I am a big fan of the Olympics, especially the Winter Olympics. But when I started watching on opening night, I was wondering: 1) who told Bob Costas he looks good with his new glasses; 2) what in the world was wrong with his left eye, and; 3) how could NBC let him go on the air looking like that? His left eye was partially swollen shut and also appeared red and watery. As the week went on, his condition had spread to his right eye. By the end of the week, myself, along with millions of viewers, were apparently so disturbed that he was pulled from the broadcast for a few days.
So if a patient such as Bob Costas walked into my office with a swollen, red, and watery eye, what could be the possible diagnosis? The first condition I would think of would be conjunctivitis, or “pink eye”. Conjunctivitis is an inflammation of the conjunctiva, which is the thin, clear tissue covering the white part of the eye. It can be due to an allergy, bacteria, or a virus. In addition, although not as likely, I would also consider dry eye, exposure to an irritating substance such as a chemical or noxious fumes, and uveitis, which is inflammation inside the eye. Other less likely causes could be an outbreak of the herpes virus or even a sexually transmitted disease.
All of the above conditions have their own signs and symptoms which help me narrow down the diagnosis. However, I did not have the luxury of examining Mr. Costas. But based on his appearance, and the fact that it spread to his right eye (he probably infected himself), I was confident that he had conjunctivitis caused by a virus, which is typically very contagious.
Of course, it is important to have the correct diagnosis because each condition has different treatments. I would not prescribe an antibiotic used for a bacterial infection for someone with dry eyes. Likewise, treatment for the herpes virus is much different than for an allergic reaction. However, some “pink eyes” may not have such straightforward signs and symptoms which allow for any easy diagnosis and treatment. Sometimes there are overlapping or subtle signs and symptoms from which I can narrow down the diagnosis but not be totally sure. Fortunately, my office at Normandy Optical is approved to administer the AdenoPlus in-office immunoassay test. This test allows me to diagnose with great accuracy whether someone has the highly contagious adenovirus form of conjunctivitis and proceed more quickly with the appropriate precautions and treatment. The test is noninvasive and painless, and the results are available in about 10 minutes. If you or a family member suddenly develops a “pink eye”, give me a call as soon as possible.
Searching for Sugar Man…
…is a documentary that I watched a few weeks ago which was recommended by a patient (thanks, Phil). It tells the unbelievable story of Sixto Rodriguez, who was supposed to be the next greatest ’70s rock icon. He was discovered in a Detroit bar, recorded an album with lyrics and music similar to Bob Dylan, but the album bombed. Rodriguez disappeared into obscurity amid rumors of an on-stage suicide. But a boot-legged copy of his album found its way to South Africa and over time, he was more popular there than the Rolling Stones. The movie documents the efforts of 2 South African fans in the late 1990s who set out to find out what really happened. The movie starts out kind of slow, but it turns out to be an extraordinary story. If you like documentaries, I recommend that you check it out.
MY DAUGHTER HAD CELLULITIS ON HER EYELID WHEN SHE WAS 13 YEARS OLD WHICH ADVANCED IN A COUPLE OF DAYS TO SUCH A DEGREE THAT SHE WAS ADMITTED TO THE HOSPITAL FOR 5 DAYS OF INTRAVENUS ANTIBIOTICS (CECLOR). I THOUGHT MAYBE THAT WAS WHAT BOB COSTAS HAD.
Hi Marsha,
Yes, orbital cellulits is very serious.