Diploma In Family Health
Care
Professor Noshad Ahmed Shaikh
Vice Chancellor
Liaquat University of Medical and Health
Sciences/Jamshoro.
Dr Isam Al-Qurainy
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Dr Isam Al-Qurainy
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Dr Isam Al-Qurainy
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The Red Eye
Differential Diagnosis
Sameen Afzal Junejo
MCPS; DOMS; FCPS
Professor of Ophthalmology
LUMHS/Jamshoro
Causes Of Red Eye
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1)
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6)
Conjunctivitis.
Corneal Abrasions and Ulcer.
Acute Angle Closure Glaucoma.
Uveitis.
Episcleritis and Scleritis.
Sub-Conjunctival Haemorrhage.
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Conjunctivitis
Papillae
FolliclesPurulent
discharge
Redness
Chemosis
Acute Bacterial Conjunctivitis
Acute Viral Conjunctivitis
Corneal Abrasion
• Surface epithelium sloughed
off.
• Stains with fluorescein
• Usually due to trauma
• Pain, FB sensation, tearing,
red eye
Corneal Ulcer
• Infection
– Bacterial:
– Viral: HSV, HZO
– Fungal:
– Protozoan: Acanthamoeba in CL wearer
• Mechanical or trauma
• Chemical: Alkali injuries are worse than acid
Corneal ulcer stained green
with fluorescein dye.
Purulent Corneal Ulcer with
Hypopyon
Excessive Steroid Usage
Acute Angle-closure
Glaucoma
• Symptoms
– Pain, headache,
nausea-vomiting
– Redness,
Ciliary hyperaemia
photophobia,
– Reduced visionCorneal oedema
– Haloes around lights
– Raised IOP
Dilated pupil
Acute Angle Closure
Glaucoma
Uveitis
Anterior: acute recurrent and
chronic
Intermediate: Ciliary Body
Posterior: vitritis, retinal vasculitis,
retinitis, choroiditis
Pan uveitis: anterior and posterior
Anterior uveitis (Iritis)
• Photophobia, red eye, decreased vision, pain
• Idiopathic. Commonest
• Associated to systemic disease
– Seronegative arthropathies:AS, Psoriatic
arthritis, Reiter’s Disease
– Autoimmune: Sarcoidosis, Behcets
– Infection: Shingles, Toxoplasmosis, TB,
Syphillis, HIV
Ciliary flush
Small
Pupil
Fibrin
KPs
Keratic Precipitates ( KPs)
Circum Corneal Conjunctival
Congestion In
Uveitis
A.C Glaucoma
Episcleritis
• Superficial
• Idiopathic, collagen
vascular disorder (RA)
• Asymptomatic, mild pain
• Self-limiting or topical
treatment(NSAIDs,
Steroids)
Scleritis
• Idiopathic
• Collagen vascular disease (RA, SLE,
Wegener Granulomatosis, PAN)
• Zoster
• Sarcoidosis
• Dull, deep pain wakes patient at night
• Systemic treatment with NSAID or Steroids.
Scleritis
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Red Eye In
Scleritis
Conjunctivitis
Dr Isam Al-Qurainy
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Subconjunctival Haemorrhage
• Diffuse or localised area
• of blood under conjunctiva.
Asymptomatic
• Idiopathic, trauma, cough,
sneezing, aspirin, HT
• Resolves within 10-14 days
• Treatment of Cause.
Differential Diagnosis Of Red Eye
• Stress Upon 4 Vital Structures:
• 1- Conjunctiva
• 2- Cornea
• 3- Pupil
• 4- Intraocular Pressure (IOP)
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Differential Diagnosis Of “Red Eye”
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Conjunctiva Cornea Pupil IOP
• Conjunctivitis Diffuse cong Normal Normal Normal
• Uveitis
Cir.Corn.Cong
• Ac.Cong
Glaucoma
Cir.Corn.Cong Hazy
• Sub.Conjunctival Bright Red
Haemorrhage
KPs
Normal
Small
Normal
Dilated Raised
Fixed
Normal Normal
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Dr Isam Al-Qurainy
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• Your Eyes Are For Ever
• Take Care Of Them
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