WK3 response to Ericka

Please reply on this post regarding case study. Make a comment on Ericka’s post and her differential diagnosis or you may add a differential diagnosis based on the case study.

 

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Case Study 1

An 86-year-old widowed female is brought to the office by her daughter-in-law. The patient complains of constant tearing and an itchy, burning sensation in both eyes. The patient states this is not a new problem, but it has worsened in the past week and is affecting her vision. The patient complains that her eyes are dry. She thinks the problem must be caused by one of her medications. Her patient medical history is positive for hypertension, atrial fibrillation, and heart failure. She has an allergy to erythromycin that causes rash and elevated liver enzymes. Medications currently prescribed include Furosemide 40 milligrams po twice a day, diltiazem 240 milligrams po daily, lisinopril 20 milligrams po daily, and warfarin 3 milligrams po daily. The physical examination reveals a frail older female with some facial dryness and slight scaling. Her visual acuity is 20/60 OU, 20/40 OD, 20/60 OS. The eyelids are erythematous and edematous with yellow crusting around the lashes. Sclera are injected, conjunctiva are pale, and pupils are equal and reactive to light and accommodation.

 

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(ERICKA’S POST)Case Study #1

 

The primary diagnosis for the patient in case study #1 would be dry eye syndrome. Dry eye syndrome is a combination of visual changes, eye pain or discomfort and abnormal tear production (Buttaro, Trybulski, Polgar-Bailey and Sandberg-Cook, 2017). The patient is complaining of her eyes burning, itching and constant tearing, which could be reflex tearing as a response to the irritation (Buttaro et al., 2017). These symptoms match the definition of dry eye syndrome, according to Buttaro et al., (2017). Her eyes are also reported as injected or reddened. This symptom could be from multiple causes.

Differential Diagnosis:

1). Conjunctivitis. Maldonado and Zuniga (2019) describe conjunctivitis as inflammation of the eye with symptoms such as pain, burning, itching, discharge, or excessive tearing of the eye. This diagnosis is probable, but the patient is presenting with bilateral eye irritation. Often conjunctivitis is unilateral for a few days before spreading to the opposite eye (Buttaro et al., 2017). The patient also stated that this was “not new

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