Clinical Approach to Red Eye

Question 1

What can redness of the eye mean?

Answer 1

Pain, blindness or systemic disease

Question 2

What are some diagnostic tools that can be used for red eye?

Answer 2

Fluorescein, STT, Tonometry and Cytology

Question 3

Redness always =

Answer 3

Blood

Question 4

What should you always ask yourself about this blood?

Answer 4

Is it in the vessels (promiant or neovascularization)
Is it outside the vessels?

Question 5

What is conjunctival hyperemia?

Answer 5

Diffuse redness or small network of vessels

-Bulbar conjunctiva - mobile over globe
-Palpebral conjunctiva - eyelids
-Palpebral and bulbar surface NM as well

Question 6

What is episcleral Injection?

Answer 6

Distinct and relatively straight vessels
-Adherent to sclera, posterior to equator from limbus

Question 7

What is corneal neovascularization?

Answer 7

-Loss physiologic corneal transparentcy

-Define vessel type/location by appearance

-Deep tromal hedge like not at limbus
Superficial - tree like branching, cross limbus
360 deep

Question 8

What is hemorrhage in the eye?

Answer 8

Blood outside the vessels in no distinct pattern

-Subconjunctival
-Hyphema - intraocular hemorrhage replace normal aqueous humor, change over time

Question 9

What are some differentials for subconjuctival hemorrhage?

Answer 9

coagulation disorder/vasculitis, proptosis, trauma and strangulation

Question 10

What are some causes of hypema?

Answer 10

Retinal detachment, coagulation disorder/vasculitis, systemic hypertension, uveitis and neoplasia

Question 11

What does conjunctivitis mean?

Answer 11

Diffuse conjunctival hyperemia and chemosis

(diagnose with cytology)

Question 12

What does superficial keratitis/keratoconjunctivitis look like?

Answer 12

Long branching corneal vessels
Conjuctival hyperemia

Differntials: Nonulcerative superfiical keratitis (KCS, exposure, abberant hair, IMK, pannus, corneal ulceration

Question 13

What dose keratitis look like?

Answer 13

Depth in corneal vessels can determine ulcer or corneal inflammatory disease

Differential: Nonulcerative keratitis, ulcerative keratitis

Question 14

Ulcerative Keratitis?

Answer 14

Assess vessel pattern, fluorescein locaiton and pattern STT

Question 15

Intraocular disease?

Answer 15

Episcleral injection
Conjuctival hyperemia
360 degree deep corneal vessels

Uveitis and glaucoma

Question 16

What are some diagnostics you may choose to use if you think the disease causing the redness is superficial?

Answer 16

Schirmer teat test, fluorescein stain, cytology and culture

Question 17

What are some diagnostics that may be used for a red eye that you suspect intraocular disease in?

Answer 17

Evaluate pupil size and tonometry (uveitis and glaucoma)

Question 18

What are the most important rule outs for red eyes?

Answer 18

Corneal Ulcer, Uveitis, Glaucoma, Dry eye

Question 19

What type of diagnostics should be used on most all red eyes?

Answer 19

Close Exam
Schirmer Tear Test
Fluoresiien stain
Tonometry

Question 20

What is a normal value for Schirmer Tear Test?

Answer 20

> 15mm

Question 21

How do you know a fluorescein test is positive?

Answer 21

Increase uptake of stain in a localized area

Question 22

What could be an indication for conreoconjuctival cytology?

Answer 22

Plaques (fungal)

Question 23

What coat color is associated with multiple congenital ocular anomalies like retinal detachement?

Answer 23

Merle

Question 24

What type of retinal detachment is expected to bleed intermittently?

Answer 24

Rhegmatogenous

Question 25

What is the normal intraocular pressure in dogs eyes?

Answer 25

10-25mmHG
(Above 50 can cause blindness)
(Differences greater than 8 significant)