2. ACUTE RED EYE
► Most common ocular complaint
► Common in both children and adults
► Careful history is vital to establish the cause
► Thorough clinical examination including visual acuity, slit lamp examination
fluorescein staining is necessary.
3. HISTORY
• Onset, duration (acute, subacute, chronic, recurrent)
• Location (unilateral /bilateral /sectoral/diffuse)
• Pain/ discomfort (gritty, FB sensation, itch, deep ache)
• Photosensitivity
• Watering +/or discharge ( purulent/clear)
• Change in vision (blurring, halos etc)
• Exposure to person with red eye
• Trauma
• Contact lens wear
• Previous ocular history
4. EXAMINATION
► Visual acuity for both eyes
► Eye lids (swelling, redness, crusting or matting of lashes)
► Pupillary reaction ( shape/ reaction to light/ accommodation)
► Conjunctiva (bulbar and palpebral) ( follicles ,papillae, subtarsal foreign body)
► Conjunctival hyperemia, ciliary congestion
► Cornea (clarity, sensation, fluorescein staining )
► Anterior chamber (cells/flare/depth of ac)
► Fundal examination
► Eye movements
► Lymphadenopathy ( pre-auricular lymphnodes)
6. BLEPHARITIS
Inflammation of lid margin
Meibomian gland dysfunction
Characterized by
lid crusting and redness
Capping of meibomian
glands
Frequently associated
with dry eyes, styes and
chalazion
Staphylococcus and other skin
flora major causes.
Mainstays of treatment
Lid hygiene
Topical antibiotics
Lubricants
Doxycycline- meibomian
gland disease.
7. TRICHIASIS
• Inward turning lashes
• Aetiology: Idiopathic/ Secondary to
chronic blepharitis
• Symptoms- foreign body sensation,
tearing
• Treatment
• Lubricants
• Epilation with forceps
• Electrolysis- few lashes
• Cryotherapy- many lashes
8. SUBTARSAL FOREIGN BODY
• History of foreign body
• Must evert eyelid and ask the
patient to look down
• Remove with cotton bud
• Stain with fluorescein for
corneal abrasions
• Treatment
Lubricants
+/- antibiotics
9. SUBCONJUNCTIVAL HEMORRHAGE
Aetiology:
Idiopathic
Coughing/straining
Hypertension
Bleeding disorder
Trauma
Symptoms:
Painless red eye, asymptomatic
VA not affected
Clear demarcationborders
Masks conjunctival vessels
Treatment:
Check BP
No treatment (lubricants)
10-14 days to resolve
If recurrent: clotting,FBC
10. PTERYGIUM
• Triangular fold of conjunctiva that usually grows
from the medial portion of the palpebral
fissure towards & invades the cornea
• Non-malignant fibrovascular growth
• Predisposing factors:
– Hot climates
– Chronic dryness
– Exposure to sun
• Management
• Topical fluorometholone for inflamed
ptrygium
definitive treatment is surgical removal
Recurrence is common.
11. PINGUECULA
• Yellow-white deposits on bulbar
conjunctiva adjacent to the nasal or
temporal limbus
• May become acutely inflamed-
pingueculitis
• Treatment:
• Normally unnecessary as growth is slow or
absent
• Topical fluorometholone for pingueculitis
12. EPISCLERITIS
► Episcleral inflammation
► Localized (sectoral) or diffuse
► Symptoms/Signs:
Often asymptomatic
Mild tearing/ irritation
Tender to touch
Vessels blanch with
phenylephrine
► Self-limiting (may last for
months)
► Treatment
Lubricants
NSAIDS
Low dose steroids