Clinical Approach to Red Eye Flashcards
What can redness of the eye mean?
Pain, blindness or systemic disease
What are some diagnostic tools that can be used for red eye?
Fluorescein, STT, Tonometry and Cytology
Redness always =
Blood
What should you always ask yourself about this blood?
Is it in the vessels (promiant or neovascularization)
Is it outside the vessels?
What is conjunctival hyperemia?
Diffuse redness or small network of vessels
-Bulbar conjunctiva - mobile over globe
-Palpebral conjunctiva - eyelids
-Palpebral and bulbar surface NM as well
What is episcleral Injection?
Distinct and relatively straight vessels
-Adherent to sclera, posterior to equator from limbus
What is corneal neovascularization?
-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
What is hemorrhage in the eye?
Blood outside the vessels in no distinct pattern
-Subconjunctival
-Hyphema - intraocular hemorrhage replace normal aqueous humor, change over time
What are some differentials for subconjuctival hemorrhage?
coagulation disorder/vasculitis, proptosis, trauma and strangulation
What are some causes of hypema?
Retinal detachment, coagulation disorder/vasculitis, systemic hypertension, uveitis and neoplasia
What does conjunctivitis mean?
Diffuse conjunctival hyperemia and chemosis
(diagnose with cytology)
What does superficial keratitis/keratoconjunctivitis look like?
Long branching corneal vessels
Conjuctival hyperemia
Differntials: Nonulcerative superfiical keratitis (KCS, exposure, abberant hair, IMK, pannus, corneal ulceration
What dose keratitis look like?
Depth in corneal vessels can determine ulcer or corneal inflammatory disease
Differential: Nonulcerative keratitis, ulcerative keratitis
Ulcerative Keratitis?
Assess vessel pattern, fluorescein locaiton and pattern STT
Intraocular disease?
Episcleral injection
Conjuctival hyperemia
360 degree deep corneal vessels
Uveitis and glaucoma
What are some diagnostics you may choose to use if you think the disease causing the redness is superficial?
Schirmer teat test, fluorescein stain, cytology and culture
What are some diagnostics that may be used for a red eye that you suspect intraocular disease in?
Evaluate pupil size and tonometry (uveitis and glaucoma)
What are the most important rule outs for red eyes?
Corneal Ulcer, Uveitis, Glaucoma, Dry eye
What type of diagnostics should be used on most all red eyes?
Close Exam
Schirmer Tear Test
Fluoresiien stain
Tonometry
What is a normal value for Schirmer Tear Test?
> 15mm
How do you know a fluorescein test is positive?
Increase uptake of stain in a localized area
What could be an indication for conreoconjuctival cytology?
Plaques (fungal)
What coat color is associated with multiple congenital ocular anomalies like retinal detachement?
Merle
What type of retinal detachment is expected to bleed intermittently?
Rhegmatogenous
What is the normal intraocular pressure in dogs eyes?
10-25mmHG
(Above 50 can cause blindness)
(Differences greater than 8 significant)