Common and classic red eye presentation

1. 5

2. LEARNING OBJECTIVES
TO OBTAIN EXPERTISE TO:
1. RECOGNIZE THE COMMON OF RED EYE CONDITIONS
2. ADEQUATELY DIAGNOSE AND TREAT THE COMMON CAUSES OF RED EYE
3. RECOGNIZE AND REFER PATIENTS WITH RED FLAGS

3. HISTORY RED EYE
• Change in vision ( Blur/ Halo )
• Contact lens wear
• Ill contact with another person?
• Systemic disease ( Eg; Autoimmune /Atopy)
• Established ocular disease?
• Eye trauma / surgery/ occupational hazard
• Using any eyedrops / oral medication?
• Onset? Course? Duration
• Single / Both eyes
• Pain / Discomfort?
• Foreign body sensation?
• Photophobia?
• Watering? Discharge?
• Itching?

4. ALL RED EYES =
CONJUNCTIVITIS

5. ETIOLOGY OF RED
EYE DISORDER
INFECTION
STYE
CONJUNCTIVITIS
CORNEAL ULCER
INFLAMMATION
IRITIS
SCLERITIS
EPISCLERITIS
TRAUMA
CORNEAL ABRASION
SUBCONJUNCTIVAL
HEMORRHAGE
CHEMICAL
MECHANICAL
PENETRATING
NON PENETRATING (BLUNT)
OTHERS
ACUTE
GLAUCOMA

6. EXAMINATION RED EYE
• Inspect whole patient then eye
• Eyelid ( Evert the lid )
• Conjunctiva and sclera
• Cornea ( Clarity, stain with fluorescein )
• Pupil ( Shape/ Reaction to light )
• Visual Acuity ( Each eye)
• Eye movement
• Others : Fundoscopy/ Preauricular lymph nodes

7. STYE & CHALAZION

8. PAPILLAE
Watery
++
CONJUNCTIVITIS

9. ANY DISCHARGE ??
ANY ITCHINESS??

10. EPISCLERITIS

11. EPISCLERITIS &
SCLERITIS
(Bright red)

12. IRITIS
CILIARY
FLUSH
IRREGULAR
PUPIL
KERATIC
PRECIPITATES
(KP)
Moderateto severe pain

14. A CASE
SHALLOW ANTERIOR
CHAMBER
CILIARY
FLUSH
EMERGENCY REFERAL
CLOUDY
CORNEA
Acute Closure
Glaucoma

16. TRAUMA…WHAT CAN HAPPEN ??
• A 10 years old got hit directly to his eye by his colleague during
fighting
• One of the teacher bring him to you and he did not witness the fight.
• Patient is conscious, hemodynamically stable
• He can’t open his eye & block it with his hand
• Claim having felt fb sensation with continuous tearing..

17. SUBCONJUNCTIVAL HEMORRHAGE
CORNEAL ABRASION
TRAUMATIC IRITIS
HYPHEMA
RUPTURED GLOBE

18. CORNEAL ABRASION
REFER
INJURY
MECHANISM
WEAR
CONTACT
LENS?
ANY FB
INSERTION?

19. ANY FOREIGN
BODY ??
IRON DUST

21. CHEMICAL INJURY
• Immediate continuous eye irrigation with nearest
source of water (at least 15-30minutes)
• Aim to normalize (PH 7.0-7.2) in the eye
• Even up to 20 Litres of water to achieve the
desire PH
• Refer opthal

22. Sudden Persistent Vision Loss
Severe Unexplainable Eye Pain
Absent/ Sluggish Pupil Response
Corneal involvement
History of Significant Trauma
REFER

23. TAKE HOME MESSAGE:
TQ
• Pain, Photophobia, Decrease Visual Acuity with red eye are
worrisome
• Do Not forget to check for Visual Acuity, Cornea and Pupil
• Not all red eye equal to conjunctivitis especially Unilateral