Case 1 A 52-year-old female presented with daily intermittent tearing and ocular irritation that she described as both burning and a sandy sensation. She had been a contact lens wearer for approximately 20 years and, of late, was experiencing discomfort with her contact lenses that necessitated their removal by mid-afternoon. Her medical history was significant for seasonal allergies, for which she had taken over-the-counter systemic loratadine to relieve symptoms of ocular itching and runny nose. What do you suspect as contributing to the patients complaints? What is your diagnosis and treatment plan? Case 2 A 3-year-old girl is brought to your office by her mother because she has a fever and complains that her ear hurts. She has no significant medical history. The child is not pleased to be in the physician’s office and has been crying. Her mother explains that she developed a cold about 3 days ago with sniffles. Her temperature is 37.8C (100F), and the rest of the physical examination is completed with some difficulty. The only abnormalities are slight redness of the throat, a nose full of thick green mucus, and injected tympanic membranes. What is your diagnosis What findings other than red tympanic membranes should lead you to your diagnosis ? Discuss whether to treat with antibiotics, why or why not? *references not older than 5 yearsShow more
