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and exposures of a toxic nature require the immediate diagnostic workup and management that is best carried out in the emergency department (ED) While many problems can, and should be, managed by the ED clinician alone, others may require immediate or expedited ophthalmologic evaluation The ED clinician must be capable of conducting an ophthalmic history and physical examination to accurately assess ocular complaints This chapter discusses the approach to ophthalmic emergencies commonly seen in the ED Ocular trauma (including injuries to the globe, cornea, and eyelids) is discussed in Chapter 114 Ocular Trauma The approach to several other common eye complaints is outlined in the related chapters mentioned below KEY POINTS The pediatric eye examination can be challenging and often requires an age-adjusted approach It is critical to distinguish periorbital cellulitis from the much more serious orbital cellulitis Patient age and associated symptoms can often help the clinician differentiate between different types of conjunctivitis Copious ocular irrigation immediately following caustic exposure to the eye can be vision-saving RELATED CHAPTERS Signs and Symptoms Eye: Red Eye: Chapter 27 Eye: Strabismus: Chapter 28 Eye: Unequal Pupils: Chapter 29 Eye: Visual Disturbances: Chapter 30 Medical, Surgical, and Trauma Emergencies Infectious Disease Emergencies: Chapter 94 Ocular Trauma: Chapter 114 The Children’s Hospital of Philadelphia Clinical Pathway Clinical Pathway for Patient With Suspected Preseptal or Orbital Cellulitis URL: https://www.chop.edu/clinical-pathway/preseptal-or-orbitalcellulitis-clinical-pathway Authors: G Binenbaum, MD; L Lin, BS; I Kuhn, CRNP; M Russo, MD; T Kaur, MD; J Lavelle, MD; M Hayes, PharmD; W Katowitz, MD; K Reddy, MD; M Rizzi, MD; K Revere, MD; A Buzi, MD; M Blackstone, MD; C Wilbur, MD; V Scheid, MD Posted: April 2019, last revised June 2019 EXAMINATION Many children regard eye examinations and administration of eye drops with the same fear that they harbor for injections Therefore, it is important to gather as much information as possible before touching the patient or instilling eye drops A detailed history can be a valuable tool in focusing the examination and making a diagnosis Questions regarding unilaterality/bilaterality, acute/chronic onset of symptoms, and prior ophthalmic care are particularly helpful For example, a patient may be known to have an eye with poor vision, or to have had one eye patched for a visual problem, suggesting amblyopia Conversely, a child may be unaware of having poor vision in one eye because the pediatric brain is able to suppress the blurred image and focus solely on the clear image, allowing the child to proceed with normal activity unaware of the unilateral visual deficit Importantly, an unremarkable visual screening examination at school does not necessarily imply that the vision was normal because false-negative tests are well known to occur ... EMERGENCIES DEBORAH SCHONFELD, BRUCE M SCHNALL GOALS OF EMERGENCY CARE A wide variety of pediatric ocular complaints are first seen by clinicians in the emergency room A number of acute disorders such...plexus cauterization: cerebrospinal fluid turbulence and choroid plexus visualization J Neurosurg Pediatrics 2016;18(3):287–295 Schrot RJ, Muizelaar JP Mannitol in acute traumatic brain injury Lancet... toxic nature require the immediate diagnostic workup and management that is best carried out in the emergency department (ED) While many problems can, and should be, managed by the ED clinician alone,