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Missed diagnoses in external disease can be rectified
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SALVADOR, Brazil — Some of the most commonly missed diagnoses in external disease can be easily addressed and rectified, according to a visiting professor speaking here.
Todd P. Margolis, MD, PhD, a professor of ophthalmology at the University of California in San Francisco, listed five ocular problems that are often managed incorrectly because of common oversights.
He addressed these points at the Brazilian Congress of Ophthalmology, being held here this week.
Medication toxicity, exposure keratoconjunctivitis, posterior blepharitis, molliscum contagiosum and dry eye are all easily missed, Dr. Margolis said. An improper diagnosis in these cases can be potentially debilitating, he said.
The major culprits involved in medication toxicity are preservatives, lanolin, vasoconstrictors, anesthetics and punctal plugs. In many cases, simple steps to remedy medication toxicity include stopping the medications, removing punctal plugs — which he said may be trapping toxic substances in the eye — and switching to nonpreserved artificial tears.
Overall, clinicians must be patient, Dr. Margolis said, because symptoms “will not go away in a week.”
With all these problems, clinicians must ask the right questions and patients must disclose more information to avoid missing the diagnoses.