Conjunctivitis
i read the other day that "conjunctivitis" is one of the most common diagnoses given out by primary care providers/GP's. i found that very interesting for multiple reasons:
1) any time any GP/nurse practitioner sees an eye that is red, they diagnose "conjunctivitis". technically they're kind of right: conjunctivitis is inflammation of the conjunctiva, or surface layer of the eye. a red eye *is* "itis" of the conjunctiva. the problem with this diagnosis is that its not nearly specific enough. diagnosing a red-eyed patient with "conjunctivitis" is like saying a person who feels malaise is ill. no kidding. but the specific cause of the inflammation absolutely has to be determined before a treatment plan is initiated. "conjunctivitis" aint specific enough: you gotta tell me WHAT KIND of "conjunctivitis" it is. viral, bacterial, inflammatory, allergic. most GP's dont go that far tho. they assume bacterial conjunctivitis & look in their trusty Palm device for the cheapest Rx antibiotics they could write, which is frequently incorrect (I know b/c I see them all later).
2) a lot of the time the patient has SECONDARY "conjunctivitis". in other words, the conjunctiva is inflamed, true, but thats not the primary problem. the conjunctivitis is present b/c of the primary problem. I'll give you a few REALLY common ones. these are non-conjunctivitis eye problems that *FREQUENTLY* get mis-diagnosed & consequently mis-treated by non-eye docs:
iritis: internal inflammation
keratitis: corneal inflammation (also can be viral, bacterial, inflammatory)
if you have a red eye, go to an eye doc. if you are a contact lens wearer & have a red eye, do not go to any non-eye doc practitioner unless its just an emergency.
1) any time any GP/nurse practitioner sees an eye that is red, they diagnose "conjunctivitis". technically they're kind of right: conjunctivitis is inflammation of the conjunctiva, or surface layer of the eye. a red eye *is* "itis" of the conjunctiva. the problem with this diagnosis is that its not nearly specific enough. diagnosing a red-eyed patient with "conjunctivitis" is like saying a person who feels malaise is ill. no kidding. but the specific cause of the inflammation absolutely has to be determined before a treatment plan is initiated. "conjunctivitis" aint specific enough: you gotta tell me WHAT KIND of "conjunctivitis" it is. viral, bacterial, inflammatory, allergic. most GP's dont go that far tho. they assume bacterial conjunctivitis & look in their trusty Palm device for the cheapest Rx antibiotics they could write, which is frequently incorrect (I know b/c I see them all later).
2) a lot of the time the patient has SECONDARY "conjunctivitis". in other words, the conjunctiva is inflamed, true, but thats not the primary problem. the conjunctivitis is present b/c of the primary problem. I'll give you a few REALLY common ones. these are non-conjunctivitis eye problems that *FREQUENTLY* get mis-diagnosed & consequently mis-treated by non-eye docs:
iritis: internal inflammation
keratitis: corneal inflammation (also can be viral, bacterial, inflammatory)
if you have a red eye, go to an eye doc. if you are a contact lens wearer & have a red eye, do not go to any non-eye doc practitioner unless its just an emergency.
I have a question. I went to the eye doctor recently because my eye was very read and irritated. I am a contact lens wearer. I was told I had EKC, my eye does not look anywhere near the examples I have seen o the internet. It is not even very read just irritated. Is it possible this diagnosis is incorrect? I did sleep in my contacts prior to this.
ReplyDeleteof course its possible that the diagnosis is incorrect...but its also equally possible that the diagnosis is 100% correct. just b/c you dont think it looks like the pictures on the internet does not mean the diagnosis is wrong. if you are concerned, you should consider a 2nd opinion with a different eye doc
ReplyDeletejust saw a patient who went tho the hospital with metal in his eye. he TOLD them it was metal. they said they "couldn't see it" (not too surprising), so they did a CT SCAN (and people wonder why health care is so high...) and announced that it "couldn't be metal" b/c it didn't show up on the CT scan. wow. so they of course diagnosed him with "conjunctivitis" and sent him home with antibiotic ointment. brilliant
ReplyDeletea 1.5 sec slit lamp exam revealed a rather large (0.5mm) fleck of metal dead center in his cornea. how can people not see this? scary. it was easily removed with a needle. no problem.
so yeah. to reiterate: any article you read about how "common" conjunctivitis is...I personally believe that information is horribly misleading and wrong, b/c I am personally witnessing the amount of incorrectly diagnosed cases of "conjunctivitis".
I've already had three cases this week (this would make 4 now, and it's only Wed) who were diagnosed by a PCP or nurse practitioner with "conjunctivitis"... who did not have conjunctivitis. it's rampant. I go back to what I always say: if you have an EYE PROBLEM, go to an EYE DOCTOR. the PCP & the ER don't usually know what to do. sorry, but they don't.
i was diagnosed with Conjunctivitis 3 weeks ago, and it was okay already, but the problem is I'm still having blurry vision till today. Can somebody tell me why
ReplyDeletewell "conjunctivitis" is not usually a cause of blurry vision. if the conjunctivitis is "okay" now, it's probably something else causing the blurry vision
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