Dr. Wellington Chang discusses ocular emergencies

Post date: May 26, 2012 8:51:21 PM

Dr. Wellington Chang of the Mitchell Eye Institute in Vienna, VA, and Bethesda, MD, spoke at the TLC Tysons Corner CE Lecture Series this past Thursday. Dr. Chang completed his ophthalmology residency training at Washington Hospital Center, a Level I Trauma Center. (It's easy to get all those gross pictures at a busy trauma hospital!) He served as Chief Resident.

Dr. Chang presented a lecture on various ocular emergencies that we should keep in mind when managing patients. While some of these more severe emergencies might present directly to the ER, quite a few scenarios present themselves in the primary eye care office.

Some interesting facts that piqued my interest:

1. It's been quite a while since I saw a photo of segmental optic nerve edema. It's crazy and cool how the eye anatomy can be that specific in its presentation. This is pathognomonic for AION.

2. I always thought jaw claudication meant pain on chewing; however, Dr. Chang pointed out that this is a common mistake. Instead, this term describes the tiring of the jaw after a period of chewing. GCA involves a decrease in general blood flow. Chewing is an energy-intensive activity, so those with GCA will have difficulty with this task.

3. While I had heard of provocative testing for those with narrow angles before, I did appreciate the quantification of the IOP differential between pre- and post-dilation. An 8 mmHg increase in IOP after dilation is a positive provocative test, indicating that a patient may benefit from PI for treatment of narrow angles.

A big thank you goes out to our guest photographer of the evening, Dr. Adel Ibrahim.

We usually take a CE break during the summer, but we'll see you back here when Fall rolls around for another series of exciting lectures. - jw