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  1. Approach To Medicine
  2. Surgical Specialties
  3. Opthalmology

Opthalmology

Modified 08:59, 26 Mar 2016 by apavel | Page History
    Table of Contents
    1. 1. Approach to Red Eye
    2. 2. Uveitis
    3. 3. Corneal Ulcer
    4. 4. Episcleritis
    5. 5. Scleritis
    6. 6. Glaucoma
      1. 6.1. Open Angle
      2. 6.2. Closed Angle
    7. 7. Conjunctivitis

    Approach to Red Eye

    Eyelids, Orbit & Adnexa Cornea
    • Blepharitis
    • Dacryocystitis
    • Dacryoadenitis
    • Preceptal & Orbital Cellulitis
    • Abrasion
    • Ulcer
    • Keratitis
      • Toxic, Eye Injury, UV
      • Herpes Simplex (HSV)
      • Herpes Zoster (HZV)
    Conjunctiva Anteriour Chamber and Uvea
    • Subconjunctival Hemorrhage
    • Conjunctivitis
      • Bacterial, Viral, Allergic
    • Pingueculum, Pterigium
    		  

     

     

    Uveitis

    • Triad of:
      • Unilateral eye pain
      • Redness
      • Photophobia
    • On Exam:
      • circumferential redness around border of sclera and cornea (corenal limbus) aka "Ciliary flush"
      • Pupillary miosis
      • Slit Lamp: inflammatory "Flare" cells in anterior chamber.
    • Causes:
      • Idiopathic
      • Autoimmune (HLA-B27 arthridities)
      • Infection (syphilis, TB, HSV)
      • Malignancy
      • Sarcoid

     

    Corneal Ulcer

    • Causes:
      • Trauma
      • Contact lens wear
      • HSV infection
      • Bacterial infection
      • Connective Tissue Disorders

    Episcleritis

    • Symptoms:
      • Redness
      • Irritation
      • Tearing
      • NO (or minimal) Ocular Pain!
    • Widespread redness, not just at the limbus.

    Scleritis

    • Bilateral
    • Redness across entire sclera
    • No ciliary flush

     

    Glaucoma

    Open Angle

    Causes of 2° Open Angle Glaucoma

    • Steroid induced glaucoma (4 weeks)
    • Trauma
    • Pseudoexfoliation Syndrome
    • Pigment Dispersion Syndrome

    Closed Angle

    Causes of 2° Angle closure glaucoma

    • Neovascular glaucoma
    • Uveitis (post. Synechiae)

     

    Conjunctivitis

    • Bacterial or viral
      • Bacterial: purulent, usually one sided.
      • Viral: often clear discharge, redness, often spreads to other eye
        • Can sometimes see a "pseudomembrane" on the led which is indicative of adenovirus
        •  
      • Often hard to tell apart
    • Treatment:
      • Polysporin ointment (esp for kids because easy to apply.
      • Apply to lower lid 1/2 inch QID until redness disappears.
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