-One of the most common complaints in

ophthalmology.

- It means redness of the exposed white of the

eye; the exposed conjuctiva and underlying

sclera.

- Associated symptoms will help establish the

diagnosis.

Major Causes Trauma

Infection

Acute Glaucoma

Other inflammations

Associated symptoms Discharge

Pain

Photophobia

Blurred vision

beacauseBright red, y? hemorrhage: Subconjuctivalthe blood is well oxygenated so remains bright . Maybe associated with HTN or blood clotting disorders including anti-coagulatant therapy so check INR + Hx

: Extreme pain, Corneal foreign body & abrasions watering. Ciliary or Limbal flush is a reflex vasodialtion of limbal episcleral vessels often in the meridian of the lesion aiding in its detection.

: Alkali is worse than acid burn, y?Chemical Injury

Because alkali diffuse more , while acid coagulate forming a layer that prevent its diffusion .

Ttx by irrigation immediately.

Discharge, visual blur due to :Conjuctivitis

discharge cleared on blinking. Bacterial gives

purulent discharge giving sticky eyelids. Viral

gives watery discharge.

ry infection.2 :entropionand Blepharitis

Affects visual axis, sight Corneal infection:

threatening esp. acanthamoeaba keratitis. Hx of

lens. Mucopurulent discharge.

op, -post ):endophthalmitisIntraocular infection (

painful red eye, reduced vision. Emergency.

, swollen, cellulitisorbital Infection of the orbit:

erythematous lids, chemotic conjuctiva, red,

reduced eye movements, proptosis. Emergency

because the vision may be rapidly lost due to Optic

Nerve Damage.

Ttx IV antibiotics and admission

Acute angle closure glaucoma.

Generalized red eye, corneal clouding, reduced

vision and severe pain. Urgent.

Spring & summer, :conjuctivitisSeasonal allergic

allergens. Chomotic, itchy, watery, sneezing,Hx of

atopy. Vision unaffected.

MILD redness, irritation and tired eyes. Dry eyes:

No discharge. Vision unaffected. :Episcleritis

Pain deep and boring, associated with :Scleritis

collagen vascular diseases.

analogues used ProstglandinTopical. Medications:

in treatment of Glaucoma.

.pinguecula& Pterygia Others:

28 year old male presents with painful, red eye.

Blurred vision increasing over last 2 days.

Wears contact lenses. Vision is 6/60 in right

eye, there is central opacity on the cornea. A

small hypopyon is present.

Diagnosis?

Bacterial keratitis

Approach & Ttx?

Fortified broad spectrum

Antibiotic ( vancomycin and

tobramycin )

:Pain

Itching & discomfort

Deep severe pain

Eye strain

Headache

Discomfort Blepharitis

Dry eyes

Conjuctivitis

Allergy

Dysthyroid eye disease

Pain on eye movements Optic Neuritis

Pain around eye Giant cell arteritis

Migraine

Orbital cellulitis

Causes of headache

Severe Pain Keratitis

Corneal abr./ul./FB

Uveitis

Angle Closure Glaucoma

Endophthalmitis

Scleritis

Myositis of extraocular muscles

A 75 year old female presents with nausea and vomiting. Rt eye is painful and red. Reduced vision. She is longsighted. No history of medical problems.

Cornea is cloudy , the pupil is dilated and oval on the affected side.

Diagnosis?

Acute angle closure glaucoma

Confirm by..?

Tonometer , goniometer

Ttx?

All effort to decrease IOP by oral acetazolamide and b-blocker and pilocarpine urgently . But the main step is to do bilateral iridotomy .

Most chemical substances that come in contact with the conjunctiva or cornea cause little harm.

The chief danger comes from alkali-containing compounds found in household cleaning fluids, fertilizers and pesticides. They erode and opacify the cornea.

Acid-containing compounds (battery fluid,

chemistry labs) are somewhat less dangerous.

There are no antidotes to these chemicals. The best you can do is to dilute them immediately with plain water.

The resultant reaction of the tissue causes the damage.

Treatment should be instituted immediately, even before testing vision.

Emergency treatment:

1-copious irrigation of the eyes, preferably with saline or ringer lactate.

Don’t use acidic solutions to neutralize alkalis or vice versa.

Pull down the lower eyelid and evert the upper eyelid to irrigate the fornices

2-irrigation should be continued until neutral PH is reached.

The volume of irrigation fluid required to reach neutral PH varies with the chemical and the duration of the chemical exposure

For mild to moderate burns (during and

after irrigation):

cycloplegic

topical antibiotic

oral pain medication

if increase IOP use drugs to reduce it

(acetazolamide, methazolamide add b

blocker if additional IOP control is required)

frequent use of preservative free artificial

tear

For severe burns (Treatment after irrigation): Admission to the hospital Lysis of conjunctival adhesion Debride necrotic tissue Topical antibiotic Topical steroid Consider a pressure patch Antiglaucoma medication if the IOP is increased or cant be

determined Frequent use of preservative free artificial tear Other consideration: Therapeutic contact lenses, collagen, amniotic membrane

transplant IV ascorbate and citrate for alkali burns If any melting of the cornea occurs, collagenase inhibitors may

be used If the melting progresses an emergency patch graft or corneal

transplat may be necessary.

A hazy cornea

following an

alkali burn