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Not " THE  RED EYE " Again! Stephen Brodovsky MD, FRCSC Associate Professor Dept of Ophthalmology University of Manitoba Private Practice Cataract/Corneal/Refractive Surgery
Ocular History & Examination Visual Acuity Pupils Motility Anterior segment (cornea & conjunctiva) Posterior segment Confrontation Fields Intraocular Pressure
Usual ”RED EYE” Lecture ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Photophobia
? Pupil Size ? Location of Injection
 
What is your provisional Diagnosis ? Iritis
If painful, usually not “pink eye” ,[object Object],[object Object],[object Object],[object Object],[object Object]
Keratic Precipitates
Keratic Precipitates
Iritis Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Why is the patient having difficulty working ? ,[object Object],[object Object]
Photophobia &/or Ciliary Injection ,[object Object],[object Object],[object Object]
Photophobia & Ciliary Injection Herpes Simplex Corneal Abrasion Corneal Ulcer
Corneal Ulcers:  Rosacea & Blepharitis
Contact lens wearer & corneal ulcer ALWAYS ASK ABOUT CONTACT LENS WEAR!!!
Chronic Irritation
What is your provisional Diagnosis ? Dry Eye
History ,[object Object],[object Object],[object Object],[object Object]
Dry Eyes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Keratitis in Advanced Dry Eye
Schirmer Test Tear production measured
Rule-out Blepharitis Frequently co-exists with dry eye Erythema of lid margin Scales on Lashes Loss of Cilia
Dry Eye Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Acute Red Eye
 
 
Red Eye ,[object Object],[object Object],[object Object],[object Object]
What is your provisional Diagnosis ? Sub-conjunctival hemorrhage
Provisional Diagnosis Subconjunctival hemorrhage ?  Trauma ? Blood Clotting ? Valsalva Maneuver ? Elevated BP
Subconjunctival Hemorrhage Management ,[object Object],[object Object],[object Object],[object Object]
Red Eye with Discharge
 
What is your provisional Diagnosis ? Bacterial Conjunctivitis
Clinical Pearls ,[object Object],[object Object],[object Object]
Differential Diagnosis Lacrimal System Obstruction
Bacterial Conjunctivitis Treatment ,[object Object],[object Object],[object Object],[object Object]
Bacterial Conjunctivitis Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bacterial Conjunctivitis Treatment ,[object Object],[object Object]
Chronic Red Eye
 
Chronic Conjunctivitis Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object]
Diagnosis ? Chronic Conjunctivitis  Secondary to toxic or allergic reaction to topical medication
Management ,[object Object],[object Object],[object Object]
Toxic Reaction to Eye Drops ,[object Object],[object Object],[object Object],[object Object]
Itching
What is your provisional Diagnosis ? Allergic Conjunctivitis
Allergy Mast cells Factors Released: Histamine, Chemotactic factors, Prostaglandin  synthesis IgE Allergen
Management of Ocular Allergy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Red Eye Summary Photophobia Chronic Irritation Acute Red Eye Red Eye with Discharge Chronic Red Eye Itching
Decreased Vision Post-Cataract Surgery
History of “Perfect Vision” then “Unable to Distinguish Material” in first week after Surgery
 
What is your provisional Diagnosis ? Endophthalmitis
What is your management ? ,[object Object],[object Object],[object Object],[object Object],Referral to ophthalmologist in
Complications Post-Cataract Surgery ,[object Object],[object Object],[object Object],[object Object]

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