STUDY - Technical - New Dacian's Medicine
Eye
discharge (Classical / Allopathic Medicine)
Usually associated
with conjunctivitis, eye discharge is the excretion of any
substance other than tears. This common sign may occur in one
or both eyes, producing scant to copious discharge. The
discharge may be purulent, frothy, mucoid, cheesy, serous,
clear, or stringy and white. Sometimes, the discharge can be
expressed by applying pressure to the tear sac, punctum,
meibomian glands, or canaliculus.
Eye discharge is
common with inflammatory and infectious eye disorders, but it
may also occur with certain systemic disorders. (See Sources
of eye discharge.) Because this sign may accompany a disorder
that threatens vision, it must be assessed and treated
immediately.
HISTORY:
Ask the patient when the discharge began and its frequency. Does it occur at certain times of the day or in connection with certain activities?
If the patient complains of pain, ask him to show you its exact location and to describe its character. Is the pain dull, continuous, sharp, or stabbing?
Ask the patient if his eyes itch or burn. Do they tear excessively? Are they sensitive to light? Does it feel like there's something in them?
Ask the patient when the discharge began and its frequency. Does it occur at certain times of the day or in connection with certain activities?
If the patient complains of pain, ask him to show you its exact location and to describe its character. Is the pain dull, continuous, sharp, or stabbing?
Ask the patient if his eyes itch or burn. Do they tear excessively? Are they sensitive to light? Does it feel like there's something in them?
Sources of eye
discharge
Eye discharge can come from the tear sac, punctum, meibomian glands, or canaliculi. If the patient reports discharge that isn't immediately apparent, you can express a sample by pressing your fingertip lightly over these structures. Then characterize the discharge, and note its source.
PHYSICAL ASSESSMENT:
Take the patient's vital signs.
Carefully inspect the eye discharge. Note its amount, consistency, and color.
Test visual acuity, with and without correction.
Examine external eye structures, beginning with the unaffected eye to prevent cross-contamination. Observe them for eyelid edema, entropion, crusts, lesions, and trichiasis. Ask the patient to blink as you watch for impaired lid movement.
If the eyes seem to bulge, measure them with an exophthalmometer.
Test the six cardinal fields of gaze.
Examine the patient for conjunctival injection and follicles and for corneal cloudiness or white lesions.
Eye discharge can come from the tear sac, punctum, meibomian glands, or canaliculi. If the patient reports discharge that isn't immediately apparent, you can express a sample by pressing your fingertip lightly over these structures. Then characterize the discharge, and note its source.
PHYSICAL ASSESSMENT:
Take the patient's vital signs.
Carefully inspect the eye discharge. Note its amount, consistency, and color.
Test visual acuity, with and without correction.
Examine external eye structures, beginning with the unaffected eye to prevent cross-contamination. Observe them for eyelid edema, entropion, crusts, lesions, and trichiasis. Ask the patient to blink as you watch for impaired lid movement.
If the eyes seem to bulge, measure them with an exophthalmometer.
Test the six cardinal fields of gaze.
Examine the patient for conjunctival injection and follicles and for corneal cloudiness or white lesions.
SPECIAL
CONSIDERATIONS:
Apply warm soaks to soften crusts on eyelids and lashes, then gently wipe the eyes with soft gauze. Carefully dispose of all used dressings, tissues, and cotton swabs to prevent the spread of infection.
Apply warm soaks to soften crusts on eyelids and lashes, then gently wipe the eyes with soft gauze. Carefully dispose of all used dressings, tissues, and cotton swabs to prevent the spread of infection.
PEDIATRIC
POINTERS:
In infants, prophylactic eye medication (silver nitrate) may cause eye irritation and discharge.
In children, eye discharge usually results from eye trauma, an eye infection, or an upper respiratory tract infection.
In infants, prophylactic eye medication (silver nitrate) may cause eye irritation and discharge.
In children, eye discharge usually results from eye trauma, an eye infection, or an upper respiratory tract infection.
PATIENT
COUNSELING:
Inform the patient that bacterial and viral conjunctivitis are contagious. If the patient has bacterial conjunctivitis, advise him to avoid contact with other people until 24 hours after receiving antibiotic treatment. Also tell him to avoid sharing towels, pillows, or cosmetic eye products and to stop wearing contact lenses until conjunctivitis resolves.
If the patient has allergic conjunctivitis, inform him that the inflammation that accompanies this form of conjunctivitis isn't contagious.
Inform the patient that bacterial and viral conjunctivitis are contagious. If the patient has bacterial conjunctivitis, advise him to avoid contact with other people until 24 hours after receiving antibiotic treatment. Also tell him to avoid sharing towels, pillows, or cosmetic eye products and to stop wearing contact lenses until conjunctivitis resolves.
If the patient has allergic conjunctivitis, inform him that the inflammation that accompanies this form of conjunctivitis isn't contagious.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)