Red Eye Red Eye Lid Blepharitis Blepharitis Lacrimal system - PowerPoint PPT Presentation

Red Eye Red Eye � Lid � Blepharitis � Blepharitis � Lacrimal system � Dacryocystitis � Conjunctiva � Conjunctiva � Conjunctivitis � Pterygium & Pinguecula � Pterygium & Pinguecula

R d E Red Eye � Acute uveitis � Scleritis � Acute glaucoma g � Corneal defects � Abrasion � Abrasion � Ulceration

Inflammation of the uveal tract

U Uveitis : Classification Uveitis : Classification U iti iti Cl Cl ifi ifi ti ti � Anatomical � Anatomical � Clinical � Etiological � � Pathological i

Uveitis : Anatomical Classification Uveitis : Anatomical Classification � Anterior uveitis � Intermediate uveitis � Intermediate uveitis � Posterior uveitis � Panuveitis

U U Uveitis : Clinical classification Uveitis : Clinical classification iti iti Cli i Cli i l l l l ifi ifi ti ti � Acute � S dd � Sudden onset t � < 6 week persistence p � Recurrent � Chronic � Chronic � Prolonged persistence � Less symptomatic

Uveitis : Etiological Classification Uveitis : Etiological Classification Uveitis : Etiological Classification Uveitis : Etiological Classification • Exogenous g • Endogenous • @ systemic diseases @ t i di • Infectious • Idiopathic

Uveitis : Pathological Classification Uveitis : Pathological Classification � Granulomatous � Granulomatous � Nongranulomatous � Nongranulomatous

Anterior Uveitis Anterior Uveitis � Signs � Signs � S � Symptoms t � Ciliary injection � Photophobia � Keratic precipitates � Keratic precipitates � Pain � P i � Aqueous cells/flare � Decreased vision � Iris atrophy � Iris atrophy � L � Lacrimation i i � Synechiae � Red eye

Intermediate Uveitis • Symptoms • Floaters • Signs • Signs • Decreased vision • Decreased vision • Vitreous cells

Posterior uveitis Posterior uveitis � Symptoms � Floaters � Floaters � Impaired vision � Signs g � Vitreous cells/flare & opacities � Ch � Choroiditis idi i � Retinits � Vasculitis

Uveitis & Arthritis � Ankylosing spondylitis � Reiter’s syndrome � Psoriatis arhritis � Juvenile RA

Uveitis & Systemic diseases Uveitis & Systemic diseases � Infectious � AIDS � Acquired syphilis � Acquired syphilis � Non-infectious � Tuberculosis � L � Leprosy � � Sarcoidosis � Behcet’s disease � Vogt-Koyanaki-Harada syndrome

Uveitis & Infections Uveitis & Infections � Parasite � Fungus � Toxoplasmosis � Histoplasosis p � Toxocariasis � Candidiasis � Virus � Herpes zoster � Herpes simplex � Congenital rubella g

Treatment of Uveitis Treatment of Uveitis � Goals � Prevent visual complications � Relieve discomfort � Relieve discomfort � Treat the underlying disease, if possible

Treatment of Uveitis � C � Cycloplegics / mydriatics l l i / d i ti � Relieve ciliary spasm � Prevent posterior synechia formation � Synechialysis � Synechialysis

Treatment of Uveitis Treatment of Uveitis � Steroids � Topical � Side effects � Periocular � Systemic � Ocular � Glaucoma � Glaucoma � Cataract � Corneal complications � Systemic � Systemic

Treatment of Uveitis � Immunosuppressive agents � Cytotoxic drugs � Cyclosporins

S l i i Scleritis � Diffuse � Nodular • Immune disease Immune disease

� A � Angle-closure glaucoma l l l � Primary angle-closure glaucoma � Secondary � Lens dislocation � Neovascular glaucoma � Open-angle glaucoma � Acute uveitis � Phacolytic glaucoma

Primary Angle Closure Glaucoma Primary Angle-Closure Glaucoma � Relatively common in Orientals � > 40 years � > 40 years � Women > men � Risk factors � Increased lens thickness � Small corneal diameter � Short axial length � Short axial length

Primary Angle Closure Glaucoma Primary Angle-Closure Glaucoma � Mechanism � Mechanism � Relative pupillary block � Iris bombe � Iris bombe � Iridotrabecular contact

� Closed angle � Open angle l � O

Primary Angle-Closure Glaucoma � Symptoms � Symptoms � Pain � Nausea & vomiting � H l � Halos � Blurred vision � Red eye

Primary Angle-Closure Glaucoma � Signs � Signs � Ciliary flush � Elevated IOP � Corneal edema � Fixed,oval, dilated pupil � Glaukomflecken � Glaukomflecken

Primary Angle Closure Glaucoma Primary Angle-Closure Glaucoma � Medical Rx � Hyperosmotic agents � Carbonic anhydrase inhibitors y � Beta-blockers � Alpha 2 agonists � Alpha 2 agonists � Miotics

PACG Surgical Rx PACG Surgical Rx I id Iridectomy : the definitive Rx t th d fi iti R

PACG Surgical Rx PACG Surgical Rx Goniosynechialysis

PACG Surgical Rx PACG Surgical Rx Filtering surgery : trabeculectomy

� Signs � Ciliary injection � Ciliary injection � Symptoms � Irregular light reflex � Pain � Fluorescein staining � Lacrimation � Photphobia � Blurred vision � Red eye

Corneal Abrasion Rx � P � Pressure patching t hi � Debridement � Contact lens � � Lubrication i i � Stromal puncture St o a pu ctu e

� Infections � Bacteria � Bacteria � Fungus � Parasite � Virus � Virus

Corneal Ulceration Rx � Antimicrobial agents � Antimicrobial agents � Cycloplegics � Steroids