Eyes Eyes Brought to you by You are not alone A very popular topic How much time at medical school? What do the acuity numbers mean Brought to you by Special history One or both? What disturbance of.Eyes Eyes Brought to you by You are not alone A very popular topic How much time at medical school? What do the acuity numbers mean Brought to you by Special history One or both? What disturbance of.
Eyes Brought to you by You are not alone! A very popular topic How much time at medical school? What the acuity numbers mean! Brought to you by Special history One or both? What disturbance of vision? Rate of onset? Any blind spots? Any associated symptoms e.g floaters? flashing lights? Exactly what is worrying the patient Brought to you by Contact lens use? Myopia? (increases risk of retinal detachment 10 fold) Any family history? (FH of glaucoma in a 1st degree relative gives you a 1/10 lifetime risk, or squint) Any history of diabetes, hypertension or connective tissue disease? Brought to you by Examination Snellan chart, 3m or 6m, simple text for near vision, Pinholes Fields, remember red and the quality of the red, simple quadrant testing Pupils: a bright torch and magnifying glass Squint Movements Opthalmoscopy: Start at 10, red reflex?, green filter enhances blood vessels, dilate prn, risk of acute closed angle glaucoma remote Brought to you by Clinical classification Red eye Lids and tears Slow visual loss in the quiet eye Trauma Squints, new and congenital, rare movement disorders … (then a rare specialist rag bag) Brought to you by Red eye Conjunctivitis Commonest, an uncomfortable red eye Bacterial Discomfort Purulent discharge Spreads from one eye to the other Vision normal Uniform engorgement Chloramphenicol first choice (?) Brought to you by Conjunctivitis Viral Often with an URTI Gritty Discomfort Watery discharge May last many weeks Photophobia Small corneal opacities may develop Prolonged (often adenoviral) may need specialist therapy with steroids Chloramphenicol to prevent 2nd infection Brought to you by Conjunctivitis Chlamydia Mucopurulent, cornea inflamed, visual loss Often with STD Permanent damage possible, topical and? systemic tetracyclines Refer Infants Less than one month is notifiable disease - any cause May lead to scarring and permanent damage Refer most Allergic Itching and discomfort Chemosis and visual acuity loss possible Papillae and if big cobblestones Cromoglycate may take days to Brought to you by start to work if bad Episcleritis / scleritis Red sore eye No discharge Localised (viz conjunctivitis=generalised) inflammation Episcleritis usually self limiting and idiopathic, no treatment needed Scleritis often with CT diseases, dangerous (perforation possible) Refer Brought to you by Blepharitis Common, underdiagnosed Persistently sore eyes Gritty Often with chalazions or styes Inflamed lid margins, crusts, may have inflamed lids Associated with psoriasis, eczema and roseacea Keep clean, antibiotic ointment[tetracycline], artificial tears ? oral tetracyclines Brought to you by Acute dacrocystitis Medial inflammation over lacrimal sac Refer, systemic therapy and topical urgently Brought to you by Orbital cellulitis Life threatening and blinding Usually from sinuses Especially important in children who may become blind in hours Unilateral swollen lids which may not be red The patient is ill, there is tenderness over the sinuses, restricted eye movements ADMIT Brought to you by Ectropion Watery eye Laxity from age or nerve palsy Ointment and refer for LA operation to correct Entropion Common especially in the elderly Scarring from the lashes Often results from blepharitis or chronic conjunctivitis Refer Brought to you by Ingrowing lashes Damage to lids May be removed but will often need electrolysis or cryocautery to prevent recurrence Brought to you by Watering eyes Differential diagnosis.your homework! Dry eyes Common, Remember to treat associated blepharitis Brought to you by Sudden visual loss An easy list really as they all need specialist assessment! Brought to you by Retinal detachment Floaters, photopsias, the shadow or curtain across the sight Optic neuritis More women, pain on moving the eye, central scotoma Posterior vitreous detachment Aged 50+, flashing lights, floaters Vitreous haemorrhage Floaters, red haze may be present Red reflex absent.0 Brought to you by Disciform macular degeneration •Sudden disturbance of central vision Vascular occlusions •Field loss Diabetes, hypertension Migraine •Youth, headache, zigzag lines, multicoloured lights Cerebrovascular disease •Elderly, bilateral loss Brought to you by Slow visual loss Refer to optician then ? refer Cataracts Corneal opacities Macular problems Retinal problems Brought to you by Trauma Refer ! Unless really trivial Brought to you by Squints Refer Remember the orthoptist Can you a cover test? Brought to you by This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause Brought to you by Our views have increased the mark of the 25,000 Thank you viewers Looking forward for franchise, collaboration, partners Brought to you by Brought to you by Contact ,011-41425180 :-Us ,011-25464531 011-66217387 91-+,91-9818308353 + 9818569476 othermotherindia@gmai l.com www.other-mother Saxbee Consultants Details :-www.parveenchadha.com in https://cparveen.wix.com/other-mother https://twitter.com/othermotherindi http://www.linkedin.com/profile/view?id=326103341&trk=nav_responsive_tab_profile https://www.facebook.com/pages/Other-Mother-Nursing-Crusade/224235031114989?ref=hl A WORLDWIDE MISSITION JOIN US ... conjunctivitis Refer Brought to you by Ingrowing lashes Damage to lids May be removed but will often need electrolysis or cryocautery to prevent recurrence Brought to you by Watering eyes Differential... diagnosis.your homework! Dry eyes Common, Remember to treat associated blepharitis Brought to you by Sudden visual loss An easy list really as they all need specialist assessment! Brought to you. .. artificial tears ? oral tetracyclines Brought to you by Acute dacrocystitis Medial inflammation over lacrimal sac Refer, systemic therapy and topical urgently Brought to you by Orbital cellulitis Life