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Comprehensive Guide to Red Eye Examination: Causes, Symptoms, and Management

This tutorial provides a thorough examination of red eye conditions, detailing signs, associated symptoms, and underlying causes. Key assessments include visual acuity, pupil response, and examination of the cornea and eyelids. Recognize potential issues such as iritis, scleritis, acute glaucoma, conjunctivitis, and orbital cellulitis. Learn about urgent referral criteria and treatment options for inflamed eyes, including the use of steroids, medication, and the need for specialized care. Understand how to identify associated symptoms like pain, photophobia, and proptosis.

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Comprehensive Guide to Red Eye Examination: Causes, Symptoms, and Management

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  1. Eyes Tutorial 12/7/05

  2. Red Eye

  3. Red Eye

  4. Examination • Pattern- danger around cornea • Discharge- watery/purulent • Ant eye chamber- pus/bld, colour, equal pupils • Cornea- RR, glossy/dull, FB • Proptosis • Eyelids- red,swelling, entropian, ectropian, FB

  5. Examination cont • PAIN • Reduced VA • PHOTOPHOBIA • TRAUMA THEN TEST VA, PERLA, opthalmoscopy, flouriscin

  6. Corneal Inflammation/Keratitis (ulcer) • Sxs- pain, red vision, photophobia, pericorneal redness • Assc- contact lenses, Inf – HZ/HSx, Elderly (eyelid dx), poor eye closure • Fx to Id may lead to perm scarring- stain with flouriscin> show up green with blue filter • Tx underlying infn

  7. Red Eye Causes • IRITIS • Assc with inflammation of cilliary body> may be assc with abn pupil or pus/precipitate in ant chamber • Acute onset of pain, photophobia, watering, irregular pupil, pain on convergance and constriction • Systemic dx- sarcoid/ ank spond • Infn (rare)- Syphillis/TB/HZ • Urgent referral- steroids and mydritics • Relapse - common

  8. SCLERITIS • Generalised inflammation of the episclera • Can be compication of CT dx • Urgent referral • Pain, generalised redness, more florid, bluish discolouration to sclera with ischaemia • EPISCLERITIS • More common • Discomfort- dull ache • Superficial vessels- localised redness

  9. Acute Glaucoma • Severe pain, N/V, red VA/loss, mild dilated fixed pupil, pericorneal redness, steamy cornea, eyeball feels hard • Warning halos • Recent use of dilators • Middle or old age • Blockage of aqueous drainage from ant chamber> sudden inc in IO pressure • Refer immd • Pilorcarpine drops/ surgery pr laser when pressure ok

  10. Summary danger s and s • Sxs • Ocular pain • Photophobia • Reduced VA • Signs • Pericorneal redness • Clouding/ staining of cornea • Abn pupil • proptosis

  11. Conjunctivitis • Inf- Bact/ viral • Allergy-atopy/CL • Tear Fn- • Eyedrops- glaucoma drops, allergy • Injury- FB, CL, trauma • Eyelid- blepharitis

  12. Others • SC haemorrhage • Spont localised haemorrhage • Elderly, bleeding dx (rare), raised BP, trauma • Redness- sharp boundaries • 1-2 weeks- • Consider referral if trauma and post edge not visible (orbital haematoma)

  13. Orbital cellulitis • Infn spread from paranasal sinuses • Fever, swelling, proptosis, pain moving eyeball • Refer for IV antibiotics immd • Complicns- meningitis, cav sinus thrombosis, blindness

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