Red Eye Part 2

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Red Eye Part 2
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Contents

• Conjunctivitis
• Keratitis

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Conjunctivitis

• Inflammation of the conjunctiva
• Infection
• Viral, Bacterial, Chlamydia
• Allergy
• History of atopy
• Use of eye drops
• Eye make-up

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Conjunctivitis

• Red
• Painless
• Rarely affects vision
• History of itch and discharge

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Conjunctivitis

• Viral
• Commonly both eyes
• Watery discharge
• Preceding URTI
• Palpable/tender pre-auricular lymph nodes
• Bacterial
• Yellow/green discharge
• Matted lashes in the morning

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Conjunctivitis

• Allergic
• Watery discharge
• Seasonal
• Very itchy
• Both eyes

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Examination

• Evert the upper lid
• Follicle vs. Papillae
• Pattern of redness
• Take a swab
• Fluorescein
• Check for corneal abrasions , FBs or ulcers
• Look at pupil

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Treatment

• Difficult to differentiate bacterial from viral
• Acceptable to treat with Chloramphenicol or
  Fucithalmic
• ABx provide protection against secondary
  infection when viral
• Viral Hygiene! Infectious for 12 days
• Treat allergic with anti-histamine drops and
  systemically
• Cromogylate is a mast-call stabiliser and can
  take weeks to have an effect
• Opatonol, Alomide, steroid (ophth supervision)

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Keratitis

• Do not mistake keratitis for conjunctivitis
• Pattern of injection different
• Circumcorneal
• Pointing at lesion
• Contact lens wearer
• Pain often reduced vision

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Examination

• Checking red reflex can reveal corneal
  abnormality
• Fluroscein with cobalt blue light
• Look for FB
• Abrasion
• Infiltrate (white hazy patches)

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Treatment

• Same day referral
• May need admission
• Corneal scrapes
• Intensive antibiotic/antiviral eye drops

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Red Eye Tutorial

• Will cover
• Acute glaucoma
• Iritis/Uveitis
• Episcleritis
• Sub-conj Haemorrhage
• Blepharitis/Meibominitis