How to Handle Common Eye Problems in Your Practice - PowerPoint PPT Presentation

Loading...

PPT – How to Handle Common Eye Problems in Your Practice PowerPoint presentation | free to download - id: 44c15e-MzkwO



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

How to Handle Common Eye Problems in Your Practice

Description:

... drops Follow up daily until healed Treat abrasions created with organic material in this manner Corneal Ulcer Risk of corneal ulcer when epithelium ... – PowerPoint PPT presentation

Number of Views:160
Avg rating:3.0/5.0
Slides: 44
Provided by: Catherin266
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: How to Handle Common Eye Problems in Your Practice


1
How to Handle Common Eye Problems in Your Practice
  • Shuan Dai, FRANZCO
  • Eye Doctors
  • Ascot Hospital
  • shuandai_at_eyedoctors.co.nz

2
The Red Eye
  • A Red Eye may be due to an abnormality of the
    ocular structures including
  • Adnexa
  • Lid Disorders
  • Lacrimal System
  • Orbital Disease
  • Globe
  • Conjunctival / Scleral Disorders
  • Corneal Disease
  • Uveitis
  • Glaucoma

3
Adnexal Redness
  • Lids
  • Blepharitis
  • Stye
  • Chalazion
  • Topical Allergic
  • Lacrimal System
  • Dacryocystitis
  • Canaliculitis
  • Dacryoadenitis
  • Orbit
  • Cellulitis
  • Preseptal
  • Orbital

4
Blepharitis
  • Symptoms signs
  • Crusting
  • Oil droplets
  • Grittiness
  • Treatment
  • Lid hygiene
  • Doxycycline 100mg daily 4-6 weeks

5
Stye Chalazion
6
Dacryocystitis
  • Recurrent watering eye
  • Mucous/purulent discharge
  • Abscess /lump over lacrimal sac
  • Blocked tear duct

7
Ophthalmia Neonatorum
  • Infantile purulent conjunctivitis
  • Chemical from antibiotic drops/silver nitrate
  • Chlamydia
  • Gonorrhea
  • An ocular emergency as GC can invade the intact
    cornea and perforate the globe

8
Lacrimal sac mucocele
  • An uncommon variant
  • Look for an elevated mass extending medially
  • Life threatening if infected refer for
    intravenous antibiotics

9
Dacryoadenitis
  • Acute painful
  • Swelling lateral upper lid
  • Viral/bacteria infection
  • Oral/iv antibiotics

10
Orbital Cellulitis
  • Proptosis
  • Limited eye movement
  • Reduced vision

11
Redness Confined to the Globe
  • Conjunctiva / Sclera
  • Subconjunctival hemorrhage
  • Ocular injection conjunctivitis
  • Pingueculum / Pterygium
  • Episcleritis
  • Scleritis
  • Cornea
  • Keratitis
  • Corneal abrasion
  • Corneal ulcer
  • Anterior chamber
  • Iritis
  • Endophthalmitis

12
Conjunctivitis
  • Bacterial
  • Purulent discharge
  • Papillary reaction
  • Associated blepharitis
  • Viral
  • Mucoid discharge
  • Follicular reaction
  • Associated URTI, epidemic
  • Allergic
  • Seasonal
  • Papillary reaction
  • Associated rhinitis, itching

13
Bacterial Conjunctivitis
  • Symptoms discharge, irritation
  • Signs papillary conjunctivitis, perilimbal
    injection if associated keratitis
  • Treatment chloramphenicol/fucithalmic
  • Danger if hyperpurulent (gonococcal) or recent
    intraocular surgery REFER!

14
Viral Conjunctivitis
  • Highly contagious, epidemics
  • Symptoms previous URTI, previous contacts,
    mucoid discharge, often photophobia
  • Signs preauricular node, pseudoptosis,
    follicular conjunctivitis ,conjunctival
    injection, punctate keratitis
  • Treatment cool compresses, ocular lubricants.
    Referal
  • Warning extreme infectivity, second eye at one
    week, lasts 10 14 days

15
Allergy -Papillary conjunctival reaction
16
Allergic Conjunctivitis
  • Symptoms itching, seasonal, atopic history,
    rhinitis
  • Signs papillary reaction, mucus
  • Treatment cool compresses, ocular lubricants,
    anti-histamines - topical (Vasocon A) or
    systemic, Opticrom (Na chromoglycate)
    prophylaxis
  • Possible history of contact lens wear with giant
    papillary conjunctivitis
  • Treatment
  • Lomide
  • Patanol
  • Steroid, i.e. FML

17
Pingueculum Pterygium
Pingueculum is degenerative collagen within the
interpalbebral fissure
Pterygium extends onto the cornea
18
Episcleritis Scleritis
Diffuse Scleritis Extremely painful Elderly, RA,
systemic vasculitis
Episcleritis Less painful Younger age No
systemic association
19
Herpes Simplex Keratitis
  • Viral replication in cornea
  • Symptoms irritation, photophobia
  • Signs
  • red eye involving limbus,
  • dendrite with terminal bulbs
  • seen best with staining
  • ulcer formation
  • Treatment refer, antivirals, BEWARE STEROIDS!

