Ocular Symptoms and Possible Diagnosis

ITCH

Allergic conjunctivitis (all year round)

Vernal conjunctivitis (young male, spring)

Blepharitis

Dry eye syndrome

Drug allergy/toxicity

Giant papillary conjunctivitis (most common for CL wearers)

BLUR

Refractive error

Dry eye (intermittent, improves with blink)

Cataract

Amblyopia

Macular degeneration

Keratoconus

DISTORTION

Wet macular degeneration

Central serous retinopathy (stress related)

Cataract (usually cortical)

Refractive error (astigmatism >3 D, irregular)

Pterygium

Keratoconus

BURN

Blepharitis (flakes on conj.)

Dry eye syndrome

Conjunctivitis

Inflamed pterygium/pinguecula

Episcleritis

TEARING

Dry eye syndrome

Foreign body

Corneal abrasion

Blepharitis

Trichiasis

Allergic/toxic conjunctivitis

Ectropion

Recurrent corneal erosion

Anterior uveitis

Nasolacrimal duct obstruction

Bell’s palsy (can’t close eye)

LIGHT SENSITIVITY

Anterior uveitis (iritis)

Migraines

Corneal abrasion

Corneal edema

Keratoconus

FOREIGN BODY SENSATION

Dry eye syndrome

Superficial punctate keratitis

Blepharitis (lash falls, stuck to cornea)

Pterygium/pinguecula

Conjunctivitis

Trichiasis

Corneal abrasion

Foreign body

Recurrent corneal erosion

Giant papillary conjunctivitis

EYELID SWELLING

Chalazion (noninfectious, usually developed from internal hordeolum, chronic, less painful)

Internal hordeolum (infection of Meibomian glands, acute, painful)

External hordeolum (infection of Zeis glands, acute, painful)

Contact dermatitis

Preseptal cellulitis

Orbital cellulitis (deadly) (painful EOMs)

FLASHES AND FLOATERS

Migraines

PVD

Vitreous hemorrhage

RD

*Need to dilate

REDNESS

Subconjunctival hemorrhage (most common “red eye” that pts overreact about)

Dry eye syndrome

Inflamed pterygium/pinguecula

Conjunctivitis

Episcleritis

Scleritis

Anterior uveitis

Corneal ulcer

Keratitis

PAIN

Anterior uveitis

Dry eye syndrome

Blepharitis

Conjunctivitis

Inflamed pterygium/pinguecula

Corneal abrasion

Corneal ulcer

Foreign body

Preseptal cellulitis

Herpes simplex

Herpes zoster

Episcleritis

Scleritis

Orbital cellulitis (deadly)

Angle closure glaucoma

HEADACHES

Tension/stress

Migraines

Asthenopia (near point stress)

Toxic

Sinus (congestion)

Cluster (wave after wave of HAs, boring pain)

Hypertension

Idiopathic intracranial hypertension (CSF too high in 3rd ventricle)

Giant cell arteritis (deadly) (>60 y.o.)

Meningitis (deadly)

Tumor (deadly)

Aneurysm (deadly) - causes HA few minutes before a patient dies

DIPLOPIA

Dry eye syndrome

Refractive error of any kind/astigmatism

Strabismus

Non strabismus binocular disorder

Thyroid disease

Multiple sclerosis

Sixth nerve palsy (horizontal diplopia)

Fourth nerve palsy (vertical diplopia)

Third nerve palsy

Cataract

Myasthenia gravis

Internuclear ophthalmoplegia

Tumor (deadly)

Aneurysm (deadly)