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OpthalmologyTopic :- Red Eye

Shujat Ali Jafri4th Year MBBS Gmc Sukkur

RED EYE

• Red eye-non-specific term to describe an eye that appears red due to illness, injury, or some other condition

• Caused by enlarged, dilated blood vessels, leading to the appearance of redness on surface of eye

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History Taking

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EXAMINATION :-

Causes of red eye

There are many different causes of a red eye. After taking a full history

and thoroughly examining the eyes, a management plan can be made.

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Anterior uveitis

• Inflammation of the iris and ciliary body

• Clinical features:

• Young or middle aged patients

• Pain worse when reading

• Photophobia

• Reduced visual acuity

• On examination:

• Pupil may be small and irregular (due to posterior synechiae - adhesions of iris to the lens)

• On using slit lamp, anterior chamber may show:

– cells (moving, white specks)

– hypopyon - pus in anterior chamber

– flare (looking through frosted glass)

• keratic precipitates may be seen at the back of the cornea

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Conjunctivitis

• The eye discharge in conjunctivitis may be clear (serous) or puslike (purulent)

Purulent – bacterial conjunctivitis

Clear – viral or allergic cause

Serous Purulent

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Subconjunctival haemorrhage

• Bright red blood between white sclera and conjunctiva. Usually benign.Can be caused by:

• Severe coughing or straining

• Hypertension

• Blood disorders

• Idiopathic

• Clinical features:

• Diffuse area of bright red blood

• May be a foreign body

• No pain, blurred vision or photophobia

• Eye examination otherwise normal

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Scleritis

• Inflammation of white sclera itself

• Usually very painful; significantly more redness present compared to episcleritis

• Associated with other autoimmune conditions• Visual acuity may be affected• Management - may need immunosuppressants• Complications - corneal ulceration, intraocular inflammation

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Corneal ulceration

• Causes• Infection• Corneal abrasion• Contact lenses

• Clinical Features• Pain• Foreign body sensation• Mild to moderate red eye• Blurred vision• Photophobia

• Examination• Staining the cornea with fluorescein shows an area of corneal epithelial defect,

and shows up yellow.

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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

*Prevalent in Southern Countries

• Mx – surgical removal

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SYMPTOMS ASSOCIATED WITH RED EYE

SYMPTOMSPainVisual lossEye discharge Purulent – bacterial conjunctivitisClear – viral or allergic cause

Gritty sensation – common in conjunctivitis Itching – common in allergic eye disease,

blepharitisPhotophobia

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SIGNS OF THE RED EYES

1. Vesicles 2. Follicles 3. Ciliary flush4. Irregular pupil 5. Papillae 6. Foreign body7. Dilated conjunctival vessels8. Discharge9. Corneal ulcer10. Hypopyon11. Dendritic ulcer 12. Dilated episcleral vessels

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Shujat Ali Jafri4th Year MBBS Gmc Sukkur