This document provides guidance on eye conditions that may present in casualty and their examination and treatment. It discusses:
- Common less serious conditions like conjunctivitis, corneal abrasions and foreign bodies.
- Rarer but more serious conditions like acute glaucoma, central retinal artery occlusion, giant cell arteritis and retinal bleeding.
- Examination of the eyes, including visual acuity, visual fields, pupils, conjunctiva, anterior chamber, red reflex and discs.
- Diagnosis and treatment of conditions like corneal abrasions, foreign bodies, iritis and acute glaucoma. More serious conditions require urgent referral.
- Posterior segment conditions like retinal detachment,
Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye.
Glaucoma is one of the leading causes of blindness for people over the age of 60. It can occur at any age but is more common in older adults.
Glaucoma treatment In Indore. Glaucoma treatment at Vinayak Netralaya With Laser for the different type of Glaucoma. Glaucoma Clinic with Latest Equipment for diagnosis and treatment of Glaucoma.
Glaucoma is the name for a group of eye conditions in which optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer, the retina, to the brain where it is perceived as a picture.
In some people, the glaucoma damage is caused by raised eye pressure. Others may have an eye pressure within normal limits but damage occurs because there is weakness in the optic nerve.
Different types of Glaucoma
Open angle glaucomas (chronic glaucoma): It is most common. The eye is anatomically normal, but blockage or malfunction of the drainage channels slowly over many years causes elevated eye pressure. There is no pain but the field of vision gradually becomes impaired. We need to use chemical cleaner (eye drops) to open the drain or turn down the faucet. If this is insufficient, we can stake the drain (laser trabeculoplasty) & if that doesn’t work. We need to put in new plumbing (surgery / implants)
Angle closure glaucoma (Acute glaucoma): The trabecular meshwork is normal, but the iris is pushed against the meshwork & there is sudden and more complete blockage to the flow of aqueous. It means the drainage channels are covered by a stopper & we need to remove the stopper (laser iridotomy). This glaucoma can be quite painful & will cause permanent damage to sight if not treated promptly. Glued iol surgery in indore with best doctors at glaucoma treatment hospital in indore.
Secondary and developmental glaucoma: When a rise in eye pressure is cause by another eye condition it is called secondary glaucoma. Glaucoma in childhood is called developmental or congenital which is caused by malformation in the eye.
Risk factors
> Hypertension
> Diabetes
> People over the age of 45.
> People with family history of glaucoma.
> People with myopia are more prone to develop open angle glaucoma & those with hyperopia are more prone to develop angle closure.
Warning Signs of Glaucoma
> Trouble adjusting to dark rooms
> Difficulty focusing on near or distant objects
> Squinting or blinking due to sensitivity to light or glare
> Recurrent pain in or around eyes
> Double vision
> Dark spot at the center of viewing
> Lines and edges appear distorted or wavy
> Excess “watery eyes”
> Dry eyes with itching or burning
Surgical facility includes
> Trabeculectomy with anti-fibrotic agents (MMC)
> Trabeculotomy for congenital glaucoma
> GLAUCOMA VALVE IMPLANT/ GLAUCOMA
> DRAINAGE DEVICE for complicated cases
Talk by peter simcock on elderly eyes to national geriatrics societyTheEyeExpert
Peter Simcock, The Eye Expert, gave a talk at the National trainee weekend meeting of the British Geriatrics Society at the Forum Centre of Exeter University in February 2014
some people are affected with this problem they want to know about the glaucoma causes, risk factor, pathophysiology, signs and symptoms, treatment and complication, etc and they get more knowledge and they will avoid the complication especially loss of vision.
conjunctivitis is an eye disorder .this is all so known as pink eye .in the India south side people it is called as madras eye ..in this slide mentioned about .definition, review anatomy and physiology, types including causes , pathophysiology, signs and symptoms, treatment, nursing management, and prevention are there. the client who is affected with this use separate towels, wash your hands daily, eat eye healthy foods like vitamin a , e,omega 3 fatty acid, this will help the eyes verywell.eye exercise very helpful for eye health.if eye sensitive is there use sun glass that is very help full for the eye , eye staraning should be avioded.if the school student is affected means student should not go to the school for one week.
To know about definition , causes, types, signs and symptoms, diagnosis, treatment home remedies for floating these can give knowledge by this presentation
Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye. Glaucoma is one of the leading causes of blindness for people over the age of 60
Glaucoma presentation for ophthalmology course, presented as a student seminar. Class location: ophthalmology unit, An-Najah National University Hospital.
Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye.
Glaucoma is one of the leading causes of blindness for people over the age of 60. It can occur at any age but is more common in older adults.
Glaucoma treatment In Indore. Glaucoma treatment at Vinayak Netralaya With Laser for the different type of Glaucoma. Glaucoma Clinic with Latest Equipment for diagnosis and treatment of Glaucoma.
Glaucoma is the name for a group of eye conditions in which optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer, the retina, to the brain where it is perceived as a picture.
In some people, the glaucoma damage is caused by raised eye pressure. Others may have an eye pressure within normal limits but damage occurs because there is weakness in the optic nerve.
Different types of Glaucoma
Open angle glaucomas (chronic glaucoma): It is most common. The eye is anatomically normal, but blockage or malfunction of the drainage channels slowly over many years causes elevated eye pressure. There is no pain but the field of vision gradually becomes impaired. We need to use chemical cleaner (eye drops) to open the drain or turn down the faucet. If this is insufficient, we can stake the drain (laser trabeculoplasty) & if that doesn’t work. We need to put in new plumbing (surgery / implants)
Angle closure glaucoma (Acute glaucoma): The trabecular meshwork is normal, but the iris is pushed against the meshwork & there is sudden and more complete blockage to the flow of aqueous. It means the drainage channels are covered by a stopper & we need to remove the stopper (laser iridotomy). This glaucoma can be quite painful & will cause permanent damage to sight if not treated promptly. Glued iol surgery in indore with best doctors at glaucoma treatment hospital in indore.
Secondary and developmental glaucoma: When a rise in eye pressure is cause by another eye condition it is called secondary glaucoma. Glaucoma in childhood is called developmental or congenital which is caused by malformation in the eye.
Risk factors
> Hypertension
> Diabetes
> People over the age of 45.
> People with family history of glaucoma.
> People with myopia are more prone to develop open angle glaucoma & those with hyperopia are more prone to develop angle closure.
Warning Signs of Glaucoma
> Trouble adjusting to dark rooms
> Difficulty focusing on near or distant objects
> Squinting or blinking due to sensitivity to light or glare
> Recurrent pain in or around eyes
> Double vision
> Dark spot at the center of viewing
> Lines and edges appear distorted or wavy
> Excess “watery eyes”
> Dry eyes with itching or burning
Surgical facility includes
> Trabeculectomy with anti-fibrotic agents (MMC)
> Trabeculotomy for congenital glaucoma
> GLAUCOMA VALVE IMPLANT/ GLAUCOMA
> DRAINAGE DEVICE for complicated cases
Talk by peter simcock on elderly eyes to national geriatrics societyTheEyeExpert
Peter Simcock, The Eye Expert, gave a talk at the National trainee weekend meeting of the British Geriatrics Society at the Forum Centre of Exeter University in February 2014
some people are affected with this problem they want to know about the glaucoma causes, risk factor, pathophysiology, signs and symptoms, treatment and complication, etc and they get more knowledge and they will avoid the complication especially loss of vision.
conjunctivitis is an eye disorder .this is all so known as pink eye .in the India south side people it is called as madras eye ..in this slide mentioned about .definition, review anatomy and physiology, types including causes , pathophysiology, signs and symptoms, treatment, nursing management, and prevention are there. the client who is affected with this use separate towels, wash your hands daily, eat eye healthy foods like vitamin a , e,omega 3 fatty acid, this will help the eyes verywell.eye exercise very helpful for eye health.if eye sensitive is there use sun glass that is very help full for the eye , eye staraning should be avioded.if the school student is affected means student should not go to the school for one week.
To know about definition , causes, types, signs and symptoms, diagnosis, treatment home remedies for floating these can give knowledge by this presentation
Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye. Glaucoma is one of the leading causes of blindness for people over the age of 60
Glaucoma presentation for ophthalmology course, presented as a student seminar. Class location: ophthalmology unit, An-Najah National University Hospital.
eye emergency occurs any time we have foreign objects or chemical in our eyes. this slide contain definition, classification, types of injury, identification, management, medical management, nursing management. care of eye in the condition.
Opthalmology, the red eyes & more on the red eyesSalimKun
Opthalmology, the red eyes & more on the red eyes
Objective
To Know about reason of the red eyes.
Avoid or prevent of the red eyes.
