sudden onset of severe eye pain, foreign body sensation, tearing, and redness are signs and symptoms
• Fluorescein staining reveals a defect in the corneal epithelium on the physical exam
• If there is persistent pain, significant vision loss, or signs of infection like purulent discharge, refer urgently for red flags
• Fluorescein staining is used to highlight the abrasion, and slit lamp examination for deeper lesions
• Topical antibiotics like erythromycin ointment, and oral analgesics for pain is treatment
• Patch therapy is not routinely recommended.
• Instruct on proper eye care and the importance of avoiding contact lenses until the cornea is healed in patient education
• Referral if the abrasion is large, deep, or complicated by infection
• Follow-up within 24-48 hours to ensure healing

Subconjunctival Hemorrhage

• A bright red area in the white part of the eye --sclera due to a broken blood vessel are signs and symptoms
• Physical exam: No pain, no visual disturbance, and no discharge, with a clear, intact cornea
• If there is associated pain, vision changes, or recurrent hemorrhages, consider underlying conditions like bleeding disorders red flags
• Clinical diagnosis based on appearance, with a history of trauma or other risk factors like anticoagulant use.
• No treatment is required for most cases, reassurance and monitoring
• Explain that the condition is usually benign and self-limiting
• Encourage avoiding activities that may increase pressure e.g., heavy lifting in patient education
• Referral if associated with recurrent hemorrhages, trauma, or underlying systemic conditions
• Follow-up if the hemorrhage does not resolve after 2-3 weeks

Nasolacrimal Duct Obstruction

• Chronic tearing or watery eyes, particularly in infants or older adults are signs and symptoms
• Physical Exam: Pressure applied to the lacrimal sac may express discharge through the puncta
• If infection or abscess develops indicating dacryocystitis, refer immediately for treatment and is a red flag
• Diagnostics include clinical diagnosis, with possible lacrimal duct probing or dacryocystography if the obstruction is persistent
• Infant treatment involves massage and warm compresses
• Adult treatment may need surgical intervention like dacryocystorhinostomy.
• Patient Education includes Advise cleaning the area around the eye and ensuring proper hygiene
• Referral is needed to an ophthalmologist if symptoms persist or worsen
• Follow-up if no improvement in 4-6 weeks

Hyphema

• Blood in the anterior chamber of the eye, blurred vision, pain, and light sensitivity are the signs and symptoms
• Physical Exam involves visible blood in the lower part of the iris or anterior chamber upon slit lamp examination
• Immediate referral to an ophthalmologist is required for management, especially if the blood is affecting vision are red flags
• Slit lamp examination is preformed to confirm the presence of blood
• Also intraocular pressure measurement can be done to assess for glaucoma.
• Treatment involves bed rest with an elevated head position
• Avoidance of anticoagulants is also advised
• Explain the need for rest and avoid activities that increase pressure in the eye and is used for patient education
• Urgent referral to ophthalmology for evaluation and management is needed in this case
• Follow-up in 24-48 hours to monitor for complications, such as increased intraocular pressure or rebleeding is needed