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Eyes

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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