Showing 1-20 of 43 for: Essential Evidence Topics > Eye and ear 
- Acoustic neuroma (vestibular schwannoma)
Essential Evidence Topics, 3-May-2019
Overall Bottom Line: Vestibular schwannoma (acoustic neuroma) is an important consideration in a patient presenting with asymmetric sensorineural hearing loss. Use auditory brainstem response (ABR) audiometry for the initial evaluation; however, if th
- Allergic rhinitis
Essential Evidence Topics, 18-Jun-2019
Overall Bottom Line: Empiric treatment of patients with classic symptoms is appropriate. Treatment with intranasal steroids and nonsedating antihistamines is sufficient for most patients. Intranasal steroids are also effective in treating ocular sympt
- Blepharitis
Essential Evidence Topics, 30-Jul-2019
Overall Bottom Line: Suspect blepharitis in patients with recurrent itchy eyes and conjunctival irritation. Patients with all forms of blepharitis can benefit from eyelid hygiene (eg, warm compresses, scrubbing eyelid margins with a cotton swab dipped i
- Cataract
Essential Evidence Topics, 3-May-2019
Overall Bottom Line: Visual function questionnaires, a complete ophthalmic examination, and an assessment for functional impairment under different light conditions help to determine the indication for surgery. Extracapsular cataract surgery by phacoe
- Cerumen impaction
Essential Evidence Topics, 21-Nov-2018
Overall Bottom Line: Perform otoscopy on patients complaining of ear discomfort or decreased hearing. Saline alone is as effective as commonly used cerumenolytics for removal of impacted cerumen. Removal may be easier with curettage under direct ot
- Conjunctivitis (allergic)
Essential Evidence Topics, 15-Mar-2019
Overall Bottom Line: The diagnosis of allergic conjunctivitis is made via history and physical examination. Topical antihistamines or mast cell stabilizers are effective treatment. Consider intranasal steroids or systemic antihistamines in patients
- Conjunctivitis (infectious)
Essential Evidence Topics, 14-Mar-2019
Overall Bottom Line: Meticulous handwashing and good hygiene can prevent acute bacterial conjunctivitis. Eyes glued shut upon awakening suggests a bacterial etiology, whereas itching and/or a history of recurrent conjunctivitis suggest a noninfectious
- Corneal abrasion and ulcer
Essential Evidence Topics, 7-Jun-2019
Overall Bottom Line: The diagnosis is made on the basis of a history of foreign body or trauma to the eye and a positive fluorescein stain on examination. Oral analgesic medications can help alleviate pain and discomfort. Consider using topical NSAIDs
- Diabetic retinopathy
Essential Evidence Topics, 23-Apr-2019
Overall Bottom Line: Type 1 diabetes: dilated, comprehensive eye examination by an ophthalmologist or optometrist within 3 to 5 years of onset of diabetes followed by annual eye examinations. Type 2 diabetes: dilated, comprehensive eye examination by
- Dry eye
Essential Evidence Topics, 7-Apr-2017
Overall Bottom Line: Dry eye syndrome (DES) usually can be diagnosed by oral history. DES may be a symptom of an autoimmune disorder. Medications, environmental humidity, and eye use can be addressed to lessen symptoms. Artificial tears and ointment
- Episcleritis and scleritis
Essential Evidence Topics, 28-Mar-2017
Overall Bottom Line: Suspect scleritis or episcleritis in a patient with red or violet eye, especially if history of autoimmune or collagen vascular disease. Diagnosis of scleritis requires a complete ophthalmic examination and a systemic evaluation to
- Foreign body (nasal and ear)
Essential Evidence Topics, 14-Jun-2019
Overall Bottom Line: Perform otoscopy or rhinoscopy to confirm diagnosis of ear or nasal foreign body (FB) in a child presenting with unilateral mucopurulent discharge of the ear or nose. Remove external auditory canal FBs using irrigation, suction, or i
- Glaucoma
Essential Evidence Topics, 7-Jun-2019
Overall Bottom Line: Glaucoma is a chronic progressive disease diagnosed by elevated intraocular pressure (IOP), optic neuropathy, and glaucomatous visual field loss. Patients should be referred to ophthalmology if glaucoma is suspected. The only effec
- Hearing loss in adults (diagnostic approach)
Essential Evidence Topics, 15-May-2019
Overall Bottom Line: The United States Preventive Services Task Force (USPSTF) found insufficient evidence to assess the balance of benefits and harms of screening for hearing loss in asymptomatic adults aged 50 years or older. In any patient with a comp
- Hordeolum and chalazion
Essential Evidence Topics, 29-May-2019
Overall Bottom Line: Hordeolum (stye) is an acute, tender, and erythematous lesion of the eyelid that can safely be treated with warm compresses and topical erythromycin. Chalazia usually present as a chronic, nontender, SC nodule within the eyelid, som
- Hyphema
Essential Evidence Topics, 29-Jul-2019
Overall Bottom Line: Small (grade 1) hyphemas do not require hospitalization but require daily slit lamp and intraocular pressure examinations for the first 4 days. This will require referral in almost all cases. Initial treatment includes rest with the
- Intraocular foreign body
Essential Evidence Topics, 20-Jun-2019
Overall Bottom Line: A high index of suspicion for intraocular foreign body (IOFB) is warranted for patients with a foreign body sensation associated with hammering, grinding, or other force-related mechanism. Refer most, if not all, patients with IOFB
- Iritis and uveitis
Essential Evidence Topics, 2-May-2017
Overall Bottom Line: Anterior uveitis usually presents as a unilateral, painful red eye with blurred vision, photophobia, and tearing. Rule out other more common causes of the painful red eye, including conjunctivitis, corneal abrasions and ulcers, and
- Macular degeneration
Essential Evidence Topics, 20-Jun-2019
Overall Bottom Line: Regular screening by an opthalmologist, especially for adults over age 55 years, is recommended according to AAO guidelines. High-dose antioxidants and lutein slow progression of disease. Wet age-related macular degeneration (ARMD
- Mastoiditis
Essential Evidence Topics, 11-Jun-2019
Overall Bottom Line: Suspect acute mastoiditis in a patient with otalgia, postauricular pain, fever, and postauricular swelling, tenderness, and erythema. Order a CT scan in patients with suspected intracranial complications, those requiring mastoidecto
