presented by: awatif k. al-mutairi hind k. bin-drees sarah n. al-gubaisi supervised by: dr....
TRANSCRIPT
![Page 1: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/1.jpg)
Presented by:Awatif K. Al-MutairiHind K. Bin-Drees
Sarah N. Al-Gubaisi
Supervised by:Dr. Al-Johara Al- Quaiz
![Page 2: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/2.jpg)
Red Eye
Iron deficiencyAnaemia
acne
![Page 3: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/3.jpg)
RED EYEOutlines:• What is red eye?• Red eye in PHC.• DDx.• How to deal with pt. with red eye?
![Page 4: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/4.jpg)
A 14-year-old boy. Complains of itching eyes for three years with sticky clear discharge. VA 6/6.
![Page 5: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/5.jpg)
Six-year-old male. Painful eye for ten days. Had malaria one month ago. Corneal sensation reduced when tested. VA 6/60.
![Page 6: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/6.jpg)
25 year-old woman. No pain or discharge. Complained of red eye since this morning. VA 6/6.
![Page 7: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/7.jpg)
19 -year-old male. Complains of gritty foreign body sensation, painful eye for three days with sticky yellowish discharge. VA 6/9.
![Page 8: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/8.jpg)
Back groundCardinal sign of ocular inflammation.Most cases can managed effectively by
the PC provider.Account ≈ 2% of GP consultation (at least
1 case/week).In KSA, trachoma prevalence was 22.2% in
1984, while in 1994, it was 10.7%.Conjunctivitis in KSA is very common but
least researched.
![Page 9: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/9.jpg)
Pathophysiology Due to dilatation of BVs in the eye. BV either ciliary OR conj. Injection
Ant. cil. a. superficial a.(cornea,iris, ↑↑redness
cili.body) ↔ ê topical VC
![Page 10: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/10.jpg)
DDx
![Page 11: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/11.jpg)
Blepharitiseither staphylococcal or seborreic, FB sensation, burning, matting of the lashes, Worse in the morning.
![Page 12: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/12.jpg)
CellulitisPreseptal:
tender, swollen, red lid,,, ??? insect bites, minor trauma, and
sinus disease.
Orbital: tender, swollen, and red eyelid.
![Page 13: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/13.jpg)
![Page 14: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/14.jpg)
DacrocystitisPain, redness, and swelling over lacrimal
sac
Tearing and discharge from the sac.
The vision is unchanged
Antibiotics, if not improve >>> refer
![Page 15: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/15.jpg)
Conjunctivitis Viral:
– Watery discharge, redness, discomfort , photophobia.
– Bilateral– lymphoid follicles– Enlarged tender preauricular
nodes.
![Page 16: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/16.jpg)
Conjunctivitis (Cont.)Bacterial:
– acute redness(pink eye), grittiness, burning
– mucupurulent discharge– crusted eyelids on waking
![Page 17: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/17.jpg)
Conjunctivitis (Cont.)Chlamydia (trachoma):
– red, mildly irritated eye, mucopurulent discharge.
– lids stuck together on awakening.– Unilateral, preauricular node, papillae
![Page 18: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/18.jpg)
Conjunctivitis (Cont.)
• allergic rhinoconjunc.:
– red , itchy, watery eyes,
– sneezing , watery nasal discharge
![Page 19: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/19.jpg)
Conjunctivitis (Cont.)
• Vernal keratoconjunctivitis– itching, lacrimation, burning , FB
sensation, photophobia.– Hx of atopy,– Giant Papillae, Tranta's Dots.
![Page 20: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/20.jpg)
Keratoconj. Siccasandy sensation, dryness, burning
peak in the afternoon
Rx: eye lubricants
![Page 21: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/21.jpg)
Corneal abrasion/ulcer
Pain (a.m), ↓ ↓ VA, photophopiaFB, bacterial, fungal(contact lenses),herpis(dendritic keratitis)
![Page 22: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/22.jpg)
![Page 23: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/23.jpg)
Scleritisglobe is tender, sclera swollen, ↓ ↓ VA
Deep scleral injection
If sever, deep violet discoloration
![Page 24: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/24.jpg)
Iritis + Uveitis Pain, perilimbal flush, ↓ ↓ VA,
photophopia, small pupil.minor trauma, chronic inflammatory
conditions UC.??? acute glaucoma, cataract.
![Page 25: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/25.jpg)
Acute angle closure
glaucomared, hard eye, mid dilated pupil,cloudy corneaunilateral
![Page 26: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/26.jpg)
Medicationsalt solution, alcohol, ground cowries,
human sputum, bird and lizard faeces, urine, …etc.)
corneal ulcers ,scars or eye
perforations
![Page 27: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/27.jpg)
How to approach the patient
At first: is this emergency case?
Neonates should always be referred to an ophthalmologist.
![Page 28: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/28.jpg)
Management
Rule out serious ophthalmic conditions
YESNO
Refer URGENTLY
corneal abrasion
Conjunctivitiscellulitis Hordeolum Blepharitis
![Page 29: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/29.jpg)
Management (cont.)
corneal abrasion
Conjunctivitiscellulites Hordeolum Blepharitis
Lid hygieneAbcs
(fusidic acid Tetracycli)
HOT COMPRESSNO Abcs
??(stye)
periorb. Abcs
Orbital refer
Superficial deep
LAAbcsErythromNSAID
refer
![Page 30: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/30.jpg)
Management (cont.)
Conjunctivitis
Watery discharge Preauric.LN
( Viral conj).
Preaur.LN .hx sex .Contact
(chlamydia)
Mucopurul. stick lid
( a.m)( bact. Conj ).
Severe itching
(allergic)
lid vesicle(HSV, HZ)
REFER
Adeno.Cold comp.Herpis
< refer>
Cold comp.Antihist.
Abcs(Fucithalmic)
1wk.
Not improve
![Page 31: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/31.jpg)
A 14-year-old boy. Complains of itching eyes for three years with sticky clear discharge. VA 6/6.
![Page 32: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/32.jpg)
Six-year-old male. Painful eye for ten days. Had malaria one month ago. Corneal sensation reduced when tested. VA 6/60.
![Page 33: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/33.jpg)
25 year-old woman. No pain or discharge. Complained of red eye since this morning. VA 6/6.
![Page 34: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/34.jpg)
19 -year-old male. Complains of gritty foreign body sensation, painful eye for three days with sticky yellowish discharge. VA 6/9.
![Page 35: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/35.jpg)
conclusion
![Page 36: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/36.jpg)
Refrences • Farina A.2005.red eye evaluation.e-medicine.• Yorston d., Zondervan m.2005. Red eye: the role of primary
care.community Eye Health Journal Vol 18 No.53 2005 p78• Allan V. Diagnosis and Treatment of Red Eye.Primary Care Case
Reviews: Volume 4)1( March 2001 pp 23-31• Leibowitz H. The red eye. N Engl J Med. 2000. 3;343)5(:345-51.• Jacobs DH. Evaluation of the Red Eye. UpToDate 2003.• Tabbara KF, al-Omar OM. Trachoma in Saudi Arabia.
Ophthalmic Epidemiol. 1997 Sep;4)3(:127-40• www.sunmed.org/redeye/htm • http://www.eyeweb.org/the_red_eye.htm
![Page 37: Presented by: Awatif K. Al-Mutairi Hind K. Bin-Drees Sarah N. Al-Gubaisi Supervised by: Dr. Al-Johara Al- Quaiz](https://reader030.vdocuments.net/reader030/viewer/2022032703/56649f585503460f94c7dc1a/html5/thumbnails/37.jpg)