Children commonly present to emergency departments with eye complaints in the absence of antecedent trauma. Signs and symptoms of ocular disease are often nonspecific. Red, swollen, or painful eyes may represent benign or vision-threatening processes, making recognition and triage challenging for the emergency clinician. This issue reviews the presentations of common nontraumatic ocular complaints and provides evidence-based recommendations for management in the emergency department.
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Following are the most informative references cited in this paper, as determined by the authors.
6. * Prentiss KA, Dorfman DH. Pediatric ophthalmology in the emergency department. Emerg Med Clin North Am. 2008;26(1):181-198. (Review) DOI: 10.1016/j.emc.2007.11.001
18. * Wallace DK, Morse CL, Melia M, et al. Pediatric Eye Evaluations Preferred Practice Pattern®: I. Vision screening in the primary care and community setting; II. Comprehensive ophthalmic examination. Ophthalmology. 2018;125(1):P184-P227. (Guideline) DOI: 10.1016/j.ophtha.2017.09.032
22. * McLaughlin C, Levin AV. The red reflex. Pediatr Emerg Care. 2006;22(2):137-140. (Review) DOI: 10.1097/01.pec.0000199567.87134.81
32. * Patel KN. Acute vision loss. Clinical Pediatric Emergency Medicine. 2010;11(2):137-142. (Review) DOI: 10.1016/j.cpem.2010.05.001
36. * Seguin J, Le CK, Fischer JW, et al. Ocular point-of-care ultrasound in the pediatric emergency department. Pediatr Emerg Care. 2019;35(3):e53-e58. (Case series) DOI: 10.1097/pec.0000000000001762
41. * Lee JY, Kim JH, Cho HR, et al. Requirement for head magnetic resonance imaging in children who present to the emergency department with acute nontraumatic visual disturbance. Pediatr Emerg Care. 2019;35 (5):341-346. (Retrospective; 39 patients) DOI: 10.1097/pec.0000000000001506
58. * Kiger J, Hanley M, Losek JD. Dacryocystitis: diagnosis and initial management in pediatric emergency medicine. Pediatr Emerg Care. 2009;25(10):667-669. (Review) DOI: 10.1097/PEC.0b013e3181b922f9
66. * Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013;310(16):1721-1729. (Systematic review; 86 articles) DOI: 10.1001/jama.2013.280318
74. United States Centers for Disease Control and Prevention. “Prevent epidemic keratoconjunctivitis (EKC). “ Accessed January 15, 2020. (CDC guidance)
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Keywords: nontraumatic ocular complaints, nontraumatic ocular conditions, nontraumatic ocular diseases, red eye, red eyes, anterior chamber, blepharitis, eye, eye diseases, eye infections, cataracts, chalazion, chalazia, choroid, ciliary body, conjunctivitis, cornea, fovea, glaucoma, hordeolum, hordeola, hyphema, iris, iritis, Kawasaki, Langerhans cell histiocytosis, macula, nasolacrimal, neuroblastoma, ocular, ophthalmic, optic, pupil, optic nerve, optic neuritis, orbital cellulitis, periorbital cellulitis, pink eye, posterior chamber, retinal artery occlusion, retinal detachment, retrobulbar hemorrhage, retinoblastoma, rhabdosarcoma, sclera, scleritis, stye, uvea, uveitis, vitreous, eye anatomy, vision development, visual acuity, ocular pain, eye discharge, pruritus, photophobia, visual changes, Woods lamp, slit lamp, red reflex, tonometry, ophthalmoscope, ophthalmoscopy, LEA symbols, fluorescein, ocular ultrasound, lacrimal system, dacryostenosis, dacryocystocele, dacryocystitis, dacryoadenitis, neonatal conjunctivitis, childhood conjunctivitis, gonococcal conjunctivitis, chlamydial conjunctivitis, subconjunctival hemorrhage, episcleritis, corneal abrasion, keratitis, vitreous hemorrhage, orbital hemorrhage, transient smartphone blindness
Ammarah Iqbal, MD, MPH; Melissa L. Langhan, MD, MHS, FAAP; Jill Rotruck, MD; Gauthami Soma, MD
Marni Kriegel, MD; Jennifer E. Sanders, MD, FAAP, FACEP
February 2, 2021
March 1, 2024
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