To know method to treat of the red eyes.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. What conditions to expect
How to get help
History
Examination
Common (less serious) conditions
Rarer but more serious conditions
Helpful websites
The Eye in Casualty: a seminar
2. What conditions to expect: working in pairs, (2 minutes) think of:
• Common (less serious) conditions, e.g.
• Rarer but more serious conditions
If time, work out how you would refer, treat
3. Feedback…………what conditions to expect
• Common (less serious) conditions, e.g.
– Conjunctivitis
– Corneal abrasion
– Foreign body
– Blunt eye injury
• Rarer but more serious conditions
– Acute glaucoma, acute uveitis
– Central retinal artery occlusion
– CVA
– Giant Cell arteritis
– Papilloedema
– Retinal bleeding: maculopathy or diabetes
– Severe trauma
4. • Common less serious
– Conjunctivitis---------------
– Corneal abrasion-----------
– Foreign body---------------
– Blunt eye injury------------
• Rarer serious conditions
– Acute glaucoma,
acute uveitis
– Central retinal artery
occln
– CVA-------------------------
– Giant Cell arteritis---------
– Papilloedema---------------
– Retinal bleeding:
maculopathy or diabetes
– Severe trauma--------------
– Orbital cellulitis-----------
again in pairs, (2 minutes) think of best method of referral/treatment
6. Referral: severe problems/out of hours, Eye Casualty, City Hospital
Immediate
Chemical
burn, plaster
under upper
lid
Irrigation+++
refer
Refer asap
(even at night)
Severe trauma
GCA
CRAO
Acute glaucoma
Orbital cellulitis
(to paediatrician
for IV Rx?)
Trauma: examine
gently/carefully
ESR
Hours
(if present after
11pm, best to seek
advice, some seen
next morning)
Retinal detachment
Hypopyon uveitis
Corneal abscess
Most milder
uveitis present in
evening can be
treated next day
Refer to
eye clinic
or to GP
(optometrist
should check?)
Retinal vein
occlusion
Macular
haemorrhage
(Cataract
Dry eyes)
Treat in
A & E
•Conjunctivitis
•Corneal abrasion
•Foreign body
•Sub-tarsal
•Lid infections
that may need
flucloxacillin
7. Referral: severe problems/out of hours, Eye Casualty, City Hospital
Immediate Refer asap
(even at night)
Hours
(if present after
11pm, best to seek
advice, some seen
next morning)
Refer to
eye clinic
or to GP
(optometrist
should check?)
Treat in
A & E
Chemical burn,
plaster under
upper lid
Severe trauma
GCA
CRAO
Acute glaucoma
Orbital cellulitis
(to paediatrician
for IV Rx?)
Retinal detachment
Hypopyon uveitis
Corneal abscess
Retinal vein
occlusion
Macular
haemorrhage
(Cataract
Dry eyes)
•Conjunctivitis
•Corneal abrasion
•Foreign body
•Sub-tarsal
•Lid infections
that may need
flucloxacillin
Irrigation++++
refer
Trauma: examine
gently/carefully
ESR
Most milder
uveitis present in
evening can be
treated next day
Will be many conditions you’re
unsure of. Exclude more urgent
problems; ring for advice.
17. Check discs & retina
• Dim light
• pupils, eyelids, red reflex
• Patients look in distance, 15o
up
• Try not to obstruct sight in other eye,
otherwise examined eye will move.
• Look 15o
medially, to see the optic nerve
first.
• Going close increases field of view
• Optic nerve first
• Move along vessels
• Find macula last (this will make pupils
small)
• Dilating pupil makes examination easier,
quicker and more complete. But it is
time consuming, and is rarely needed to
exclude papilloedema .
22. Slides, with a few questions
Lids
Conjunctivitis
Foreign body & cornea
Anterior segment (uveitis/glaucoma)
Retina
Optic nerve
Major trauma
Previous eye surgery
23. Give out quiz for later, in pairs, 2 minutes, what is the treatment/plan
Corneal abrasion Diagnose how…………
treat…………………
Foreign body Diagnose how…………
treat…………………
iritis findings……………………….
Refer? …comments……………
Acute glaucoma findings……………………….
Refer? …comments……………
Chemical burn Treat…………………………….
Which is worst chemical…………..
