RED EYE KAROLÍNA SKORKOVSKÁ RED EYE – SUBJECTIVE SYMPTOMS • PAIN? • BLURRED VISION? • PHOTOPHOBIA? • DISCHARGE? • ITCHING? RED EYE – OBJECTIVE SIGNS • TYPE OF INJECTION? • TARSAL CONJUNCTIVA AFFECTED? • CORNEA AFFECTED? • FOREIGN BODY? • INTRAOCULAR PRESSURE? • INTRAOCULAR INFLAMMATION? CONJUNCTIVITIS • DIFFUSE, SUPERFICIAL INJECTION • TARSAL CONJUNCTIVA USUALLY ALSO AFFECTED • CORNEAL OEDEMA • WITH DISCHARGE • ESSENTIALLY NO PAIN • VISION GENERALLY UNAFFECTED • CORNEA CLEAR • VERY COMMON CONJUNCTIVITIS • VIRAL, BACTERIAL, CHLAMYDIA, PARASITES… • OFTEN EPIDEMIC OCCURANCE • LOCAL ANTIBIOTICS AND CORTICOSTEROIDS • HYGIENIC MEASURES • IF NOT RESPONDING TO THERAPY – SWAB FROM THE CONJUNCTIVA AND TARGETED ANTIBIOTIC TREATMENT VIRAL CONJUNCTIVITIS • GROUP OF ADENOVIRUSES • HIGHLY INFECTIOUS!!! • EPIDEMIC KERATOCONJUNCTIVITIS • IF CORNEA IS AFFECTED, SOMETIMES LONG-TERM CORTICOSTEROIDS ARE NECESSARY • PHARYNGOCONJUNCTIVAL FEVER IN CHILDREN (IN ASSOCIATION WITH UPPER RESPIRÁTORY TRACT INFECTION) BACTERIAL CONJUNCTIVITIS SUBACUTE CONJUNCTIVITIS • ADULT INCLUSION CONJUNCTIVITIS RESULTS FROM C TRACHOMATIS SEROTYPES D-K • CHRONIC FOLLICULAR CONJUNCTIVITIS THAT CAN OCCUR IN ADULTS OR IN THE NEONATE • THE ADULT DISEASE IS TRANSMITTED SEXUALLY OR FROM HAND-TO-EYE CONTACT • GONORRHEA IS THE MOST COMMON CO-INFECTION WITH ADULT INCLUSION CONJUNCTIVITIS ADULT INCLUSION CONJUNCTIVITIS • PRESENTS AS A UNILATERAL (OR LESS COMMONLY BILATERAL) RED EYE WITH MUCOPURULENT DISCHARGE, MARKED HYPEREMIA, PAPILLARY HYPERTROPHY, AND A PREDOMINANT FOLLICULAR CONJUNCTIVITIS. • CONJUNCTIVITIS OFTEN IS CHRONIC AND MAY LAST FOR MANY MONTHS • ADULT INCLUSION CONJUNCTIVITIS IS A SEXUALLY TRANSMITTED DISEASE. ALLERGIC CONJUNCTIVITIS • ITCHING • CHEMOSIS • EYELID OEDEMA • LOCAL AND SYSTEMIC TREATMENT WITH ANITHISTAMINES ANTERIOR UVEITIS (IRIDOCYCLITIS) • RED EYE • BLURRED VISION • PHOTOPHOBIA • PAIN ANTERIOR UVEITIS (IRIDOCYCLITIS) • DEEP, CILIARY INJECTION • KERATIC PRECIPITATES ON THE POSTERIOR SURFACE OF THE CORNEA • PUPILLOPLEGIA • POSTERIOR SYNECHIAE • HYPOPYON • ELEVATION OF INTRAOCULAR PRESSURE ANTERIOR UVEITIS - TREATMENT • LOCAL CORTICOSTEROIDS (EYEDROPS, OINTMENT, SUBCONJUNCTIVAL, SYSTEMIC) • MYDRIATIC AGENTS • NON-STEROID ANTIINFLAMMATORY DRUGS (LOCAL AND SYSTEMIC) • GLAUCOMA MEDICATION • DIAGNOSIS OF A SYSTEMIC DISEASE (BECHTEREW DISEASE AND OTHER HLA-B27 ASSOCIATED DISEASES) ANGLE CLOSURE GLAUCOMA • SEVERE PAIN OF THE EYE, THE PERIOCULAR REGION AND HEMICRANIA • VISUAL LOSS (MAY ALSO BE SEVERE) • NAUSEA, VOMITING, … ANGLE CLOSURE GLAUCOMA • CILIARY INJECTION • CORNEAL OEDEMA AND HAZE • SHALLOW ANTERIOR CHAMBRE • PUPILLOPLEGIA, MYDRIASIS • HIGH INTRAOCULAR PRESSURE • OFTEN HYPEROPIA ACUTE ANGLE CLOSURE GLAUCOMA - TREATMENT • MIOTIC AGENTS - PILOCARPINE • ANTIINFLAMMATORY DRUGS • GLAUCOMA – LOCAL AND SYSTEMIC TREATMENT • LASER IRIDOTOMY COMPLICATIONS OF ANGLE CLOSURE GLAUCOMA • PERMANENT VISUAL LOSS • CHRONIC ANGLE CLOSURE GLAUCOMA • CATARACT • POSTERIOR SYNECHIAE EPISCLERITIS • RED EYE (SECTORAL HYPEREMIA) • DISCOMFORT • NO DECREASE IN VISUAL ACUITY • NO INTRAOCULAR INFLAMMATION • NO OTHER SYMPTOMS EPISCLERITIS - TREATMENT • SLEF-LIMITING DISEASE • RECURRANCE IS POSSIBLE • NONSTEORID ANTIINFLAMMATORY DRUGS (NSAIDS) SCLERITIS • MORE SERIOUS CONDITION THAN EPISCLERITIS • SEVERE PAIN • RED EYE • IN POSTERIOR SKLERITIS MAY BE DECREASED VISUAL ACUITY • COMPLEX DIAGNOSTICS NECESSARY (AUTOIMMUNE DISEASES!!!) SCLERITIS CLINICAL DIAGNOSIS OF RED EYE • VISUAL ACUITY • SLIT LAMP EXAMINATION • PUPIL LIGHT REACTION • OPHTHALMOSCOPY IF NECESSARY • LABORATORY • MICROBIAL TESTS Thank you for your attention