Man with an eye infection I saw

[RLK]

Advertisement - Members don't see this ad

I work at a pharmacy and this man and his friend came in after work. They were doing some kind of construction. The one man, who couldn't speak much english had the worst looking eyes I've ever seen. They were so red. He was kind of laughing about it for some reason. I doubt he'll get it checked out either because he didn't seem to know what the pharmacist was talking about when she suggested going to a doctor. I felt really bad for the guy because I imagine he could probably go blind if he doesn't get them checked out. If I would have thought about it, I might have given him the number of the OD that I shadowed.

 

[drbizzaro]

I work at a pharmacy and this man and his friend came in after work. They were doing some kind of construction. The one man, who couldn't speak much english had the worst looking eyes I've ever seen. They were so red. He was kind of laughing about it for some reason. I doubt he'll get it checked out either because he didn't seem to know what the pharmacist was talking about when she suggested going to a doctor. I felt really bad for the guy because I imagine he could probably go blind if he doesn't get them checked out. If I would have thought about it, I might have given him the number of the OD that I shadowed.

bad if it's pseudomonas

 

[cpw]

if they were doing construction he probably got something in his eye... or scratched them up. there are MANY MANY possibilities... and he definitely should see a doctor.

 

[Richard_Hom]

bad if it's pseudomonas

Dear drbizzaro,

If it was pseudomonas, the patient would have 9/10 ocular pain with significant photophobia. I believe the original poster didn't include that. Many florid appearing eyes are conjunctival in nature without corneal involvement. Thus there wouldn't necessarily be a sight threatening component. Of course, I would still recommend an evaluation.

If you work in modest surroundings, you will learn to "triage" appropriately.

Richard_Hom

 

[drbizzaro]

Dear drbizzaro,

If it was pseudomonas, the patient would have 9/10 ocular pain with significant photophobia. I believe the original poster didn't include that. Many florid appearing eyes are conjunctival in nature without corneal involvement. Thus there wouldn't necessarily be a sight threatening component. Of course, I would still recommend an evaluation.

If you work in modest surroundings, you will learn to "triage" appropriately.

Richard_Hom

there is the possibility that he was "laughing" about how much it hurt his eyes... and since he couldn't speak much english, we can never know...

i was just thinking it's better to think the worst than assume the best (at least that's what some of my profs have taught = treat it as the worst condition)

 

[Richard_Hom]

(...)i was just thinking it's better to think the worst than assume the best (at least that's what some of my profs have taught = treat it as the worst condition)

drbizzaro,

There is some truth that that kind of line of thinking may be helpful in "avoiding" a lawsuit, but it doesn't necessarily improve your clinical acumen. "Triaging" is the ability to sort out what is "salvageable", which is going "south" fast, which can wait. I don't care how stoic a person is, a full-fledged corneal ulcer is almost impossible to ignore by anybody. It is often called the worst pain they can think of and the the photophobia that ensues is utterly unavoidable.

Not only was the patient bilateral (pseudomonas secondary to infection isn't necessarily bilateral), but there was no significant pain. Even if one was to th ink herpes, rarely is it bilateral.

I think it is appropriate to think "zebras" but this goes in line with the appropriate differential diagnoses. I think your professorial colleagues would agree with this notion.

Richard_Hom

 

[drbizzaro]

drbizzaro,

There is some truth that that kind of line of thinking may be helpful in "avoiding" a lawsuit, but it doesn't necessarily improve your clinical acumen. "Triaging" is the ability to sort out what is "salvageable", which is going "south" fast, which can wait. I don't care how stoic a person is, a full-fledged corneal ulcer is almost impossible to ignore by anybody. It is often called the worst pain they can think of and the the photophobia that ensues is utterly unavoidable.

Not only was the patient bilateral (pseudomonas secondary to infection isn't necessarily bilateral), but there was no significant pain. Even if one was to th ink herpes, rarely is it bilateral.

I think it is appropriate to think "zebras" but this goes in line with the appropriate differential diagnoses. I think your professorial colleagues would agree with this notion.

Richard_Hom

i see what you're saying... it'll just take more experience on my part...

i think alot of profs teach us the way i was suggesting so that we prevent lawsuits, as you were saying