Dr. Jay Woody is a diplomat of the American Board of Emergency Medicine, a Fellow of the American College of Emergency Medicine and is an Attending Physician at Parkland Health and Hospital System, Children's Medical Center of Dallas as well as several other north Texas facilities. He is a well-known and widely published authority in the field of emergency medicine and the former regional medical director of a freestanding emergency medicine practice.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Treatment at your ophthalmologist's office or at an emergency department will vary widely, from giving you instructions to apply warm compresses on a sty or a chalazion to taking you into emergency surgery for acute glaucoma.
Conjunctivitis: The bacterial form is treated with antibiotic eyedrops, eye ointment, and pain medication. Viral conjunctivitis (pinkeye) is typically treated the same as bacterial conjunctivitis, because it may be difficult to tell the difference between bacterial versus viral infections. Allergic conjunctivitis is normally treated with antihistamines, such as Benadryl or non-sedating antihistamines.
Corneal abrasions and ulcerations: These are treated with antibiotic eye drops (to prevent infection), eye ointment, and pain medication.
Foreign body in the eye: There are different techniques to remove foreign bodies: irrigation with eye wash, removal with a cotton tip applicator, removal with a small needle, or removal with an ophthalmologic drill. After foreign body removal, there may be an abrasion or a rust ring (rust from a metal foreign body), which would be treated separately.
Chemical eye burns and corneal flash burns: Chemical eye burns are treated immediately with great amounts of water to wash out the eye and anesthetic eye drops until normal levels of acid or alkali of the eye are reached. The acid or alkali levels will be checked with a special paper called pH paper. After thorough washing is complete and the pH is normal, evaluation by an ophthalmologist is required for further treatment, depending on the extent of the chemical burn. Flash burns are treated as many small abrasions with antibiotic eyedrops, eye ointment, and pain medication. Typically, follow up with an ophthalmologist is recommended.
Blepharitis: You will be instructed to scrub the eyelid edges with mild shampoo like baby shampoo on a soft washcloth twice a day to remove excess oil.
Styes or chalazions: These can initially be treated conservatively by placing warm compresses, such as a washcloth that has been warmed with hot water, on the eye or eyes for 15 to 20 minutes, four times a day. An antibiotic ointment can be applied. If the chalazion does not go away in three to four weeks, your ophthalmologist may open it up so the infection can drain out.
Glaucoma: Glaucoma has many treatment options depending on the type, severity, and duration of the attack. Severe glaucoma can be a true eye emergency with permanent eye damage occurring within several hours. Treatment typically begins with eye drops containing a topical beta-blocker [for example, timolol (Timoptic)], a topical steroid drop, and a pupillary constricting eyedrop; other medicines may be given intravenously or in pill form. If these treatments fail to decrease intraocular eye pressure, surgery may be considered.
Iritis: This condition may be treated with eyedrops that cause your pupils to dilate (get bigger) and with topical steroid eyedrops. In severe cases of iritis, oral steroids may be used.
Optic neuritis: Gradual loss of vision and painful eye movement are normally signs of a disease throughout the body, which needs to be diagnosed and treated. Most commonly, a thorough work-up needs to be performed with both ophthalmologists and neurologists to determine the cause of optic neuritis.
Sinusitis: When sinusitis is determined to be a bacterial infection, it can be treated with antibiotics.
Migraines: When migraines cause eye pain, both can be treated with routine over-the-counter medications, such as ibuprofen (Motrin) and acetaminophen (Tylenol), as well as with prescription migraine medications.
Traumatic events to the eye: Penetrating injuries to the globe of the eye are always best managed by ophthalmologists and require immediate evaluation in the emergency department.