- Mononucleosis15:34What Would I Do Next? | Headache & Eye Pain18:43Paper Chase #1 | Opioid Rx and Household Use4:27Excellence in the Physical Exam Series | The Throat13:22Elder Abuse19:31Paper Chase #2 | Accuracy of Bedside POC Testing3:22Anxiety17:16Abnormal Uterine Bleeding14:45Paper Chase #3 | Capsaicin for Cannabis Hyperemesis Syndrome4:07HemoptysisFree Chapter24:27Paper Chase #4 | ATB Rx in Pediatric UTI's4:46Not To Miss Foot Injuries18:41Paper Chase #5 | Broad vs Narrow-Spectrum ATB w Pediatric RTI's5:21The Summary13:30
Important diagnostic considerations in patients with headache that may have an ocular component include glaucoma, temporal arteritis, orbital cellulitis, optic neuritis, iritis, corneal abrasion, and Herpes Zoster Opthalmicus (HZO). The prodrome of HZO consists of pain/paresthesias of the scalp, photophobia, headache and malaise, and can last 1-7 days before the rash appears, making the diagnosis very difficult in this stage. Immunocompetent patients can be managed as outpatients. Treatment includes antiviral medications +/- steroids. Steroids will decrease pain and duration of symptoms, but don't prevent post-herpetic neuralgia. Follow up with Ophthalmology has been the standard, however, a recent small Canadian study (see below) suggested that patients without a red eye or a supratrochlear rash (forehead just above the nasal bridge) have a very low incidence of keratitis and iritis, the dangerous complications of HZO, and therefore do not require Ophthalmologic follow up.