PRESENTATION OPTHALM - RED EYE Flashcards
What are some differentials for a Red Eye?
(pass med)
Acute angle glaucoma
Anterior uveitis
Scleritis
Conjunctivitis
Subconjunctival haemorrhage
Endopthalmitis
Presentation of a red eye: What are KEY distinguishing features of :
Acute angle closure glaucoma
Severe pain (ocular / headache)
Decreased visual acuity
Haloes
semi-dilated pupil
hazy cornea
Presentation of a red eye: What are KEY distinguishing features of :
Anterior uveitis
acute onset
pain
blurred vision
photophobia
small fixed oval pupil, cilliary flush
Cilliary flush
Presentation of a red eye: What are KEY distinguishing features of :
Scleritis
severe pain (often worse on movement)
tenderness
underlying autoimmune disorder e.g. RA
Presentation of a red eye: What are KEY distinguishing features of :
Conjunctivitis
Bacterial : purulent discharge
Viral : clear discharge
Presentation of a red eye: What are KEY distinguishing features of :
Subconjunctival haemorrhage
Hx of trauma / coughing bouts
Presentation of a red eye: What are KEY distinguishing features of :
Endophthalmitis
red eye
pain
visual loss
post intraocular surgery
What questions should you cover in the history taking of a pt who presents with a red eye?
Onset (sudden / gradual)
Location (unilateral, bilateral)
Pain (discomfort/ gritty / FB sensation, itch, deep ache)
Photosensitivity
Watering +/or discharge
Change in vision (blurring / halos / central / peripheral / distortion / double vision etc.)
Trauma
Contact lens use
Previous ocular Hx
PMHx
What cause(s) does a pt presenting with a red eye and describing the below symptoms indicate?
Scratchiness / burning
Lid, conjunctival, corneal disorders, foreign body, trichiasis
What cause(s) does a pt presenting with a red eye and describing the below symptoms indicate?
localised lid tenderness
Hordeolum
Chalazion
What cause(s) does a pt presenting with a red eye and describing the below symptoms indicate?
Deep intense pain
corneal abrasions, scleritis, iritis, acute glaucoma, sinisitus,
What cause(s) does a pt presenting with a red eye and describing the below symptoms indicate?
Photophobia
corneal abrasions, iritis, acute glaucoma
What cause(s) does a pt presenting with a red eye and describing the below symptoms indicate?
Halo vision
corneal oedema (acute glaucoma, contact lens overwear)
What are useful tools to have on hand when examining a pt with a red eye?
Near vision card
Penlight with blue filter
topical anaesthetic
Fluorescein strip
topical mydratic
What will you do when examining a pt with a red eye?
(walk through what you will check systematically)
Inspect whole patinet
Visual acuity - each eye + PH
Eyelids
Conjunctiva (bulbar and palpebral)
Cornea (clarity, staining with fluorescein, sensation)
Anterior chamber (depth)
Pupils shape / rxn to light / accomodation
Fundoscopy
Eye movements
What will you do when examining a pt with a red eye?
(walk through what you will check systematically)
Inspect whole patient
Visual acuity - each eye + PH
Eyelids
Conjunctiva (bulbar and palpebral)
Cornea (clarity, staining with fluorescein, sensation)
Anterior chamber (depth)
Pupils shape / rxn to light / accomodation
Fundoscopy
Eye movements
What is your schema for an acute red eye?
(just categories for now)
1) Painful / discomfort
2) Painless
Now you have your schema, list differentials for an acute red eye that is PAINFUL
Conjunctivitis
Anterior Uveitis
Corneal foreign body
Scleritis
Keratitis
Episcleritis
Think of your differentials for an acute red eyes that is PAINFUL
State whether assessment of vision would be normal (N) or Reduced (R)
Conjunctivitis - N
Episcleritis - N
Keratitis - R
Anterior Uveitis - N/R
Corneal foreign body - N/R (based on where FB is)
Scleritis - N/R
Now you have your schema, list differentials for an acute red eye that is PAINLESS
Subconjunctival haemorrhage
Think of your differentials for an acute red eyes that is PAINFLESS
State whether assessment of vision would be normal (N) or Reduced (R)
Subconjunctival haemorrhage -N
What is your schema for reduced vision + red eye?
(just categories for now)
Normal IOP
Increased IOP
Think of your differentials for reduced vision + red eye with
NORMAL IOP
Many causes but think of:
Corneal abrasion
Keratitis
Endopthalmitis
Think of your differentials for reduced vision + red eye with
INCREASED IOP
Acute glaucoma
Anterior uveitis
What would you see on examination for pt w/ AACG?
(zero to finals)
Red-eye
Teary
Hazy cornea
Decreased visual acuity
Dilatation of the affected pupil
Fixed pupil size
Firm eyeball on palpation
