Evaluation of the Painful Eye

Area of Science:

• Ophthalmology
• Primary Care

Background:

• Eye problems account for 2-3% of primary care and emergency visits.
• Common causes of eye pain include conjunctivitis, corneal abrasion, and hordeolum.
• Serious conditions like acute angle-closure glaucoma and orbital cellulitis can present with eye pain.

Purpose of the Study:

• To outline the diagnostic approach for patients presenting with eye pain.
• To identify key symptoms and examination findings suggestive of serious ophthalmologic conditions.
• To emphasize the importance of timely referral for potential ophthalmologic emergencies.

Main Methods:

• Focusing history on vision changes, foreign body sensation, photophobia, and headache.
• Performing a physical examination including visual acuity and evaluation of ocular structures (conjunctiva, eyelids, cornea, etc.).
• Utilizing diagnostic tools such as fluorescein staining and tonometry when indicated.

Main Results:

• Systematic history and physical examination are essential for diagnosing eye pain causes.
• Certain symptoms and signs may indicate underlying serious conditions requiring immediate attention.
• Referral to ophthalmology is warranted for conditions like acute angle-closure glaucoma, optic neuritis, and infectious keratitis.

Conclusions:

• Eye pain is a significant symptom that warrants thorough evaluation.
• Early recognition of ophthalmologic emergencies through careful assessment is critical.
• Appropriate referral ensures patients receive specialized care for severe eye conditions.