red eyes • ocular emergencies • ophthalmoscopywichita.kumc.edu/documents/wichita/familymed/eye...
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Family Medicine Eye Workshop
• Red Eyes• Ocular Emergencies• Ophthalmoscopy
2
Refer to Ophthalmologist
Traumatic injury to eyeLoss of visionExtreme eye pain not explained by pathologyKeratitisSuspected uveitis or glaucomaChemical injury (esp. alkali)Corneal abrasion not healing
Anatomy of eyelid
Staphylococcal Blepharitis
5
Staphyloccal Blepharitis
Warm, moist packsBaby shampoo scrubsErythromycin ointment HS
Discharge with Staphyloccocal Blepharitis
Seborrheic Blepharitis
8
Seborrheic Blepharitis
Warm, moist packsBaby shampoo scrubs
Hordeolum (external)
External hordeolum
11
Hordeolum
Warm, moist compressesTreat blepharitis if present
Chalazion
Chalazion
Chalazion
1
Orbital Cellulitis
Orbital Cellulitis
Orbital Cellulitis
• Hospitalize• CT Orbits• CT Sinus• Blood Cultures• ENT Consult• Ophthalmology Consult
Viral Keratitis
19
Dendritic keratitis
Fluorescein stain
Subconjunctival Hemorrhage
Conjunctiva Anatomy
Viral conjunctivitis
23
Viral Conjunctivitis
Usually starts in one eye and frequently spreads to other eyeProfuse watery dischargeOften seen in epidemics
Bacterial Conjunctivitis
25
Bacterial Conjunctivitis
Often in one eyePurulent discharge
Allergic Conjunctivitis
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Allergic Conjunctivitis
Usually in both eyesItchy eyesMucoid dischargeOften accompanies allergic rhinitis
Upper eyelid eversion
Foreign Body – Upper Eyelid
Corneal Abrasion
• Symtoms: Tearing, Pain, Photophobia• Causes: Trauma, Welding Burn, Contact
Lens Overwear
Fluorescein stain
Corneal abrasion
Corneal Abrasion Treatment
• Antibiotic drops• Consider NSAID topical (Ketoralac)• No evidence that patching is beneficial
(patching may cause harm, in fact)• Re-examine patient the following day• Refer if corneal abrasion is not healing
Normal retina
Ophthalmoscope exam
36
Conventional vs. Panoptic
14 magnifications50 field of view
18 magnifications250 field of view
37
Ophthalmoscope Apertures
Small: Undilated pupilLarge: Dilated pupilSlit: Look for retinal elev./depressionCobalt Blue light: Fluorescein examGreen light: Retinal hemorrhageRed-Free filter: excl. red raysHalf-Moon: Combination of depth perception and field of view
Red reflex
Cataract
Papilledema
HTN Retinopathy
Diabetic Retinopathy
Macular Degeneration
Retinal Detachment
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