Websites on red eye management

Recommended websites relating to red eye by Dr Keith Barnard

Eye images
This website will not teach you much in the way of management, but it will certainly give you a reference point if you are not sure about the appearance of an eye. Just browsing through an image library like this is an education in itself.

I take my hat off to the doctors who compiled this, and then after all their efforts let anyone look at it for free. What an altruistic lot physicians can be.

This website is regularly updated, and the layout is excellent. It is subdivided by location, so has sections on the anterior chamber, cornea, conjunctiva, eyelid, lens and orbit.

You will find most red eye cases under cornea and conjunctiva, but it is all good stuff.
 
The quality of the images is first class, even when you click on a thumbnail for the enlarged version.

Why go there: look and learn.
Downside: no clinical information.
Information from: Eye Atlas online.
Address: www.eyeatlas.com/Eyeatlas/Home.html


Antibiotic use for conjunctivitis
I nearly did not bother with this article because the web address is so long. But then I thought, of course, you can go to healthcarerepublic.com/clinical for the link.

These pages report on a piece of research that examined the different strategies for prescribing antibiotics for bacterial conjunctivitis in general practice.

I would have have been a little happier if an actual GP was one of the authors, because research like this needs a worker bee’s perspective.

The conclusions are interesting, because if antibiotic prescribing was delayed, it was associated with reduced antibiotic use and reduced re-attendance.

This was deemed a good thing because the condition was not medicalised, and if prescribing was delayed or omitted, patients reported being less likely to return for more antibiotics for a recurrence.

Now, I am not so sure this is of benefit. The next time the patient might ignore a dentritic ulcer or acute glaucoma. But then, what do I know?

Well, I know that antibiotics for conjunctivitis are cheap, the consultation is quick and the patient goes away happy.

It may not be very scientific, but it sounds alright to me.

Why go there: to see if you nod in agreement.
Downside: wait until you are not busy to read it.
Information from: British Medical Journal.
Address: www.bmj.com/cgi/reprint_abr/333/7563/321.pdf


Dendritic ulcers
I remember becoming excited the first time I diagnosed herpes simplex keratitis in a patient, because after flourescein staining the lesion had a certain delicate beauty.

The patient did not share my enthusiasm. The images on this page reminded me of this incident, because these ulcers are more like snowflakes — all different. But we must not be deceived, they do not melt away, and need careful management.

Why go there: two superb images.
Downside: not much detail.
Information from: University of Toronto.
Address: http://eyelearn.med.utoronto.ca/Lectures04-05/RedEye/11Keratitis.htm 

Website of the week

I have recommended this site in the past when discussing the red eye in primary care, and it’s still hard to beat.

Nowhere have I found such a succinct, well illustrated, colourful and easily downloadable account.

As the author points out, GPs probably see most red eyes in the first instance and we all worry about whether we are going to miss an acute angle glaucoma, an iritis or a corneal ulcer.

There is no substitute for experience, but these pages offer guidelines to try and make sure the pitfalls are avoided.

All the acute bacterial, viral and allergic conditions are described, as well as the less common but equally important diagnoses.

There is also an excellent management algorithm that on its own makes this site worth a visit.

You cannot go wrong, and if you have a decent colour printer, I suggest you print off a copy and keep it for reference.

Why go there: excellent summary.
Downside: none.
Information from: University of Ottawa Eye Institute, Canada
Address: www.eyeinstitute.net/redeye.pdf

 

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