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Red Eye
Red Eye ¾Lid ¾Blepharitis ¾Lacrimal system ¾Dacryocystitis ¾Conjunctiva ¾Conjunctivitis ¾Pterygium & Pinguecula R d E Red Eye ¾ Acute uveitis ¾ Scleritis g ¾ Acute glaucoma ¾ Corneal defects ¾Abrasion ¾Ulceration Inflammation of the uveal tract U iti : Cl Uveitis Classification ifi ti ¾Anatomical ¾Clinical ¾Etiological ¾ ¾Pathological i Uveitis : Anatomical Classification ¾Anterior uveitis ¾Intermediate uveitis ¾Posterior uveitis ¾Panuveitis U iti : Cli Uveitis Clinical i l classification l ifi ti ¾Acute ¾Sudden ¾S dd onsett ¾< 6 week persistence p ¾Recurrent ¾Chronic ¾Prolonged persistence ¾Less symptomatic Uveitis : Etiological Classification • Exogenous g • Endogenous • @ systemic t i di diseases • Infectious • Idiopathic Uveitis : Pathological Classification ¾Granulomatous ¾Nongranulomatous Anterior Uveitis ¾ Symptoms S t ¾Photophobia ¾P i ¾Pain ¾Decreased vision ¾L i ¾Lacrimation i ¾Red eye ¾ Signs ¾Ciliary injection ¾Keratic precipitates ¾Aqueous cells/flare ¾Iris atrophy ¾Synechiae Intermediate Uveitis • Symptoms • Floaters • Decreased vision • Signs • Vitreous cells Posterior uveitis ¾Symptoms ¾Signs g ¾Floaters ¾Impaired vision ¾Vitreous cells/flare & opacities ¾Ch idi i ¾Choroiditis ¾Retinits ¾Vasculitis Uveitis & Arthritis ¾Ankylosing spondylitis ¾Reiter’s syndrome ¾Psoriatis arhritis ¾Juvenile RA Uveitis & Systemic diseases ¾Infectious ¾Non-infectious ¾AIDS ¾Acquired syphilis ¾Tuberculosis ¾Leprosy L ¾Sarcoidosis ¾Behcet’s disease ¾Vogt-Koyanaki-Harada syndrome Uveitis & Infections ¾ Parasite ¾Toxoplasmosis ¾Toxocariasis ¾ Virus ¾Herpes zoster ¾Herpes simplex g rubella ¾Congenital ¾ Fungus ¾Histoplasosis p ¾Candidiasis Treatment of Uveitis ¾Goals ¾Prevent visual complications ¾Relieve discomfort ¾Treat the underlying disease, if possible Treatment of Uveitis ¾Cycloplegics ¾C l l i / mydriatics d i ti ¾Relieve ciliary spasm ¾Prevent posterior synechia formation ¾Synechialysis Treatment of Uveitis ¾Steroids ¾Topical ¾Periocular ¾Systemic ¾Side effects ¾ Ocular ¾Glaucoma ¾Cataract ¾Corneal complications ¾ Systemic Treatment of Uveitis ¾Immunosuppressive agents ¾Cytotoxic drugs ¾Cyclosporins S l ii Scleritis ¾Diffuse ¾Nodular •Immune Immune disease ¾ Angle-closure A l l glaucoma l ¾Primary angle-closure glaucoma ¾Secondary ¾Lens dislocation ¾Neovascular glaucoma ¾ Open-angle glaucoma ¾Acute uveitis ¾Phacolytic glaucoma Primary Angle-Closure Angle Closure Glaucoma ¾ Relatively common in Orientals ¾ > 40 years ¾ Women > men ¾ Risk factors ¾Increased lens thickness ¾Small corneal diameter ¾Short axial length Primary Angle-Closure Angle Closure Glaucoma ¾Mechanism ¾Relative pupillary block ¾Iris bombe ¾Iridotrabecular contact ¾ Open O angle l ¾ Closed angle Primary Angle-Closure Glaucoma ¾Symptoms ¾Pain ¾Nausea & vomiting ¾H l ¾Halos ¾Blurred vision ¾Red eye Primary Angle-Closure Glaucoma ¾ Signs ¾Ciliary flush ¾Elevated IOP ¾Corneal edema ¾Fixed,oval, dilated pupil ¾Glaukomflecken Primary Angle-Closure Angle Closure Glaucoma ¾ Medical Rx ¾Hyperosmotic agents y inhibitors ¾Carbonic anhydrase ¾Beta-blockers ¾Alpha 2 agonists ¾Miotics PACG Surgical Rx I id t Iridectomy : th the d definitive fi iti Rx R PACG Surgical Rx Goniosynechialysis PACG Surgical Rx Filtering surgery : trabeculectomy ¾ ¾ Symptoms ¾ Pain ¾ Lacrimation ¾ Photphobia ¾ Blurred vision ¾ Red eye Signs ¾ Ciliary injection ¾ Irregular light reflex ¾ Fluorescein staining Corneal Abrasion Rx ¾Pressure patching ¾P t hi ¾Debridement ¾Contact lens ¾ ¾Lubrication i i ¾Stromal St o a puncture pu ctu e ¾Infections ¾Bacteria ¾Fungus ¾Parasite ¾Virus Corneal Ulceration Rx ¾Antimicrobial agents ¾Cycloplegics ¾Steroids
