red eye emergencies : what do you do???

RED EYE EMERGENCIESRED EYE EMERGENCIES:: What do YOUWhat do YOU

do??? do???

The role of the front office and The role of the front office and optometric assistant in the optometric assistant in the detection and treatment of detection and treatment of

REDRED EYES EYES

Front office staff and assistants Front office staff and assistants are THE first ones to begin the are THE first ones to begin the RED EYERED EYE evaluation process evaluation processwhen answering the phone…when answering the phone…

FIRST the patient calls the officeFIRST the patient calls the officeoffice…office…

What are some of the most common What are some of the most common things they say? things they say?

““My eye/eyes are My eye/eyes are REDRED…I’m…I’m afraid I have afraid I have PINKPINK eye” eye”

Other common things Other common things they say…they say…

““I have a I have a REDRED bump on my eye and bump on my eye and it’s really sore to touch it”it’s really sore to touch it”

““I woke up with my eye all I woke up with my eye all REDRED and it and it looks like it’s bleeding” looks like it’s bleeding”


““My eye/eyes are all My eye/eyes are all REDRED and goopy in and goopy in the morning with yellow greenish pus”the morning with yellow greenish pus”

““My eyes are so My eyes are so REDRED and itchy… and itchy…I can hardly stop rubbing them”I can hardly stop rubbing them”


““My eyes are My eyes are REDRED and feel all gritty and feel all grittylike I have sand in my eyes”like I have sand in my eyes”

““I slept in my contact lenses last night I slept in my contact lenses last night and now my eyes are all and now my eyes are all REDRED and and

irritated”irritated”


““My two year old was having a temperMy two year old was having a temper tantrum and her fingernail scratched mytantrum and her fingernail scratched myeye, now it’s all eye, now it’s all REDRED and I can hardly and I can hardly

keep it opened”keep it opened”


““I was doing some work under my car I was doing some work under my car a few days ago and now my eye is all a few days ago and now my eye is all REDRED

and feels like something might be in it”and feels like something might be in it”

““I was cutting some drywall yesterdayI was cutting some drywall yesterdayand it feels like something got in my eyeand it feels like something got in my eye

and now it’s all and now it’s all REDRED” ”

Next, front office staff and assistantsNext, front office staff and assistantsmust know the proper questions to must know the proper questions to

ask… ask…

WHEN did the WHEN did the REDNESSREDNESS begin? begin?

Are you in any PAIN?Are you in any PAIN?

Do you have any BLURRED Do you have any BLURRED VISION?VISION?

Do your eyes ITCH, BURN, WATERDo your eyes ITCH, BURN, WATER or FEEL IRRITATED?or FEEL IRRITATED?

Do you have any MATTER in or Do you have any MATTER in or SECRETION from the eye?SECRETION from the eye?

Is the Is the REDNESSREDNESS in ONE or BOTH in ONE or BOTH eyes?eyes?

Any Other Questions we should Any Other Questions we should ask??ask??

Light Sensitivity??Light Sensitivity??

??????????

??????????

What should you do next??What should you do next??

Must determine how quickly the Must determine how quickly the patient needs to be seen…patient needs to be seen…

URGENT / IMMEDIATELY!!!URGENT / IMMEDIATELY!!!

Non-urgent / Later that same day Non-urgent / Later that same day

URGENT / Immediately!!URGENT / Immediately!!

REDNESSREDNESS associated with associated with the following…the following…

Sudden or severe pain and discomfortSudden or severe pain and discomfort

Bleeding in or around the eye Bleeding in or around the eye


REDNESSREDNESS associated with the associated with the following…following…

Ocular Trauma such as a SportsOcular Trauma such as a Sports Injury, Blow to the Eye, FingernailInjury, Blow to the Eye, Fingernail scratch, Paper cut, Curling Iron burn,scratch, Paper cut, Curling Iron burn, Chemical burn, etc.Chemical burn, etc.



Foreign Body or object in the eyeForeign Body or object in the eye

Extreme discomfort and sensitivityExtreme discomfort and sensitivity to lightto light

Sudden Sudden change in vision or loss of visionchange in vision or loss of vision

Copious amount of matter or dischargeCopious amount of matter or discharge


REDNESSREDNESS associated with the associated with the following… following…

REDNESSREDNESS associated with the associated with thefollowing… following…

No ocular trauma No ocular trauma

No foreign body injuryNo foreign body injury

Non-urgent / Later the same dayNon-urgent / Later the same day

Non-urgent / Later the same dayNon-urgent / Later the same day


Mild pain or discomfort that has been Mild pain or discomfort that has been present for several days to a weekpresent for several days to a week

No bleeding in or around the eyeNo bleeding in or around the eye

Non-urgent/Later the same dayNon-urgent/Later the same day


Little to no light sensitivityLittle to no light sensitivity

Little to no change in visionLittle to no change in vision

Little to no matter or dischargeLittle to no matter or discharge

Once the patient comes to the Once the patient comes to the office, what do you do? office, what do you do?

