Diploma In Family Health Care

Professor Noshad Ahmed ShaikhVice Chancellor

Liaquat University of Medical and Health Sciences/Jamshoro.

Dr Isam Al-Qurainy 3

Dr Isam Al-Qurainy 4

Dr Isam Al-Qurainy 5

The Red EyeDifferential Diagnosis

Sameen Afzal JunejoMCPS; DOMS; FCPS

Professor of OphthalmologyLUMHS/Jamshoro

Causes Of Red Eye

• 1) Conjunctivitis.

• 2) Corneal Abrasions and Ulcer.

• 3) Acute Angle Closure Glaucoma.

• 4) Uveitis.

• 5) Episcleritis and Scleritis.

• 6) Sub-Conjunctival Haemorrhage.7

Conjunctivitis

FolliclesPapillae Purulent discharge

ChemosisRedness

Acute Bacterial Conjunctivitis

Acute Viral Conjunctivitis

Corneal Abrasion

• Surface epithelium sloughed off.

• Stains with fluorescein

• Usually due to trauma

• Pain, FB sensation, tearing, red eye

Corneal Ulcer• Infection

– Bacterial:

– Viral: HSV, HZO

– Fungal:

– Protozoan: Acanthamoeba in CL wearer

• Mechanical or trauma

• Chemical: Alkali injuries are worse than acid

Corneal ulcer stained green with fluorescein dye.

Purulent Corneal Ulcer with Hypopyon

Excessive Steroid Usage

Acute Angle-closure Glaucoma

• Symptoms

– Pain, headache, nausea-vomiting

– Redness, photophobia,

– Reduced vision

– Haloes around lights

– Raised IOP

Corneal oedema

Ciliary hyperaemiaDilated pupil

Acute Angle Closure Glaucoma

Uveitis

Anterior: acute recurrent and chronic

Intermediate: Ciliary Body

Posterior: vitritis, retinal vasculitis, retinitis, choroiditis

Pan uveitis: anterior and posterior

Anterior uveitis (Iritis)

• Photophobia, red eye, decreased vision, pain

• Idiopathic. Commonest

• Associated to systemic disease

– Seronegative arthropathies:AS, Psoriatic arthritis, Reiter’s Disease

– Autoimmune: Sarcoidosis, Behcets

– Infection: Shingles, Toxoplasmosis, TB, Syphillis, HIV

KPs

Fibrin

Ciliary flushSmall Pupil

Keratic Precipitates ( KPs)

Circum Corneal Conjunctival Congestion In Uveitis A.C Glaucoma

Episcleritis

• Superficial

• Idiopathic, collagen vascular disorder (RA)

• Asymptomatic, mild pain

• Self-limiting or topical treatment(NSAIDs, Steroids)

Scleritis• Idiopathic

• Collagen vascular disease (RA, SLE, Wegener Granulomatosis, PAN)

• Zoster

• Sarcoidosis

• Dull, deep pain wakes patient at night

• Systemic treatment with NSAID or Steroids.

Scleritis

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Red Eye In Scleritis Conjunctivitis

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Subconjunctival Haemorrhage

• Diffuse or localised area

• of blood under conjunctiva. Asymptomatic

• Idiopathic, trauma, cough, sneezing, aspirin, HT

• Resolves within 10-14 days

• Treatment of Cause.

Differential Diagnosis Of Red Eye

• Stress Upon 4 Vital Structures:

• 1- Conjunctiva

• 2- Cornea

• 3- Pupil

• 4- Intraocular Pressure (IOP)28

Differential Diagnosis Of “Red Eye”• Conjunctiva Cornea Pupil IOP• Conjunctivitis Diffuse cong Normal Normal Normal

• Uveitis Cir.Corn.Cong KPs Small Normal

• Ac.Cong Cir.Corn.Cong Hazy Dilated Raised

Glaucoma Fixed

• Sub.Conjunctival Bright Red Normal Normal Normal

Haemorrhage29

Dr Isam Al-Qurainy 30

• Your Eyes Are For Ever

• Take Care Of Them

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