24. Lids
A chalazion
some ‘point’ with pus needing draining:
some lid infections need systemic antibiotics
Severe infections
like this orbital
cellulitis need
admission (often
under
paediatricians) and
IV antibiotics
28. Foreign body & fluorescein drops
•Fluorescein drops do not sting and are
comfortable for children (all other drops
sting).
•Arc eye: wake up with pain at night, due
to an ultraviolet (welding) flash earlier in
the day.
29. Conjunctiva & anterior chamber
Conjunctivitis
No pain
Watery eye
Gritty, something
in eye
Iritis/acute glaucoma
Achy eye
Tender
% fixed/sluggish pupil
Glaucoma..eye hard
32. Treatment foreign body/conjunctivitis
Remove foreign body
Fluorescein excludes corneal ulcers
Chloramphenical drops qid (ointment tid), mild cases
Severer cases 2 hourly drops
Conjunctivitis is very infectious
Refer severe cases
33. Examples of nastier corneal problems
•Dendritic ulcer (acyclovir x5
day x 10d)
•Corneal abscess
•Giant papillary conjunctivitis
•pterygium
34. Pain & irritation
Ache Inflammation
(acute glaucoma, iritis,
episcleritis etc)
Gritty scratchy eye, as
though there is something
there
Foreign body/
abrasion/ulcer
(=uneven surface)
Watery red eye
No pain
conjunctivitis
Severe knife like pain trigeminal neuralgia,
spasms: history important
39. Acute glaucoma
• Achy eye, misty
vision
• Previous mild
episodes with haloes
• Pupil fixed
(sluggish), semi-
dilated
• Eye feels hard
Press eye with 2
fingers..Try this on your
own eye
40. n o r m a l s h a llo w
a n t e r io r
c h a m b e r
Acute glaucoma cont
46. Sudden, most of sight, or part
TIA: retinal emboli, central/branch retinal artery
occlusion
47. retinal artery occlusion
If within 3 hours of onset, can dislodge clot
(massage, IV diamox, AC paracentesis)
Refer ASAP, aspirin
ESR (10% are GCA)
48. Loss of sight over weeks/days/hours
• Retinal detachment, with
flashes/floaters
• Ischaemic optic neuropathy
(older patients)
(%GCA with GCA symptoms)
• With pain on movement: optic
neuritis (younger patients)
• Retinal vein occlusion
• Eye conditions: may lose
top/bottom half of sight
49. Retinal detachment
1. Vitreous gel liquifies (floaters)
2. May pull retina if attached (flashes)
3. Causes a hole
4. Fluid enters hole
5. Retina peels off
(more floaters, vision affected)
6. Dilate pupil, with careful look usually
obvious, refer same day
50. Loss of sight over months
• Cataract
• Many other problems,
dilate pupil…………
• red reflex
• Retina
• discs
51. Visual symptoms: quiz, in pairs, 2 minutes, what are the causes……….
Misty vision Aches…………
No ache…………………
Sudden onset visual loss ………………….
Specific symptoms Give examples……………………….
Loss of sight on one side What may be going on?………….
…………………………………….
Episodes of visual loss ………………………………….
Clues…………………………..
Blurred vision with flashes
and floaters
……………………………….
52. Visual symptoms
Misty
vision
If eye aches, acute glaucoma/uveitis
No ache, cataract/retinal disease etc
Sudden
onset
visual loss
Vascular
Specific
symptoms
E.g. GCA, optic neuritis, HZO
Loss of sight on one side Differentiate eg right side of
BOTH eyes (CVA), or ONE
eye alone (eye disease)
Episodes of visual
loss
TIAs: occur suddenly, resolves
over minutes
Blurred vision with
flashes and floaters
retinal detachment/vitreous
haemorrhage
53. Eye general health: 1
• What is the history?
– Vomiting
– Nausea
– Stomach not tender
– Headache?
– Sight GOOD
– Papilloedema
– Refer to RMO/neurosurgeon
healthy
54. • Loss of sight 2 days ago, one eye
• Headaches 1 week
• Shoulder pains months
• Weight loss months
• Jaw aches eating
• unwell months
• Test needed:
• ESR high
• Giant cell arteritis
• (if eye OK, refer to RMO)
Eye general health: 2
55. • Episcleritis
• Scleritis
• No steroid drops from casualty
• Herpes zoster:
– IV antiviral if immunosuppressed
Eye general health: 3
56. Eye & major trauma
Birmingham and Tamworth are increasingly violent.
A careful eye exam will exclude problems.
