This document discusses the causes and classification of the red eye. It begins by defining various eye care professionals and then lists numerous potential causes of a red eye affecting different areas of the eye, including the lids, conjunctiva, sclera, cornea, anterior chamber angle, and orbit. Causes range from infectious conjunctivitis to traumatic injuries. The document then classifies red eyes based on whether they cause pain or reduce vision. It emphasizes referring patients promptly to an ophthalmologist and avoiding topical steroids without a prescription due to risks of side effects.

1. THE RED EYE
Dr Adekoya BJ
MBBS, FMCOphth, FWACS

2. OUTLINE
 Introduction
 Causes / Rx
 Classification
 Conclusion / summary

3. Introduction
 Definitions
 Ophthalmologist
 Optometrist
 Optician
 Ophthalmic nurse
 The red eye

4. CAUSES
 Lids
 Conjunctiva
 Sclera
 Cornea
 Anterior uvea
 Angle
 Trauma
 Panophthalmitis
 Endophthalmitis
 Orbital cellulitis
 Non traumatic sub-conj haemorrhage

5. Causes
 LIDS / ocular adnexia
 Blepharitis
 Blepharo-conjunctivitis
 Usually allergic, infectious, oily eyelid glands,
lice on the eyelashes.
 Trichiasis, entropion, ectropion, dacryocystitis
 Rx – ocular hygiene, topical antibiotics, anti-
allergic

7. Causes
 Conjunctiva
 Conjunctivitis
 Infectious, allergic, autoimmune disorders, toxic
 VA usu normal, injection is in the fornix
 Rx – antibiotics, anti-allergics –steroids, non-steriodals
 Conj tumours – SCC, Melanoma, BSC,
 Pingueculae – conj degeneration, triangular, apex to
canthus, base to cornea, Rx – anti-inflamm

9.  Pterygium
 conj degeneration, fibrovascular, triangular, apex
to cornea, base to canthus,
 Redness, FB sensation, pain, lacrimation, reduced
VA
 Rx – excision
 Optical
 Cosmetic
 Suspicious looking

10.  Sclera
 Episcleritis
 Scleritis
 VA normal, mild pain, usu assoc with auto
immune dxs SLE, WG, RA, may perforate the
eye in advanced cases
 Rx – anti-inflam, steroids, – topical and systemic

12.  Cornea
 Keratitis – usu infectious,
 Corneal ulcer
 Dry eye
 Contact lens wear
 Peripheral corneal inflamm – moorens ulcer
 VA usu reduced, photophobia, lacrim, pains,
discharge
 Rx – of the cause

14.  Acute angle closure glaucoma
 Primary or secondary, pry common in asians, VA reduced,
pain severe, redness
 Rx
 Medical - lowering of IOP with topical and systemic drugs
 Carbonic anhydrase inhibitor, beta blockers, osmotic agents,
 Surgical
 Prymary – iridectomy,
 Secondary – eg lens induced – cataract extraction

15.  Uveitis
 Esp anterior, redness (ciliary injection), pain,
photophobia, reduced VA
 Rx – anti-inflamm – steroids, non-steroidals,
topical and systemic

16.  Trauma
 FB, lacerations, sub-conj hage, uveitis, secondary glaucoma,
chemical injury (acid /alkali), thermal injury
 Rx – of the cause
 Panophthalmitis
 Inflamm of the entire coat of the eye, VA severely reduced, pain
 Rx – enucleation, evisceration
 Endophthalmitis
 Sclera is spared
 Eye filled with pus
 Rx – enucleation, evisceration

17.  Orbital cellulitis
 Inflamm of orbital tissues, usu infective
 Proptosis, reduced VA, pain, redness
 Rx – systemic antibiotics

18.  Non – traumatic subconj hage
 Blood under conjunctiva covering part or all of eye
which is otherwise quiet with normal VA.
 Systemic hypertension
 Sickle cell dx
 Intraocular tumours
 Clotting disorders
 CKD / dialysis
 Valsava manoeuvres

19. Classification
 painful causes
 Reduced VA
 Acute angle closure glaucoma
 Keratitis
 Acute anterior uveitis
 Panophthalmitis, endophthalmitis
 Orbital cellulitis
 Trauma
 Normal / variable VA
 Inflam pingueculae and pterygium
 Trauma

20.  non painful
 Conjunctivitis
 Subconj hage

21. General points
 History - pain
 VA
 Rx – DO NOT GIVE TOPICAL STEROIDS,
refer to ophthalmologist.
 Ocular Cxs of steroids
 Cataract
 Glaucoma
 Corneal melting and perforation

22. QUESTIONS