Have them fill out Have them fill out appropriate case history appropriate case history information…medical information…medical insurance companiesinsurance companies

Obtain all current medical Obtain all current medical insurance information so insurance information so that payment for the that payment for the office visit will be receivedoffice visit will be received

Specific Case history information is Specific Case history information is needed… needed…

RED EYE or EYESRED EYE or EYES must be the must be the CHIEF COMPLIANTCHIEF COMPLIANT

Which eye has the problem? Which eye has the problem? O.D./O.S./O.UO.D./O.S./O.U

Does it cause vision loss or blur?Does it cause vision loss or blur?

Specific Case history information is Specific Case history information is needed…needed…

Did it occur suddenly or gradually?Did it occur suddenly or gradually?

How severe is the problem?How severe is the problem?

Is it worse at a specific distance?Is it worse at a specific distance?

How long does it last?How long does it last?

Specific Case history information is Specific Case history information is needed…needed…

How long has it been occurring?How long has it been occurring?

Are there any associated symptoms?Are there any associated symptoms?

Does anything help?Does anything help?

What tests should be performed before What tests should be performed before the patient sees the doctor?the patient sees the doctor?

Visual Acuities? Visual Acuities? Always!!!!Always!!!!

Blood Pressure?Blood Pressure?

Intraocular Pressure? Intraocular Pressure? NO!!!! Why?NO!!!! Why?

Any others?Any others?

http://images.google.com/imgres?imgurl=http://www.mayoclinic.com/images/image_popup/vi7_visual_acuity.jpg&imgrefurl=http://www.mayoclinic.com/health/medical/IM03545&usg=__V94_UO6LKMFTuSFYMZ8zuUeupPU=&h=400&w=400&sz=135&hl=en&start=15&tbnid=97OOoWgfbph-lM:&tbnh=124&tbnw=124&prev=/images%3Fq%3Dvisual%2Bacuity%2Bchart%26gbv%3D2%26hl%3Den

Now...let’s take a look at some of Now...let’s take a look at some of the most common causes of the most common causes of RED RED

EYEEYE in an Optometric Office… in an Optometric Office…

Any ideas???Any ideas???

Signs, Symptoms, TreatmentSigns, Symptoms, Treatment

Signs – What we clinically observeSigns – What we clinically observe

Symptoms – What the patient isSymptoms – What the patient is feeling and experiencing feeling and experiencing

Treatment – What we do to manageTreatment – What we do to manage the conditionthe condition

RED EYELID / EYELIDSRED EYELID / EYELIDS Most Common ConditionsMost Common Conditions

Hordeolum – Internal and ExternalHordeolum – Internal and ExternalChalazionChalazionBlepharitisBlepharitisMeibomianitisMeibomianitisTrichiasisTrichiasisEyelid TraumaEyelid Trauma

Red EyeLID or EyeLIDS Red EyeLID or EyeLIDS : Most : Most Common Findings and TreatmentCommon Findings and Treatment

Hordeolum (Stye)Hordeolum (Stye)

Localized Localized InfectionInfection or or inflammation of the eyelid inflammation of the eyelid margin that involve hair margin that involve hair follicles of eyelashes follicles of eyelashes (external) or oil glands (external) or oil glands underneath eyelid underneath eyelid (internal)(internal)

Red EyeLID or EyeLIDS Red EyeLID or EyeLIDS : Most : Most Common Findings and TreatmentCommon Findings and Treatment

Signs:Signs:

1.1. RednessRedness

2.2. SwellingSwelling

3.3. Bump on the Bump on the outside or insideoutside or inside of the eyelidof the eyelid

Red EyeLID or EyeLIDSRed EyeLID or EyeLIDS: Most : Most Common Findings and Treatment Common Findings and Treatment

Symptoms:Symptoms:

1.1. Sore and tender to Sore and tender to the touch the touch

2.2. Mild, Moderate orMild, Moderate or Extreme PainExtreme Pain

Red EyeLID or EyeLIDSRed EyeLID or EyeLIDS: Most : Most Common Findings and TreatmentCommon Findings and Treatment

Treatment:

1. “Hot Potato” Compress

2. Topical Antibiotics, usually an ointment

3. Oral antibiotics, if required


ChalazionChalazion Hard eyelid lump Hard eyelid lump caused by a single caused by a single blocked or series of blocked or series of blocked oil glands…blocked oil glands…

