evaluation of red eye; june 2014
DESCRIPTION
A presentation on evaluation of red eye for General Practitioners.TRANSCRIPT
Red Eye EvaluationThis work shop is for GP’s and Specialists and will focus on how to proceed if you see a patient with red eye in your clinic.
The only thing we will presume is that you have access to a torch or at-least a mobile with torch function.
IMA Trivandrum Meeting 29 Feb June 2014
Dr. Devin Prabhakar MS,FRCS Dr. Kavitha Devin DO, DNB
www.DivyaPrabha.in
Top 10 causes of Red Eye
1. Conjunctivitis2. Uveitis3. Acute Angle Closure Glaucoma4. Episcleritis, Scleritis5. Subconjunctival Hemorrhage6. Dry Eye7. Blepharitis & Meimbomianitis8. Injury9. Corneal Ulcer10.Frequent eye drops
Bacterial ConjunctivitisMucopurulent orCatarrhal
DescriptionCommonly caused by S. aureus, S. pneumoniae, and H. Influenzae (pediatrics). Involvement of
1 eye followed 1-2 days later by the other eye. Conjunctival redness.
Viral Conjunctivitis
Watery
DescriptionCommonly adenoviruses. Bilateral. Contagious. Enlarged preauricular nodes, corneal infiltrates,
and follicular conjunctivitis.
DescriptionToxic reaction (keratitis) due to overuse of antibiotics, sympathomimetics, miotics, beta-blockers, topical anesthetics, etc. with no underlying immune dysfunction.
Toxic Medicamentosa
Lids Symptoms include ScratchingLid swelling Lid thickening Lid notches Loss of lashesCrusts
Blepharitis
Meibomitis
Lids
Lids
Symptoms • burning • stinging• dryness• irritation
Associated w/ Dry Eye
Signs
• pouting of meibomian gland
• blockage of meibomian gland
• scarring of meibomian gland
Dry Eye
DescriptionCharacterized by dryness, foreign body sensation, burning and tearing. Mild redness, often corneal and conjunctival staining. Many causes including decreased circulating hormones, menopause, lid disease, autoimmune disease, drying medications, meibomian disease, environmental factors.
X
X
DescriptionAngry red eye; corneal epithelial and stromal necrosis evident by opacity and fluoroscein staining. Painful and photophobic. Generally bacterial.
Corneal Ulcer
Hyperemia and chemosis of inferior bulbar conjunctiva
Allergic folliculosis due to topical alpha adrenergic agonist
Drug-induced Allergic Conjunctivitis
Management of Conjunctivitis•Prophylaxis•Hygienic measures•Local Antibiotics•Look for corneal lesions•Avoid steroid e/d
Management of Blepharitis•Eye lid shampoo•Warm compress•Artificial tears•Erythromycin ointment qid to lids•Restasis for meibomitis•Antibiotics
•Tetracycline 250 mg qid 2 weeks •Doxy 100 •Erythromycin 200 mg bd
•Look for pediculosis
Dry Eye
•Environmental factors•Personal habits
•Medications
•Antihypertensives,
•Antihistamines,
•Antidepressants
•Post-surgical.
•Discourage from Contact lens,LASIK
Management of dry eyeMild dry eye:
• Artficial tears: Refresh Tears [carboxy methyl cellulose], Tears Natural [Hydroxypropyl Methyl cellulose],Systane [polyethylene glycol and propylene glycol],Genteal [hydroxy propyl Methyl cellulose],etc
• Ocular hygiene
• Proper specs
• Treat predisposing factors
Severe dry eye
Restasis,
Mucus strands removal
Lat tarsorrhaphy
Adhesive tape
Moderate dry eye: • increase frequency of Artificial
tears,
• opt for preservative free
• Add ointment
• Punctal occlusion
• Restasis eye drops
How Many People Are Affected by Allergy?According to the Gallup Study of Allergies*:
OcularSymptoms
No OcularSymptoms
50% of the population has allergies
83% of allergy sufferers experienceocular symptoms
* Data from 2003-2004 survey.
Common Causes of Ocular Allergies
Vernal Keratoconjunctivitis (VKC)Vernal Keratoconjunctivitis (VKC)Signs/Symptoms: Ptosis Ropy mucous discharge Photophobia Large, nonuniform cobblestone papillae
Trantas dots Limbal nodules Neovascularization Shield ulcers Itching Frank inflammation with leukocyte influx
Divya Prabha Eye Hospital 0471-2442050
Acute Angle Closure Glaucoma
Divya Prabha Eye Hospital 0471-2442050
Divya Prabha Eye Hospital 0471-2442050
Forgein Body
Divya Prabha Eye Hospital 0471-2442050
Divya Prabha Eye Hospital 0471-2442050
Divya Prabha Eye Hospital 0471-2442050
Divya Prabha Eye Hospital 0471-2442050
Watch out if• History
– Pain– Blurred Vision
• Examination– Circumcorneal Conjestion– Steamy cornea– Corneal Opacity– Pupil reaction– Hypopyon
Thank You !!
www.Facebook.com/DevinPrabhakarwww.DivyaPrabha.inMobile: 9388342050
Divya Prabha Eye HospitalKumarapuram Kannanmoola Road
Trivandrum, KeralaIndia