A presentation on evaluation of red eye for General Practitioners.

1. Red Eye Evaluation
This work shop is for GP’s and Specialists and will focus on
how to proceed if you see a patient with red eye in your
clinic.
The only thing we will presume is that you have access to a
torch or at-least a mobile with torch function.
IMA Trivandrum Meeting 29 Feb June 2014
Dr. Devin Prabhakar MS,FRCS
Dr. Kavitha Devin DO, DNB
www.DivyaPrabha.in

2. Top 10 causes of Red Eye
1. Conjunctivitis
2. Uveitis
3. Acute Angle Closure Glaucoma
4. Episcleritis, Scleritis
5. Subconjunctival Hemorrhage
6. Dry Eye
7. Blepharitis & Meimbomianitis
8. Injury
9. Corneal Ulcer
10.Frequent eye drops

3. Bacterial Conjunctivitis
Mucopurulent or
Catarrhal
Description
Commonly caused by S. aureus, S. pneumoniae, and H. Influenzae (pediatrics). Involvement of
1 eye followed 1-2 days later by the other eye. Conjunctival redness.

4. Viral Conjunctivitis
Watery
Description
Commonly adenoviruses. Bilateral. Contagious. Enlarged preauricular nodes, corneal infiltrates,
and follicular conjunctivitis.

5. Description
Toxic reaction (keratitis) due to overuse of antibiotics, sympathomimetics, miotics, beta-blockers,
topical anesthetics, etc. with no underlying immune dysfunction.
Toxic Medicamentosa

6. LidsSymptoms include
Scratching
Lid swelling
Lid thickening
Lid notches
Loss of lashes
Crusts
Blepharitis

7. Meibomitis
Lids
Lids
Symptoms
•burning
•stinging
•dryness
•irritation
Associated
w/ Dry Eye
Signs
•pouting of meibomian gland
•blockage of meibomian gland
•scarring of meibomian gland

8. Dry Eye
Description
Characterized by dryness, foreign body sensation, burning and
tearing. Mild redness, often corneal and conjunctival staining. Many
causes including decreased circulating hormones, menopause, lid
disease, autoimmune disease, drying medications, meibomian
disease, environmental factors.

9. X
X
Description
Angry red eye; corneal epithelial and stromal necrosis evident by opacity and fluoroscein
staining. Painful and photophobic. Generally bacterial.
Corneal Ulcer

10. Hyperemia and chemosis of
inferior bulbar conjunctiva
Allergic folliculosis due
to topical alpha
adrenergic agonist
Drug-induced Allergic Conjunctivitis

11. Management of
Conjunctivitis
•Prophylaxis
•Hygienic measures
•Local Antibiotics
•Look for corneal
lesions
•Avoid steroid e/d

12. Management of Blepharitis
•Eye lid shampoo
•Warm compress
•Artificial tears
•Erythromycin ointment qid to lids
•Restasis for meibomitis
•Antibiotics
•Tetracycline 250 mg qid 2 weeks
•Doxy 100
•Erythromycin 200 mg bd
•Look for pediculosis

13. Dry Eye
•Environmental factors
•Personal habits
•Medications
•Antihypertensives,
•Antihistamines,
•Antidepressants
•Post-surgical.
•Discourage from Contact lens,LASIK

14. Management of dry eye
Mild dry eye:
•Artficial tears: Refresh Tears
[carboxy methyl cellulose], Tears
Natural [Hydroxypropyl Methyl
cellulose],Systane [polyethylene
glycol and propylene
glycol],Genteal [hydroxy propyl
Methyl cellulose],etc
•Ocular hygiene
•Proper specs
•Treat predisposing factors
Severe dry eye
Restasis,
Mucus strands removal
Lat tarsorrhaphy
Adhesive tape
Moderate dry eye:
•increase frequency of Artificial
tears,
•opt for preservative free
•Add ointment
•Punctal occlusion
•Restasis eye drops

15. How Many People Are
Affected by Allergy?
According to the Gallup Study of Allergies*:
Ocular
Symptoms
No Ocular
Symptoms
50% of the population has allergies
83% of allergy sufferers experience
ocular symptoms
* Data from 2003-2004 survey.

16. Common Causes of Ocular Allergies

17. Vernal Keratoconjunctivitis (VKC)
Signs/Symptoms:
 Ptosis
 Ropy mucous discharge
 Photophobia
 Large, nonuniform cobblestone
papillae
 Trantas dots
 Limbal nodules
 Neovascularization
 Shield ulcers
 Itching
 Frank inflammation with leukocyte
influx

19. Acute Angle Closure Glaucoma
Divya Prabha Eye Hospital 0471-2442050

20. Divya Prabha Eye Hospital 0471-2442050

23. Forgein Body
Divya Prabha Eye Hospital 0471-2442050

24. Divya Prabha Eye Hospital 0471-2442050

25. Divya Prabha Eye Hospital 0471-2442050

26. Divya Prabha Eye Hospital 0471-2442050

27. Watch out if
• History
– Pain
– Blurred Vision
• Examination
– Circumcorneal Conjestion
– Steamy cornea
– Corneal Opacity
– Pupil reaction
– Hypopyon
Divya Prabha Eye Hospital 0471-2442050

28. www.Facebook.com/DevinPrabhakar
www.DivyaPrabha.in
Mobile: 9388342050
Divya Prabha Eye Hospital
Kumarapuram Kannanmoola Road
Trivandrum, Kerala
India