NOT infectiousNOT infectious


Signs:Signs:1.1. RednessRedness2.2. Swelling Swelling 3.3. Hard lump/bump on Hard lump/bump on

inside or outside of the inside or outside of the eyelideyelid

Symptoms:Symptoms: No pain or tendernessNo pain or tenderness

Red EyeLID or EyeLIDsRed EyeLID or EyeLIDs: Most : Most Common Findings and TreatmentCommon Findings and Treatment

Treatment:Treatment:

1.1. ““Hot Potato” Hot Potato” compresscompress

2.2. Monitor for change Monitor for change

3.3. Excise if does notExcise if does not resolveresolve


BlepharitisBlepharitis Infection andInfection and inflammation inflammation of the outer of the outer eyelid glands eyelid glands along the entirealong the entire eyelid margineyelid margin


Signs:Signs:

1.1. Redness of eyelidsRedness of eyelids at eyelid marginsat eyelid margins2.2. Crustiness along the Crustiness along the

base of the lids andbase of the lids and lasheslashes3.3. Tendency to Tendency to frequently rub eyesfrequently rub eyes


Symptoms:Symptoms:

1.1. Itching of eyelids Itching of eyelids 2.2. Grittiness of lidsGrittiness of lids3.3. Burning and irritation of Burning and irritation of

the eyethe eye4.4. Watering of the eyesWatering of the eyes



1.1. Hot soaks and lid Hot soaks and lid massagemassage

2.2. Commercially available Commercially available eyelid scrubseyelid scrubs

3.3. Topical antibiotics usually Topical antibiotics usually an ointmentan ointment


Meibomianitis Meibomianitis Infection andInfection and inflammation of inflammation of the inner eyelidthe inner eyelid glands along theglands along the entire lid marginentire lid margin


Signs:Signs:1.1. Redness and Redness and

inflammation of inflammation of inner eyelid inner eyelid marginsmargins

2.2. Toothpaste like Toothpaste like excretion from excretion from inner eyelid glandsinner eyelid glands


Symptoms:Symptoms:

1.1. Burning of the eyesBurning of the eyes

2.2. General irritation ofGeneral irritation of the eyesthe eyes

3.3. Watering of the eyes Watering of the eyes



1.1. Hot soaks and Hot soaks and massage massage

2.2. LipoFlow ThermalLipoFlow ThermalPulsation (NEW!)Pulsation (NEW!)

3.3. Topical antibioticTopical antibiotic4.4. Oral antibiotic Oral antibiotic


TrichiasisTrichiasis

Eyelid lashes Eyelid lashes that turn inwardthat turn inward resulting in resulting in scratching of thescratching of the front surface of thefront surface of the eye eye


Signs:Signs:

1.1. MisdirectedMisdirectedeyelashes that eyelashes that grow toward eyegrow toward eye

2.2. Redness of the Redness of the eyeeye


Symptoms:Symptoms:1.1. Scratchy feelingScratchy feeling2.2. Foreign body Foreign body

sensationsensation3.3. ItchinessItchiness

Treatment:Treatment:1.1. Removal of lashesRemoval of lashes2.2. Eye dropsEye drops3.3. Bandage Contact Bandage Contact

Lens if neededLens if needed


EyeLid TraumaEyeLid Trauma Trauma occurringTrauma occurring from suddenfrom sudden impact to the eyeimpact to the eye and eyelid…and eyelid… car accident,car accident, sports injury, blowsports injury, blow to the face, chemical to the face, chemical burn, etc.burn, etc.


Signs:Signs:

1.1. Moderate to severe Moderate to severe eyelid rednesseyelid redness

2.2. Possible cut of the Possible cut of the eyelid (as seen eyelid (as seen here)here)

3.3. Total lid obliterationTotal lid obliteration (as seen in next (as seen in next

slide)slide)


Symptoms:Symptoms:1.1. Moderate to severe painModerate to severe pain2.2. Light sensitiveLight sensitive3.3. Blurred visionBlurred vision

Treatment:Treatment:1.1. Cold ice packsCold ice packs2.2. Pain managementPain management3.3. Oculoplastic surgeon Oculoplastic surgeon

Which of the Which of the RED Eyelid RED Eyelid conditions conditions are True Emergencies ?are True Emergencies ?

