Diploma In Family Health Care
Professor Noshad Ahmed ShaikhVice Chancellor
Liaquat University of Medical and Health Sciences/Jamshoro.
Dr Isam Al-Qurainy 3
Dr Isam Al-Qurainy 4
Dr Isam Al-Qurainy 5
The Red EyeDifferential Diagnosis
Sameen Afzal JunejoMCPS; DOMS; FCPS
Professor of OphthalmologyLUMHS/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.7
Conjunctivitis
FolliclesPapillae Purulent discharge
ChemosisRedness
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
Corneal oedema
Ciliary hyperaemiaDilated pupil
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
KPs
Fibrin
Ciliary flushSmall Pupil
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
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Red Eye In Scleritis Conjunctivitis
Dr Isam Al-Qurainy 26
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)28
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
Haemorrhage29
Dr Isam Al-Qurainy 30
• Your Eyes Are For Ever
• Take Care Of Them
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