practical ophthalmology for general practitioners
TRANSCRIPT
![Page 1: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/1.jpg)
Practical Ophthalmology
Mr. Micheal J. Gallagher M.M.L. FRCOphth
Consultant Ophthalmic Surgeon
Fellow Of Massachusetts Eye Research and Surgery Institute
Harvard Medical School
![Page 2: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/2.jpg)
No Financial Disclosure
![Page 3: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/3.jpg)
Content
Red Eye
Corneal Foreign Bodies
Corneal Abrasions
Chemical Injury
Ocular Trauma
Periorbital Cellulitis
Practical Demonstration
![Page 4: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/4.jpg)
![Page 5: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/5.jpg)
Red Eye
? Differential
![Page 6: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/6.jpg)
Bacterial Conjunctivitis
Staph Aureus
Staph Epidermidis
Strep Pneumoniae
H. Influenzae
![Page 7: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/7.jpg)
Viral Conjunctivitis
Adenoviral
Herpes simplex
![Page 8: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/8.jpg)
Allergic Conjunctivitis
Generalised Atopy
IgE
Itch
Follicles
Mast cell Stabilisers
Topical Steroids
![Page 9: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/9.jpg)
Chlamydial Conjunctivitis
Serotypes d-k
Concomitant genital infection
Chronic infection
Polymerase chain reaction
![Page 10: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/10.jpg)
Trachoma
Serotypes A,B,C
500 Million affected worldwide
2 Million Blind
![Page 11: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/11.jpg)
UVEITIS
![Page 12: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/12.jpg)
Bacterial Keratitis
Identify Organism
Assess Risk Factors
Staph Aureus
Staph Epidermidis
Strep Pneumoniae
Moraxella
Pseudomonas
Haemophilus Influenzae
Neisseria
Mycobacteria
![Page 13: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/13.jpg)
HSV Keratitis
Dendritiform.
Decreased sensation.
Acyclovir.
Recurrence.
![Page 14: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/14.jpg)
Acanthamoeba
< 1% of contact lenses culture proven corneal infections
Free living Protozoan
Trophozoite and Cyst
Keratocyte phagocytosis, inflammation, stromal necrosis.
![Page 15: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/15.jpg)
Fungal Keratitis
![Page 16: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/16.jpg)
![Page 17: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/17.jpg)
Acute Angle Closure Glaucoma
![Page 18: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/18.jpg)
Herpes Zoster Ophthalmica
![Page 19: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/19.jpg)
Corneal Foreign Body
Common Injury.
Topical anaesthesia.
Remove with Cotton Tip
? Rust Ring
![Page 20: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/20.jpg)
Corneal Abrasion
Trauma
?Underlying dystrophy
Very Painful
Red Eye
Tearing
Photophobia
![Page 21: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/21.jpg)
Management
Fluorescein
Pen torch
Analgesia
Mydriasis
Antibiotics
? Eye Pad
![Page 22: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/22.jpg)
Chemical Injury
First Aid First, Detailed Assessment Second
Assessment
Limit stem cell damage
Management of long term complications
![Page 23: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/23.jpg)
Management
Topical Corticosteroids
Topical Antibiotics
Topical Cycloplegics
Topical Ascorbic Acid (Na Ascorbate 10%)
Oral Ascorbic acid 1g qds
Topical Citric acid (Na Citrate 10%)
![Page 24: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/24.jpg)
Ocular Trauma
Penetrating/Non Penetrating
Examine from Front to Back
![Page 25: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/25.jpg)
Blow Out Fracture
Tissue Tethering
Diplopia
Tear Drop Sign
Antibiotics
![Page 26: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/26.jpg)
Lid Lacerations
Rule out underlying globe laceration
? Lacrimal canalicular system involved
Refer for surgical correction
![Page 27: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/27.jpg)
Traumatic Hyphaema
Intra Ocular Pressure
Fundoscopy
Danger of Rebleed
Rest, Topical Steroids, Mydriasis
![Page 28: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/28.jpg)
Traumatic Cataract
Non Penetrating and Penetrating
Injury
Glaucoma
![Page 29: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/29.jpg)
Retinal Detachment
Flashes and Floaters
Loss of Visual Field
Myopes more susceptible
![Page 30: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/30.jpg)
Preseptal/Orbital Cellulitis
Early preseptal
![Page 31: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/31.jpg)
Management
Admit
IV Antibiotics
ENT Consultation
CT Scan
![Page 32: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/32.jpg)
![Page 33: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/33.jpg)
PRACTICAL EXAMINATION
Visual Acuity measurement.
Pupillary examination.
Visual field examination.
![Page 34: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/34.jpg)
Visual Acuity
![Page 35: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/35.jpg)
Pupil Examination
![Page 36: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/36.jpg)
Visual Field Examination
![Page 37: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/37.jpg)
![Page 38: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/38.jpg)
Left homonymous paracentral scotoma
![Page 39: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/39.jpg)
Practicalities
Hands
Face
Fingers
![Page 40: Practical Ophthalmology for General Practitioners](https://reader033.vdocuments.net/reader033/viewer/2022050613/627491c28e21766b2409fc34/html5/thumbnails/40.jpg)
Friends are good on the Day of Battle
THANK YOU