ACUTE EYE CARE DR AHMED HASSAN OPHTHALMOLOGIST Monash Health MBBS, FRANZCO OPHTHALMOLOGIST Monash Health Dandenong Eye Clinic

Optic nerve Pupils Red desaturation Retina Safe to Dilate PAINLESS VISUAL LOSS Optic nerve Pupils Red desaturation Retina Safe to Dilate Left RAPD

Optic Nerve Young Optic Neuritis Older Arteritis Ischaemic

Retinal Detachment 1. Myopia or 2. Cataract Surgery Flashes, ‘Curtain’ 6/6 CF Mac ON Mac OFF

PVD Posterior Vitreous Detachment Weiss ring

CRVO BRVO

CRAO BRAO

Diabetic Macular Oedema Central Visual Loss ARMD Diabetic Macular Oedema Pinhole

Cataracts

EYE INJURIES

Conjunctiva Sub-conjunctival Haemorrhage

Hyphaema Re-bleed risk 5 days  strict rest, no aspirin

Corneal foreign bodies Local Anaesth drops: BNX, AME, OXY, TET. 25G needle

Subtarsal foreign body ‘Look down, and keep looking down’

Microbial Keratitis Corneal infiltrate Hypopyon

Penetrating eye injury No eyedrops Dont remove! Shield Keep fasted Prevent vomiting CT or Xray Seidel test for leaks

Alkali burns Anaesthetic drop Flourescein drop 3. Evert & sweep fornices 4. Irrigate Prognosis? Corneal Opacity Clock hours of clear limbus

PAINFUL RED EYE

Herpetic disease Dendritic (HSV) Shingles (VZV)

Uveitis Uva (Latin): Grape

Iritis  Pain unchanged Younger patient Pupil & vision often normal 1. Anaesthetic drop:  Pain unchanged 2. Torchlight  Pain worse

Untreated Iritis Posterior Synechiae Keratic Precipitates

Acute Glaucoma  Pain unchanged Older patient Pupil & vision abnormal Patient unwell ++ Anaesthetic drop:  Pain unchanged Don’t dilate Diamox 500mg stat if remote Refer for Laser iridectomy

Orbital Cellulitis Sinusitis ? Painful eye movements ? Lids shut: Roll apart

Orbital septum

Preseptal

Orbital

Optic nerve at risk

Orbital CT: axial & coronal

Meibomian Cyst Stye

Dacryocystitis

Conjunctivitis Acute Allergic Viral vs Chlamydia Follicles in both URTI – viral Urethritis Chemosis Itch