Overview of the Diagnosis, Evaluation, and Novel Treatment Strategies for Ophthalmic Emergencies in the Hospitalized Geriatric Patient

The review highlights common ophthalmic emergencies seen in the hospitalized geriatric patient. It describes key features of the ophthalmic examination, early identification, and treatment of ophthalmic emergencies, including transient monocular loss of vision with risk of future ischemic complications, central retinal artery occlusion, giant-cell arteritis, retinal detachment, acute angle closure glaucoma, orbital cellulitis, and orbital trauma. Research is ongoing regarding the best techniques to maximize visual outcome for these conditions. The benefits of surgical versus medical management for transient monocular blindness and central retinal artery occlusion are debated. Currently, patients with central retinal artery occlusion have low potential for visual recovery, and to change this potential there is significant ongoing research into novel medical approaches, including the use of thrombolytics, pentoxyphylline to promote vasodilation, and hyperbaric oxygen to enhance oxygenation of damaged retinal tissue. Giant-cell arteritis is another emergency with potential for poor visual outcome, and mainstream management at this time dictates prolonged steroid regimens, which have their own significant side effects. Current therapeutic research is investigating optimal glucocorticoid regimens as well as newer therapeutic advances for alternatives to glucocorticoid therapy, such as tocilizumab and methotrexate. For all the ophthalmic emergencies described, high suspicion should...
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research