Vision Change Case 2 - Faculty Comments for Question 5

Faculty Comments - Vision Change Case 2 - Answer 5:

Question 5: If you could only check two things on the eye exam, what would you choose?

Answer:

The History: scleritis usually has pain, conjunctivitis has minimal (if any)
Etiologies/probabilities: conjunctivitis is far more common

Physical Exam: the specific area/shape of the injection.

Episcleritis is often sectional.

Conjuctivitis has less/no injection around the iris.

Scleritis: Localized, raised hyperemic lesion Usually painful Uncommon, often protracted. Has an association with collagen, vascular and rheumatoid diseases.

Episcleritis: Flat, involving more superficial tissue. Often sectional. Can be painful Uncommon. Usually not associated with serious systemic disease. Source may be allergic.

Conjunctivitis: Note that the area around the iris (perilimbal region) is much less injected. Rarely, minimally painful.
Is only eye pathology that’s “itchy”
Etiology can be viral, bacterial, allergic or irritative.

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Penn State Milton S. Hershey Medical Center Š2004
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Scleritis: Localized, raised hyperemic lesion	Usually painful	Uncommon, often protracted. Has an association with collagen, vascular and rheumatoid diseases.
Episcleritis: Flat, involving more superficial tissue. Often sectional.	Can be painful	Uncommon. Usually not associated with serious systemic disease. Source may be allergic.
Conjunctivitis: Note that the area around the iris (perilimbal region) is much less injected.	Rarely, minimally painful. Is only eye pathology that’s “itchy”	Etiology can be viral, bacterial, allergic or irritative.