Clinical High-Yield · 8 min read · June 5, 2026
Acute angle-closure glaucoma: Sudden severe eye pain, halos around lights, nausea/vomiting, fixed mid-dilated pupil, rock-hard eye. Emergency. Immediate ophthalmology referral. Avoid anticholinergics and sympathomimetics.
Central retinal artery occlusion: Sudden painless monocular vision loss. Cherry-red spot on funduscopy. Stroke equivalent — immediate evaluation. Associated with carotid disease, cardiac emboli.
Retinal detachment: Flashes, floaters, then "curtain" or "shadow" across visual field. Painless. Emergency ophthalmology referral.
Chemical burns: Immediate copious irrigation before anything else. Do not delay for history-taking.
Conjunctivitis:
Hordeolum (stye): Acute, painful, localized eyelid swelling. Warm compresses. Resolves spontaneously.
Chalazion: Chronic, painless eyelid nodule. Warm compresses. May need steroid injection or surgical excision if persistent.
Open-angle glaucoma: Chronic, asymptomatic until late. Increased IOP, optic nerve cupping, visual field loss (peripheral first). Treatment: Prostaglandin analogs (latanoprost) first-line.
Macular degeneration: Age-related, central vision loss. Dry (most common, no treatment) vs. wet (anti-VEGF injections). Amsler grid for monitoring.
Diabetic retinopathy: Most common cause of blindness in working-age adults. Annual dilated eye exam for all diabetics.
Acute otitis media (AOM): Otalgia, fever, bulging tympanic membrane, decreased mobility. Most common: Streptococcus pneumoniae, H. influenzae, Moraxella catarrhalis.
Treatment: Amoxicillin 80–90 mg/kg/day × 10 days (children <2 or severe), × 5–7 days (children ≥2, mild-moderate). Watchful waiting for mild cases in children ≥2 with unilateral AOM.
Penicillin allergy: Azithromycin or cefdinir.
Otitis media with effusion (OME): Fluid without signs of acute infection. Watchful waiting × 3 months. Refer if persistent >3 months with hearing loss.
Pain with tragus manipulation. Pseudomonas most common. Treatment: Topical ciprofloxacin-hydrocortisone or acetic acid drops. Keep ear dry.
Acute bacterial sinusitis: Symptoms >10 days without improvement, OR severe symptoms (fever ≥39°C, purulent discharge, facial pain) ≥3–4 days, OR worsening after initial improvement.
Treatment: Amoxicillin-clavulanate first-line. Duration: 5–7 days adults, 10–14 days children.
Viral sinusitis (most common): Supportive care. Saline irrigation, decongestants, analgesics.
Strep throat: Sudden onset sore throat, fever, tonsilla...