acute unilateral red eye n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Acute unilateral red eye PowerPoint Presentation
Download Presentation
Acute unilateral red eye

Loading in 2 Seconds...

play fullscreen
1 / 47

Acute unilateral red eye - PowerPoint PPT Presentation


  • 113 Views
  • Uploaded on

Acute unilateral red eye. Dr. Anthony Hall MD, FRA NZ CO. differential diagnosis of the unilateral red eye. Eyelid Conjunctiva Conjunctivitis Cornea Corneal foreign body/ulcer Infectious keratitis Sclera Anterior chamber Iritis Angle closure glaucoma Orbit. Eyelid.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Acute unilateral red eye' - nona


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
acute unilateral red eye

Acute unilateral red eye

Dr. Anthony Hall MD, FRANZCO

differential diagnosis of the unilateral red eye
differential diagnosis of the unilateral red eye
  • Eyelid
  • Conjunctiva
    • Conjunctivitis
  • Cornea
    • Corneal foreign body/ulcer
    • Infectious keratitis
  • Sclera
  • Anterior chamber
    • Iritis
    • Angle closure glaucoma
  • Orbit
acute lid problems
Acute lid problems

Chalazion

Preseptal cellulitis

chalazion
Chalazion
  • Obstructed and infected and inflamed meibomian gland
  • Unilateral, unifocal lid swelling
chalazion initial treatment
Chalazion – initial treatment
  • Topical antibiotics
    • + oral if associated cellulitis
  • Hot compresses
  • If fails then surgery
chalazion surgical treatment
Chalazion – surgical treatment
  • LA
  • Lid everted
  • Chalazion incised form tarsal surface
preseptal cellulitis
Preseptal cellulitis
  • Acutely unwell
  • Swollen, tender red eyelid
  • No orbital signs
    • No proptosis, visual loss, movement problems
conjunctivitis
Conjunctivitis
  • Viral
    • Watery discharge
    • URTI
  • Allergic
    • Itch
    • Stringy discharge
    • Atopic patient
  • Usually bilateral!!
viral conjunctivitis
Viral conjunctivitis
  • URTI
  • Acute pain, redness, and watery discharge
  • Normal pupil
  • Normal VA
  • Normal cornea
  • Management
allergic conjunctivitis
Allergic conjunctivitis
  • Atopy
  • Sub-acute irritation, itch, redness, and stringy discharge
  • Normal pupil
  • Normal VA
  • Normal cornea
keratitis
Keratitis
  • Suspect if
    • Corneal fluorescein stain (dendritic)
    • Focal corneal swelling
    • Past history HSV/VZV
    • Contact lens wear
    • Post trauma
keratitis management
Keratitis management
  • HSV
    • Topical aciclovir till epithelium healed
keratitis management1
Keratitis management
  • Bacterial
    • Intensive topical antibiotics
corneal foreign body ulcer
Corneal foreign body/ulcer
  • Suspect if
    • History of grinding etc
    • Fluorescein staining
    • Corneal/subtarsal foreign body
    • Always evert eyelid
management of corneal fb
Management of corneal FB
  • Topical LA
  • Remove fb with 23 G needle
  • Oc Chloro and pad 24 hrs
corneal ulcer
Corneal ulcer
  • Without Fluorescein: 
  • Underlying cornea is clear - iris details are seen
trauma
Trauma
  • Hyphaema or corneal abrasion may follow trauma
  • In this setting beware of
    • Keratitis
    • Perforation
iritis acute anterior uveitis
Iritis(acute anterior uveitis)
  • Inflammation confined primarily to the iris and anterior chamber
  • Resolving totally within three months
  • (not associated with other significant anterior or posterior segment pathology)
iritis symptoms
pain

redness

photophobia

epiphora

Iritis - symptoms
iritis signs
Iritis - signs
  • ciliary flush
  • small irregular pupil
  • AC cells and flare
  • keratic precipitates
  • hypopyon
  • iris nodules
  • spill over vitritis
b 27 related diseases
B 27 related diseases
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Reiters syndrome (reactive arthritis)
  • Inflammatory bowel disease associated arthropathy
sarcoidosis
Sarcoidosis
  • Multisystem granulomatous disease
    • 90% lung
    • 90% lymph node
    • 25-50% joint involvement
    • 25% skin
    • 25% eye
syphilis
Syphilis
  • Primary
    • 4-6 weeks of ulcer
  • Secondary
    • 2-4 months
    • Skin rash and lymphadenopathy
    • Eye and CNS involvement
  • Latent/tertiary
    • CVS and CNS
viral
Viral
  • Suspect if
    • History of simplex or zoster
    • Chronic course
    • Iris changes
    • High pressure
    • Keratitis (old or new)
investigation of aau
Most important

Clinical

History

Family history

Examination

Less important

HLA B 27

Sarcoidosis

CXR

ACE

Syphilis serology

Investigation of AAU
principles of management of iritis
Principles of management of Iritis
  • Determine the underlying cause
  • Control the inflammation
  • Detect and control ocular complications of
    • the inflammation
    • the treatment
how to control the inflammation
How to control the inflammation
  • Adequate high potency topical steroids
  • Sub conjunctival steroids
  • Oral steroids
  • Aggressive dilation
  • Regular and close review
acute angle closure glaucoma
Acute angle closure glaucoma
  • Unusual
  • Severe pain
  • Profound visual loss
  • Cloudy cornea
  • Fixed mid position pupil
  • Treatment
    • iridotomy
orbital cellulitis
Orbital cellulitis
  • Pre septal
    • Acute lid swelling
    • No chemosis, visual loss or eye movement disorder
    • Secondary to trauma, chalazia, lacrimal sac disease
  • Orbital
    • Lid swelling
    • Chemosis, visual loss, eye movement abnormalities
    • Secondary to sinus disease
slide44
Pre septal

Orbital

treatment
Treatment

Pre septal

Orbital

Image

Drain sinus disease

Antibiotics

Drain orbital disease

  • Antibiotics
key steps in the diagnosis of the unilateral red eye
History

Ocular

Previous episodes

CL wear

Trauma

Systemic

Auto-immune disease

Recent URTI

Examination

VA

Cornea

Pupil

Conjunctiva

Key steps in the diagnosis of the unilateral red eye