History of Present Illness:
A man in his mid 20’s presents to the hospital with 10 days of unilateral eye discomfort with a FB sensation each time he blinks. He denies any discharge, photophobia or change in vision. He denies injury or contact lens use and has never had this before nor any other significant medical problems.
Vitals & Physical Exam:
Vision is 20/20, there is no discharge or photophobia, the scleral injection pictured below is only on the temporal side of the sclera of the right eye around 9 o’clock and spares the rest of the sclera. Fluoresceine exam is normal.
QUESTIONS:
What is the most likely diagnosis?
- A) Iritis
- B) Conjunctivitis
- C) Episcleritis
- D) Glaucoma
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ANSWER: What is the most likely diagnosis?
- A) Iritis – should have photophobia and have more circumferential redness
- B) Conjunctivitis – should have discharge but no limbal flush
- C) Episcleritis – CORRECT
- D) Glaucoma – should have change in vision and fixed midrange pupil if acute
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CASE OUTCOME: followed up with Ophtho. Treated with oral NSAIDS