A Letter From the Editor-in-Chief
If you read the credits in this edition of Evidence-Based Urgent Care, you may notice a small change. I call them “credits” because that’s exactly what they are: a point in the publication where we give credit to all the hard work people have done to bring this issue to life. Most people just skim this part, but I usually read all the names and affiliations to see the “Who’s Who” in urgent care. EB Medicine has assembled a tremendous group of leaders in urgent care medicine to bring to you useful, evidence-based information that is helpful in your day-to-day practice, making you a more competent clinician so you can practice at the top of your license. As a reader of Evidence-Based Urgent Care, I want to formally thank the authors, peer-reviewers, and content editors for producing such a fantastic product.
So why am I mentioning this? Let me introduce myself: my name is Tracey Davidoff. I am pleased to announce that I will be assuming the role of Editor-in-Chief of Evidence-Based Urgent Care. I have big shoes to fill in taking over for Dr. Keith Pochick, the first Editor-in-Chief, who successfully launched a product that has become a high-quality educational journal. I would like to thank him for leading the way for this fantastic one-of-a-kind product in urgent care medicine. We wish him all the success in his future endeavors.
But this leaves me with an opportunity. Great organizations often need a change in leadership to jumpstart new offerings, bring new experience and perspectives, and reinvigorate old goals. I hope to bring all these things and more to Evidence-Based Urgent Care. It is my hope that this publication (and its affiliated Urgent Care products) will become the leader in urgent care medicine education, encouraging all Urgentologists (yes, this is a thing now!) to be the best they can be, practicing high-quality evidence-based medicine for the health of all our patients. It’s a tremendous undertaking, and I am humbled to be chosen to be at the helm, leading the way. Stay tuned!
Tracey Quail Davidoff, MD, FCUCM
Meet the Editor-in-Chief
Tracey Quail Davidoff, MD, FCUCM, is board certified in Internal Medicine. She practiced emergency medicine for 18 years before turning her attention to Urgent Care Medicine. Active in the College of Urgent Care Medicine and the Urgent Care Association for more than 10 years, she has over 30 years of experience in teaching, writing, and lecturing on emergency and urgent care topics. She currently works at BayCare Urgent Care in the Tampa Bay area of Florida.
Red eyes are a common presenting complaint in urgent care settings, with causes that range from benign to vision-threatening. A thorough and efficient evaluation of red eyes is critical to identify more serious causes and provide prompt referral if needed. A detailed patient history and eye examination, along with the use of diagnostic tools such as visual acuity testing and fluorescein staining, will guide the urgent care clinician in the assessment. This review provides an evidence-based framework for evaluating red eye presentations in urgent care. Recommendations for management are also offered, including indications for consultation or emergent referral to ophthalmology, along with treatment recommendations for conditions that can be managed in urgent care.
A 23-year-old woman presents with 1 month of mild eye redness and itchiness...
A 35-year-old man presents with 48 hours of redness in his left eye...
A 69-year-old man presents with acute onset of visual loss and redness in his right eye...
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Following are the most informative references cited in this paper, as determined by the authors.
1. * Narayana S, McGee S. Bedside diagnosis of the 'red eye': a systematic review. Am J Med. 2015;128(11):1220-1224. (Systematic review; 5 studies, 957 patients) DOI: 10.1016/j.amjmed.2015.06.026
5. * Chuck RS, Dunn SP, Flaxel CJ, et al. Comprehensive adult medical eye evaluation Preferred Practice Pattern®. Ophthalmology. 2021;128(1):P1-P29. (Guidelines) DOI: 10.1016/j.ophtha.2020.10.024
7. Gurnani B, Kim J, Tripathy K, et al. Iritis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated February 27, 2023. Accessed July 10, 2023. (Online textbook chapter)
8. Singh P, Gupta A, Tripathy K. Keratitis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated February 22, 2023. Accessed July 10, 2023. (Online textbook chapter)
10. * Alteveer JG, McCans KM. The red eye, the swollen eye, and acute vision loss: handling non-traumatic eye disorders in the ED. Emerg Med Pract. 2002;4(6):1-28. (Review)
12. * Gilani CJ, Yang A, Yonkers M, et al. Differentiating urgent and emergent causes of acute red eye for the emergency physician. West J Emerg Med. 2017;18(3):509-517. (Review) DOI: 10.5811/westjem.2016.12.31798
21. Gosling D, Meyer JJ. Normal tension glaucoma. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated December 12, 2022. Accessed July 10, 2023. (Online textbook chapter)
23. * Leibowitz HM. The red eye. N Engl J Med. 2000;343(5):345-351. (Review) DOI: 10.1056/NEJM200008033430507
25. * Timlin H, Butler L, Wright M. The accuracy of the Edinburgh Red Eye Diagnostic Algorithm. Eye (Lond). 2015;29(5):619-624. (Prospective study; 39 patients) DOI: 10.1038/eye.2015.9
27. Baab S, Le PH, Kinzer EE. Allergic conjunctivitis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated May 23, 2022. Accessed July 10, 2023. (Online textbook chapter)
29. * Johnson D, Liu D, Simel D. Does this patient with acute infectious conjunctivitis have a bacterial infection?: The rational clinical examination systematic review. JAMA. 2022;327(22):2231-2237. (Systematic review and meta-analysis; 32 studies) DOI: 10.1001/jama.2022.7687
30. Pippin MM, Le JK. Bacterial conjunctivitis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated January 23, 2023. Accessed July 10, 2023. (Online textbook chapter)
31. * Jacobs DS. Conjunctivitis. In: Post T, ed. UptoDate. 2020. Updated April 11, 2023. Accessed July 10, 2023. (Online textbook chapter)
33. * Tarff A, Behrens A. Ocular emergencies: red eye. Med Clin North Am. 2017;101(3):615-639. (Review) DOI: 10.1016/j.mcna.2016.12.013
34. Schonberg S, Stokkermans TJ. Episcleritis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated September 25, 2022. Accessed July 10, 2023. (Online textbook chapter)
36. Lagina A, Ramphul K. Scleritis. In: StatPearls. NCBI Bookshelf version. StatPearls Publishing; 2023. Updated June 27, 2022. Accessed July 10, 2023. (Online textbook chapter)
41. Hayden FA. Distinguishing dendrites. ASCRS EyeWorld. March 2012. Accessed July 10, 2023. (Online article)
Subscribe to get the full list of 43 references and see how the authors distilled all of the evidence into a concise, clinically relevant, practical resource.
Keywords: red eye, conjunctival injection, viral conjunctivitis, bacterial conjunctivitis, allergic conjunctivitis, dry eye, acute angle-closure glaucoma, scleritis, uveitis, iritis, anterior uveitis, herpesvirus, keratitis, corneal abrasion, foreign body, fluorescein, entropion, trichiasis, episcleritis, subconjunctival hemorrhage
Claude Edward Shackelford, MD
Emily Montgomery, MD, MHPE, FAAP; Cesar Mora Jaramillo, MD, FAAFP, FCUCM
Bradley Laymon, PA-C, CPC, CEMC
August 1, 2023