the red eye differential diagnosis l.
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The Red Eye Differential Diagnosis. Differential Diagnosis of “red eye”. Conjunctivitis. Follicles. Purulent discharge. Papillae. Chemosis. Redness. Subconjunctival Haemorrhage. Diffuse or localised area of blood under conjunctiva. Asymptomatic

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conjunctivitis
Conjunctivitis

Follicles

Purulent discharge

Papillae

Chemosis

Redness

subconjunctival haemorrhage
Subconjunctival Haemorrhage
  • Diffuse or localised area of blood under conjunctiva. Asymptomatic
  • Idiopathic, trauma, cough, sneezing, aspirin, HT
  • Resolves within 10-14 days
dry eye syndrome
Dry Eye Syndrome
  • Poor quality
    • Meibomian gland disease,Acne rosacea
    • Lid related
    • Vitamin A deficiency
  • Poor quantity
    • KCS
      • Sjogren Syndrome
      • Rheumatoid Arthritis
    • Lacrimal disease ie, Sarcoidosis
    • Paralytic ie, VII CN palsy
corneal abrasion
Corneal Abrasion
  • Surface epithelium sloughed off.
  • Stains with fluorescein
  • Usually due to trauma
  • Pain, FB sensation,tearing, red eye
corneal ulcer
Corneal Ulcer
  • Infection
    • Bacterial: Adnexal infection, lid malposition, dry eye, CL
    • Viral: HSV, HZO
    • Fungal:
    • Protozoan: Acanthamoeba in CL wearer
  • Mechanical or trauma
  • Chemical: Alkali injuries are worse than acid
episcleritis
Episcleritis
  • Superficial
  • Idiopathic, collagen vascular disorder (RA)
  • Asymptomatic, mild pain
  • Self-limiting or topical treatment
scleritis
Scleritis
  • Deep
  • Idiopathic
  • Collagen vascular disease (RA,AS, SLE, Wegener, PAN)
  • Zoster
  • Sarcoidosis
  • Dull, deep pain wakes patient at night
  • Systemic treatment with NSAI or Prednisolone if severe
uveitis
Uveitis

Anterior: acute recurrent and chronic

Posterior: vitritis, retinal vasculitis, retinitis, choroiditis

Panuveitis: anterior and posterior

anterior uveitis iritis
Anterior uveitis (iritis)
  • Photophobia, red eye, decreased vision
  • Idiopathic. Commonest
  • Associated to systemic disease
    • Seronegative arthropathies:AS, IBD, Psoriatic arthritis, Reiter’s
    • Autoimmune: Sarcoidosis, Behcets
    • Infection: Shingles, Toxoplasmosis, TB, Syphillis, HIV
slide16

Ciliary flush

Posterior synechiae

Fibrin

Flare

Hypopyon

KPs

acute angle closure glaucoma
Acute Angle-closure Glaucoma
  • Symptoms
    • Pain, headache, nausea-vomiting
    • Redness, photophobia,
    • Reduced vision
    • Haloes around lights

Ciliary hyperaemia

Dilated pupil

Corneal oedema