Sometimes the eye is impossible to examine (as
lids are shut). Refer/ask on-call eye SPR to assess.
Causes: fist, glass bottle, car windscreen.
57. Eye & major trauma: perforating
glass bottle, car windscreen, dart
Tetanus, antibiotic, refer (ring
first), starve for operating
theatre
58. Eye & major trauma: blunt
Fist, foot, squash ball: blunt eye injury, refer many
Hyphaema:
% retinal
detachment also
59. Eye & major trauma: blunt cont.
Fist, foot, squash ball: orbit injury
Double vision:
Globe itself fine, but floor of orbit fractured, and inferior
rectus muscle tethered = blow out fracture
60. Eye & previous eye surgery
There are many possible problems after ocular
surgery: refer, sometimes urgently
62. • Common conditions less serious, need to treat (includes antibiotics,
chloramphenicol)
• Serious conditions: history provides a clue, but a careful examination through a
dilated pupil and ophthalmoscope excludes most major pathology
• Generally provide an escape plan “see your doctor if it does not get better” etc
• Serious conditions always need expert advice
• Only really ‘immediate’ action is for chemical burn such as plaster under the
lids…irrigate profusely.
• ASAP retinal artery occlusion, GCA
• Within hours..acute glaucoma
• Retinal detachment same day, operation next day often
• Many ‘none’ urgent conditions present; local optometrists help with less urgent
• RMO or nursing colleague can provide useful advice, as can on-call time in
Eye Casualty
Summary
Editor's Notes
What conditions to expect: Common (less serious) conditions, e.g. Rarer but more serious conditions
How should these patients be treated? Common less serious Conjunctivitis_______________________________________________________________________________ Corneal abrasion ____________________________________________________________________________ Foreign body _______________________________________________________________________________ Blunt eye injury _____________________________________________________________________________ Rarer serious conditions Acute glaucoma, acute uveitis _________________________________________________________________________________ Central retinal artery occln______________________________________________________________________ CVA _______________________________________________________________________________________ Giant Cell arteritis_____________________________________________________________________________ Papilloedema _________________________________________________________________________________ Retinal bleeding: maculopathy or diabetes __________________________________________________________ Severe trauma ________________________________________________________________________________
How should these patients be treated? Common less serious Conjunctivitis_______________________________________________________________________________ Corneal abrasion ____________________________________________________________________________ Foreign body _______________________________________________________________________________ Blunt eye injury _____________________________________________________________________________ Rarer serious conditions Acute glaucoma, acute uveitis _________________________________________________________________________________ Central retinal artery occln______________________________________________________________________ CVA _______________________________________________________________________________________ Giant Cell arteritis_____________________________________________________________________________ Papilloedema _________________________________________________________________________________ Retinal bleeding: maculopathy or diabetes __________________________________________________________ Severe trauma ________________________________________________________________________________
Corneal abrasion Diagnose how………… treat………………… Foreign body Diagnose how………… treat………………… Iritis findings………………………. Refer? …comments…………… Acute glaucoma findings………………………. Refer? …comments…………… Chemical burn Treat……………………………. Which is worst chemical…………..
Top: A Subtarsal foreign body. Need to evert lid..use a cotton bud. Fluorescein drops show up any scratch/abrasion. Easier to see with a blue light, but an ordinary light is sufficient. Should the foreign body be removed? Yes no What is the treatment? ………………………………………………………………………………………. Does this need referral? Yes no Bottom A corneal foreign body.
A corneal foreign body. With local anaesthetic drops first (benoxinate or amethocaine or lignocaine), use a sterile green needle (holding it flat against the cornea) to remove the foreign body. You cannot do this if you are tired! Sometimes a blunt piece of sterile plastic may be safer. There may be a rust ring left, but this heals (an ophthalmologist can remove a dense rust ring.)
Conjunctiva/corneal quiz, complete in pairs Corneal abrasion Diagnose how………… treat………………… Foreign body Diagnose how………… treat………………… Iritis findings………………………. Refer? …comments…………… Acute glaucoma findings………………………. Refer? …comments…………… Chemical burn Treat……………………………. Which is worst chemical…………..
Visual symptoms quiz, complete in pairs Misty vision Aches………… no ache………………… Sudden onset visual loss …………………. Specific symptoms Give examples………………………. Loss of sight on one side What may be going on?…………. ……………………………………. Episodes of visual loss …………………………………. Clues………………………….. Blurred vision with flashes and floaters ……………………………….