20
Herpes Zoster
  • Herpes Zoster Ophthalmicus
  • Suspect ocular involvement if the tip of the nose
    is involved (Hutchinsons sign)
  • Oral acyclovir topical acyclovir

21
Iritis
  • Signs
  • Miosis
  • Red eye to limbus
  • Flare with cell
  • Treatment
  • Cycloplegia
  • Topical steroids REFER
  • Etiology
  • 50 idiopathic, unknown
  • Ocular disease
  • Large abrasion
  • HSV, HZV
  • Primary disease in young patients
  • Systemic disease
  • JRA pauciarticular disease
  • Ankylosing spondylitis
  • Symptoms
  • Extreme photophobia
  • Reduced vision

22
Acute iritis
  • Light sensitivity
  • Deep dull ache
  • Smaller/ irregular pupil
  • Often idiopathic

23
Angle Closure Glaucoma
24
Subconjunctival Hemorrhage
  • Can occur secondary to blunt trauma or can be
    spontaneous
  • Lubrication if foreign body sensation
  • Warm compression

25
Corneal Abrasion
  • Management
  • Non-contact lens wearer
  • Antibiotic ointment and patch
  • Follow-up one day
  • Contact lens wearer
  • DO NOT PATCH
  • Antibiotic ointment or drops
  • Follow up daily until healed
  • Treat abrasions created with organic material in
    this manner

26
Corneal Ulcer
  • Risk of corneal ulcer when epithelium
    compromised, especially in contact lens wearers
  • Contact lens wearers have a higher rate of
    colonization with Pseudomonas

27
Abrasion versus Ulcer
Abrasion Ulcer
Fluorescein Stain Stain
Transparency Transparent Opaque
Corneal contour Unchanged Uneven
Level Epithelial only Involves stroma
28
Superficial Corneal Foreign Body
  • Removed under topical anesthetic
  • With burr or 25 gauge needle
  • Manage same as corneal erosion
  • Encourage safety glasses
  • Polycarbonate lenses

29
Anterior Segment
  • Linear epithelial defects is suggestive of a
    foreign body under the eye lid

30
Ultraviolet Radiation(arc eye)
  • Sources
  • Sunlamps, welding arcs
  • Management
  • Cycloplegics, antibiotic ointment, patch
  • Avoid long term topical anaethetic drop !!!

31
Chemical Injury
  • Acid precipitates quickly
  • Alkali continues to penetrate
  • Therefore can progress over an extended period of
    time
  • Management
  • Continuous irrigation with saline until neutral
    pH
  • Test fornices with Litmus paper
  • Sweep fornices to remove retain debris
  • Antibiotic ointment, cycloplegics

32
Chemical Injury
Thorough irrigation before referral !!!
33
Blunt Trauma
  • Hyphema
  • Indicates damage to angle and/or to the iris
  • Management
  • Vertical position
  • No anti-coagulants
  • Cycloplegics

34
Blunt Trauma
  • Damage to Iris and Lens
  • Iridodialysis, cataract
  • Dislocation

35
Blunt Trauma - Sequelae
  • Angle damage which can lead to glaucoma can
    develop days to years after injury

36
Blunt Trauma - Sequelae
  • A retinal tear which can progress to a retinal
    detachment

37
Open Globe Injuries
  • Blunt trauma rupture
  • Sharp trauma laceration
  • Projectile trauma
  • Penetrating in and out
  • Perforating intra ocular foreign body just in

38
Blunt Trauma
  • Severe trauma that resulted in a scleral rupture
    with delivery of the lens

39
Sharp Trauma
  • Corneal laceration and traumatic cataract from a
    thrown beer bottle

40
Penetrating Eye Injuries
  • Intraocular foreign bodies generally have to be
    removed, unlike orbital (extraocular) foreign
    bodies

41
Perforating Trauma
  • Patient was hammering and noticed a spark fly up
    to his eye.

42
Child with poor red reflex
43
Thank you
About PowerShow.com