Transcript Eyes - Audley Mills

Eyes
Tutorial 12/7/05
Red Eye
conjunctiva
cornea
infection
FB
allergy
Abrasion
injury
Erosion
SC
haemorrhage
Keratitis/ulcer
Anterior
chamber
Iris
Acute
glaucoma
Red Eye
Sclera
Eyelid
Orbit
Episcleritis
Chalazion
Cellulitis
Scleritis
Blepharitis
Trauma
HZ
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
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Examination cont
PAIN
 Reduced VA
 PHOTOPHOBIA
 TRAUMA
THEN TEST
VA, PERLA, opthalmoscopy, flouriscin

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

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

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
Acute Glaucoma
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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
Summary danger s and s
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
Sxs
 Ocular pain
 Photophobia
 Reduced VA
Signs
 Pericorneal redness
 Clouding/ staining of cornea
 Abn pupil
 proptosis
Conjunctivitis
Inf- Bact/ viral
 Allergy-atopy/CL
 Tear Fn Eyedrops- glaucoma drops, allergy
 Injury- FB, CL, trauma
 Eyelid- blepharitis

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)

Orbital cellulitis
 Infn spread from paranasal sinuses
 Fever, swelling, proptosis, pain moving
eyeball
 Refer for IV antibiotics immd
 Complicns- meningitis, cav sinus
thrombosis, blindness