Diploma In Family Health Care Professor Noshad Ahmed Shaikh Vice Chancellor Liaquat University of Medical and Health Sciences/Jamshoro.

Dr Isam Al-Qurainy

Dr Isam Al-Qurainy

Dr Isam Al-Qurainy

The Red Eye Differential Diagnosis Sameen Afzal Junejo MCPS; DOMS; FCPS Professor of Ophthalmology LUMHS/Jamshoro

Causes Of Red Eye 1) Conjunctivitis. 2) Corneal Abrasions and Ulcer. 3) Acute Angle Closure Glaucoma. 4) Uveitis. 5) Episcleritis and Scleritis. 6) Sub-Conjunctival Haemorrhage.

Conjunctivitis Follicles Purulent discharge Papillae Redness Chemosis

Acute Bacterial Conjunctivitis

Acute Viral Conjunctivitis

Corneal Abrasion Surface epithelium sloughed off. Stains with fluorescein Usually due to trauma Pain, FB sensation, tearing, red eye

Corneal Ulcer Infection Bacterial: Viral: HSV, HZO Fungal: Protozoan: Acanthamoeba in CL wearer Mechanical or trauma Chemical: Alkali injuries are worse than acid

Corneal ulcer stained green with fluorescein dye.

Purulent Corneal Ulcer with Hypopyon Excessive Steroid Usage

Acute Angle-closure Glaucoma Symptoms Pain, headache, nausea-vomiting Redness, photophobia, Reduced vision Haloes around lights Raised IOP Ciliary hyperaemia Dilated pupil Corneal oedema

Acute Angle Closure Glaucoma

Uveitis Anterior: acute recurrent and chronic Intermediate: Ciliary Body Posterior: vitritis, retinal vasculitis, retinitis, choroiditis Pan uveitis: anterior and posterior

Anterior uveitis (Iritis) Photophobia, red eye, decreased vision, pain Idiopathic. Commonest Associated to systemic disease Seronegative arthropathies:AS, Psoriatic arthritis, Reiter’s Disease Autoimmune: Sarcoidosis, Behcets Infection: Shingles, Toxoplasmosis, TB, Syphillis, HIV

Ciliary flush Small Pupil Fibrin KPs

Keratic Precipitates ( KPs)

Circum Corneal Conjunctival Congestion In Uveitis A.C Glaucoma

Episcleritis Superficial Idiopathic, collagen vascular disorder (RA) Asymptomatic, mild pain Self-limiting or topical treatment(NSAIDs, Steroids)

Scleritis Idiopathic Collagen vascular disease (RA, SLE, Wegener Granulomatosis, PAN) Zoster Sarcoidosis Dull, deep pain wakes patient at night Systemic treatment with NSAID or Steroids.

Scleritis

Red Eye In Scleritis Conjunctivitis Dr Isam Al-Qurainy

Subconjunctival Haemorrhage Diffuse or localised area of blood under conjunctiva. Asymptomatic Idiopathic, trauma, cough, sneezing, aspirin, HT Resolves within 10-14 days Treatment of Cause.

Differential Diagnosis Of Red Eye Stress Upon 4 Vital Structures: 1- Conjunctiva 2- Cornea 3- Pupil 4- Intraocular Pressure (IOP)

Differential Diagnosis Of “Red Eye” Conjunctiva Cornea Pupil IOP Conjunctivitis Diffuse cong Normal Normal Normal Uveitis Cir.Corn.Cong KPs Small Normal Ac.Cong Cir.Corn.Cong Hazy Dilated Raised Glaucoma Fixed Sub.Conjunctival Bright Red Normal Normal Normal Haemorrhage

Dr Isam Al-Qurainy

Your Eyes Are For Ever Take Care Of Them