A 58-year-old woman comes to the emergency department because of pain in her right eye that has lasted for the past 2 days. She reports a painful red right eye but denies any discharge, itchiness, or burning. She also reports frontal headaches on the right side. She describes the pain as a 7 out of a possible 10.
Her systemic health is remarkable for hypertension, a history of asthma, allergic rhinitis, rheumatoid arthritis, sarcoidosis, and a history of pulmonary embolism. All current health conditions are stable and monitored by her primary healthcare provider.
Examination findings include the following:
Best-corrected visual acuity: 20/20 OD, 20/25 OS
Extraocular movements: Full and smooth OU
Pupils: Equal, round, reactive to light, with no afferent pupillary defect OU
Confrontation fields: Full to finger count OU
Goldmann applanation tonometry: 9 mm Hg OD, 9 mm Hg OS
A dilated fundus examination revealed the following:
0.55 × 0.55 cup-to-disk ratios with pink, healthy, distinct neuroretinal rims in both eyes
Posterior fundus grounds were normal.
Peripheral fundus revealed no retinal holes, tears, or detachments in both eyes.
Slit-lamp examination revealed the following:
OS: All anterior structures were normal.
OD: See Figure
Figure. Grade 3+ diffuse injection in the bulbar conjunctiva, grade 2 injection in the palpebral conjunctiva; (-) papillae, follicles, and anterior chamber reaction.
All other anterior structures are normal.
Medscape Optometry © 2014
Cite this: Eye Pain in a Woman With Multiple Health Conditions - Medscape - Mar 24, 2014.