Diagnostic Quiz
Stubborn 'Pink Eye'
Requires Attention
Andrew S. Gurwood, O.D.
A 24-year-old woman presented to the clinic with a chief complaint of “severe pink eye” for the past week. The photo shows what she looked like. She had no history of prior ocular disease, injury or surgery. Her systemic history likewise was uneventful. She denied any significant social history, and all other historical data was noncontributory.
How would you approach this case? Read on for further details about
the patient’s visit. Then test your clinical skills by coming up with the
appropriate diagnosis and management.
 |
| After a week of involvement with no sign that things were getting better, a 24-year-old woman came to us with this presentation. The patient’s ocular history was uneventful. |
How would you approach this case? Read on for further details about
the visit. Then test your clinical skills by checking your diagnosis with
the correct answer.
Best-corrected visual acuities were 20/40 in the right eye, 20/30 in the left at distance and near. The external examination was normal with no evidence of an afferent pupillary defect. The patient reported no photophobia or pain on extraocular muscle movement. There was no significant palpable preauricular lymph node. Refraction revealed myopia with astigmatism and presbyopia in both eyes.
Slit lamp biomicroscopy demonstrated a mild inferior folliculosis, a mild inferior corneal epitheliopathy and moderate conjunctival injection in each eye. The internal anterior segment structures appeared normal. The angles were measured as open by the von Herrick method in each eye. Goldmann applanation pressures measured 18mm Hg in each eye. The dilated fundus examination revealed healthy-looking optic nerves, posterior poles and peripheries in each eye.
Are there any additional tests you require? What are the differential diagnoses? What is your diagnosis? How would you manage this patient?
Check your answer.
Or, call (610) 492-1050
April 15, 2000