1. MAINEMILITARY &COMMUNITY NETWORK HELPLINE Call 24/7: 1-888-365-9287

2. Urgent Care Evaluation and treatment of the Red Eye
LTC(ret) Ronald D Oldfield MPAS,PA-C
Emergency and Aviation Medicine

3. Learning Objectives
1. Review of clinically significant anatomy and physiology of the eye
2. Review of pathological and clinically notable conditions associated with red eye
3. Review of those conditions which warrant urgent/emergent ophthalmologist intervention.

4. INTRODUCTION
Despite being a very common presenting compliant there is very little epidemiologic or evidence based data to guide clinicians in the management of these patients.
While simple conjunctivitis is the most common cause a number of more serious conditions can occur knowing when to refer is essential
Strong history taking and examination skills are what remove all intimidation from caring for this condition

6. “RED EYE”DIFFERENTIAL DIAGNOSIS
Acute hemorrhagic conjunctivitis
Adult blepharitis
Bacterial conjunctivitis
Allergic conjunctivitis
Bacterial endopthalmitis
Chalazion
Chemical burns
Contact lens complications
Corneal foreign Body
Corneal graft rejection
Corneal Ulcer
Dacryocystitis
Distichiassis
DES-Dry eye syndrome
Ectropian
Emergent care of corneal abrasion
Entropian
Entropian
Episcleritis
Fungal endophthalmitis
Giant papilary conjunctivitis
Glaucoma Acute angle closure
Herpes Zoster
Hordeolum
Neonatal conjunctivitis
Karposi sarcoma opthomalogic manifestations
Orbital cellulitis
Post operative endophthalmitis
Preseptal cellulitis
Pterygium
Recurrent corneal erosion
Viral conjunctivitis
Stevens Johnson syndrome

8. PATIENT EVALUATION HISTORY EXAMINATION Vision affected
Foreign body sensation
Photophobia
Trauma
Contact lens wear
Discharge
Onset of symptoms
EXAMINATION
General observation
Visual acuity
Penlight examination
Fundal examination
Slit lamp examination

9. Exam devices

10. Exam -intraocularpressure

12. Diagnostic work up
Examination is generally the most revealing especially with slit lamp
Point of care adenovirus is now available
Gram stain
Culture and sensitivity
HSV PCR

14. TREATMENT Antibiotics Antivirals Nsaids Miotics
Antiglaucoma,carbonic anhydrase inhibitors
Diuretics,osmotic agents
Antihistamines,opthalmic

16. EYE ANATOMY

20. ALLERGIC CONJUCTIVITIS

21. VIRAL CONJUCTIVITIS

22. Bacterial conjuctivitis

23. GC BACTERIAL CONJUCTIVIS

24. HORDEOLUM

25. BLEPHARITIS

26. CONJUNCTIVAL HEMORRHAGE

27. EPISCLERITIS

28. EPISCLERITIS VS SCLERITIS

30. Conditions warranting referral
EMERGENT
Angle closeure glaucoma
Hyphema
Hypopyon
Bacteral keratitis
Penetrated globe
URGENT
Iritis (uveitis)
Retained foreign body
Corneal ulcer
HSV
Un-improving abrasion

31. CORNEAL ABRASION

32. RETAINED FOREIGN BODY

33. PENETRATED GLOBE

35. BACTERIAL KERATITIS

36. Hyphema

37. HSV

38. Acute angle glaucoma

39. IRITIS

40. HYPOPYON

41. Myaisis

42. QUESTIONS