RED EYE - Copy. presentation (conjunctivitis)

Patient with painful redeye shoud be considered to have potentially serious problems.

1. Red eyes Red eyes
all look similar !all look similar !

2. RED EYERED EYE

Pt. with a Pt. with a painful redpainful red eyeeye should be should be
considered to have potentially serious considered to have potentially serious
problems.problems.

Pt. with a Pt. with a painful red eye & loss of visionpainful red eye & loss of vision
may have a potentially blinding condition. may have a potentially blinding condition.

3. Red EyeRed Eye
1.1.Discharge presentDischarge present
More commonMore common: :
Conjunctivitis,ophthalmia neonatorum,blepharitisConjunctivitis,ophthalmia neonatorum,blepharitis
Less commonLess common: :
Ac.allergic reaction,dacryocystitis,canaliculitis.Ac.allergic reaction,dacryocystitis,canaliculitis.

4. 2.2.No discharge presentNo discharge present
A. PainfulA. Painful
i. i. Typically mild to modrate: Typically mild to modrate:
Dry-eye Dry-eye
syndrome,blepharitis,pingueculitis, inflamed syndrome,blepharitis,pingueculitis, inflamed
pterygium FB (corneal or conjunctival),corneal pterygium FB (corneal or conjunctival),corneal
disorders (superficial punctate keratitis etc), disorders (superficial punctate keratitis etc),
episcleritis,etc.episcleritis,etc.

5. ii. Typically moderate to severeii. Typically moderate to severe: :
Corneal disorders Corneal disorders
(abrasion,erosion,infiltrate/ulcer),anterior (abrasion,erosion,infiltrate/ulcer),anterior
uveitis,scleritis,ac.angle closure glaucoma.uveitis,scleritis,ac.angle closure glaucoma.
B. Minimal or no painB. Minimal or no pain..
More commonMore common: : Sub.conj.hae.,injected Sub.conj.hae.,injected
pterygium/pingueculum,blepharitis,dry-eye pterygium/pingueculum,blepharitis,dry-eye
syndrome.syndrome. Contact lens complications Contact lens complications
Less commonLess common: : Conj tumurConj tumur

6. Differential DiagnosisDifferential Diagnosis
TRAUMATIC TRAUMATIC

Usually with pain.Usually with pain.
Vision loss variable.Vision loss variable.
NON TRAUMATICNON TRAUMATIC

Usually With ↓ pain or Usually With ↓ pain or
discomfort.discomfort.
Vision loss ↓ variableVision loss ↓ variable

7. TRAUMATRAUMA

Subconjunctival haemorrhage.Subconjunctival haemorrhage.

Corneal trauma: Corneal trauma:
abrasion/laceration/edema .abrasion/laceration/edema .

Scleral rupture/laceration.Scleral rupture/laceration.

Hyphema.Hyphema.

Vitreous haemorrhage.Vitreous haemorrhage.

Retinal tear/detachment.Retinal tear/detachment.

8. NO TRAUMANO TRAUMA
ConjunctivitisConjunctivitis
Acute GlaucomaAcute Glaucoma
Anterior Uveitis/IritisAnterior Uveitis/Iritis
Corneal Inflammation/ ulcerationCorneal Inflammation/ ulceration
Corneal infectionCorneal infection
Episcleritis/ ScleritisEpiscleritis/ Scleritis
Dry eyeDry eye
Sub conjunctival haemorrhageSub conjunctival haemorrhage
BlepharitisBlepharitis
Contact lens complicationsContact lens complications

9. Serious Red EyesSerious Red Eyes

Acute GlaucomaAcute Glaucoma

Iritis/UveitisIritis/Uveitis

Penetrating TraumaPenetrating Trauma

Microbial KeratitisMicrobial Keratitis
Pain,reduced vision and Pain,reduced vision and
unreactive pupil. Haloes unreactive pupil. Haloes
around lights.around lights.
Blurred vision, Blurred vision,
photophobia , deep photophobia , deep
boring pain .boring pain .
Reduced vision and Reduced vision and
history of trauma.history of trauma.
Pain in excess of signs, Pain in excess of signs,
reduced vision, reduced vision,
photophobia.photophobia.

10. Differential Diagnosis of “red eye”Differential Diagnosis of “red eye”

Conjunctiva


Pupil Cornea Anterior
chamber
IOP
Subconjunctival
Haemorrhage

Bright red Normal Normal Normal Normal
Conjunctivitis Injected
vessels,
fornices.
Discharge

Normal Normal Normal Normal
Iritis Injected
around cornea

Small,
fixed,
irregular

Normal,
KPs
Turgid,
deep
Normal
Acute glaucoma Entire eye red Fixed,
dilated,
oval

Hazy Shallow High

11. Mostly cornea-clearMostly cornea-clear

ViralViral- - Preauricular node, Preauricular node, mucoid dischargemucoid discharge

BacterialBacterial- - Thicker dischargeThicker discharge

Allergic Allergic - - Itching ChemosisItching Chemosis

Ophthalmia NodosaOphthalmia Nodosa-- Caterpillar Hair conj.Caterpillar Hair conj.
ConjunctivitisConjunctivitis

12. GLAUCOMAGLAUCOMA
Currently, we define the glaucoma as an
optic neuropathy (with multifactorial risk
factors that include increased IOP,
increasing age, and genetic
predisposition) characterized by
recognizable patterns of optic disc and
retinal nerve fiber structural and visual
field functional damage

13. Glaucomatous optic neuropathy is not the
disease; it is the end-result of several as yet
unidentified cellular disease processes.
Unlike almost all other optic neuropathies,
contour changes of the optic nerve head
(“cupping”) with progressive loss of the
retinal nerve fiber layer

14. and associated functional deficits are
features of the disease; this results from
accelerated retinal ganglion cell apoptosis,
initiated by damaging processes that target
the axons of these cells as they leave the
globe.

15. Thus, the definition varies with the
perspective of the definer: retinal ganglion
cell apoptosis to a scientist, optic
neuropathy to a clinician, and fear of
blindness for a patient.