Ear Drops in case of Perforated Drum

Ciprofloxacin

• Equally effective as aminoglycoside drops, but not ototoxic
• Would be prudent to consider their use before potentially ototoxic alternatives

In case of otitis externa

• Consider that ear drum could be perforated before Rx ear drops

What Can Present in a Myriad of Ways?

If patient Hx (or Dx) proves tricky, always consider

• Mental illness
• Endocrine dysfunction
• Anaemia
• Chemicals (Drugs: Rx; OTC; recreational | Environmental)
• Viruses; Vector-born disease
• Auto-immune disease
• A para-neoplastic syndrome

Ix to consider in such circumstances

• Serology - CRP; LFTs; TSH; fasting BSL; infection serology; RF; ANA; (PSA)
• Haematology - FBC; ESR
• Imaging - CXR; abdo/pelvic US or CT scan; brain CT/MRI scan; (mammogram)
• Clinical tool - K10 questionnaire

Common Things Occur Commonly

Ask yourself

• "What is it most likely to be?"
• "What must I not miss?"

For Any Eye Problem

Always check the visual acuity
- uncorrected
- corrected