Hordeolum – Internal and ExternalHordeolum – Internal and ExternalChalazionChalazionBlepharitisBlepharitisMeibomianitisMeibomianitisTrichiasisTrichiasisEyelid TraumaEyelid Trauma

RED Conjunctiva and ScleraRED Conjunctiva and ScleraMost Common ConditionsMost Common Conditions

Subconjunctival HemorrhageSubconjunctival HemorrhagePingueculaPingueculaPterygiumPterygiumSeasonal Allergic ConjunctivitisSeasonal Allergic ConjunctivitisAcute Allergic ConjunctivitisAcute Allergic ConjunctivitisBacterial ConjunctivitisBacterial ConjunctivitisContact Lens Associated Red Eye Contact Lens Associated Red Eye (CLARE)(CLARE)


SubconjunctivalSubconjunctival Hemorrhage Hemorrhage

Breaking of the tinyBreaking of the tiny blood vessels betweenblood vessels between the conjunctiva andthe conjunctiva and the sclerathe sclera


Signs:Signs:

1.1. Bloody looking eyeBloody looking eye2.2. Well defined area of Well defined area of

redness and redness and bleedingbleeding

3.3. Flat or slightly raised Flat or slightly raised hemorrhage hemorrhage


Symptoms: Symptoms: Usually None (Asymptomatic)Usually None (Asymptomatic)

1.1. No PainNo Pain2.2. No irritationNo irritation3.3. No discomfortNo discomfort



1.1. Check BPCheck BP2.2. Reassurance Reassurance 3.3. Cold compressCold compress followed by hotfollowed by hot compressescompresses4.4. Artificial tears Artificial tears


PingueculaPinguecula

LocalizedLocalized inflammationinflammation of the conjunctivaof the conjunctiva in the interpalpebral in the interpalpebral spacespace


Signs:Signs:

1.1. Reddish yellow inflammation with blood Reddish yellow inflammation with blood vessels running through vessels running through

2.2. Blood vessels and inflammation stops at Blood vessels and inflammation stops at the limbusthe limbus


Symptoms:Symptoms:1.1. Usually just bothersome Usually just bothersome

appearanceappearance2.2. May cause minor irritationMay cause minor irritation

Treatment:Treatment:1.1. Artificial TearsArtificial Tears2.2. Topical anti-inflammatory Topical anti-inflammatory

dropsdrops 3.3. Sunglasses Sunglasses

RED Conjunctiva and ScleraRED Conjunctiva and ScleraMost Common Conditions Most Common Conditions

PterygiumPterygium Pronounced inflammation Pronounced inflammation

and fibrovascular tissue and fibrovascular tissue in the interpalbebralin the interpalbebral space extending towardsspace extending towards the cornea the cornea


Signs:Signs:1.1. Appearance of a raised Appearance of a raised

whitish triangle shaped whitish triangle shaped vascular tissue “growing vascular tissue “growing over the eye”over the eye”

Symptoms:Symptoms:1.1. Cosmetic concern over Cosmetic concern over

appearanceappearance2.2. Dry irritated eyeDry irritated eye


Treatment:Treatment:1.1. Monitor closelyMonitor closely2.2. Use of UV Use of UV

blocking blocking sunglassessunglasses

3.3. Liberal use of Liberal use of Artificial tearsArtificial tears

4.4. Surgical excisionSurgical excision when encroachingwhen encroaching

on the pupil on the pupil


Seasonal AllergicSeasonal Allergic ConjunctivitisConjunctivitis Inflammation of theInflammation of the conjunctiva coincidingconjunctiva coinciding with pollen blooms,with pollen blooms, ragweed, animal ragweed, animal dander, dust mites, dander, dust mites, etc.etc.


Signs:Signs:

1.1. Mild diffuse pinkness Mild diffuse pinkness of the conjunctiva of the conjunctiva 2.2. Hazy conjunctivaHazy conjunctiva3.3. Rubbing of the eyes known Rubbing of the eyes known as “universal sign”as “universal sign”4.4. Watery or white stringyWatery or white stringy discharge discharge 5.5. Red swollen eyelids Red swollen eyelids


Symptoms:Symptoms:

1.1. Itching of the eyesItching of the eyes which gets worse withwhich gets worse with rubbingrubbing2.2. Tearing of the eyes Tearing of the eyes3.3. Mucus in corners Mucus in corners4.4. Sneezing Sneezing


1.1. Avoid offending allergen Avoid offending allergen (pollen blooms, animal (pollen blooms, animal dander, dust mites)dander, dust mites)

2.2. OTC allergy eye dropsOTC allergy eye drops3.3. Prescription allergy Prescription allergy

dropsdrops4.4. Cool compressesCool compresses5.5. Oral allergy medsOral allergy meds



Acute Allergic Acute Allergic ConjunctivitsConjunctivits

Sudden, extremeSudden, extreme inflammationinflammation caused by ancaused by an

abrupt exposure toabrupt exposure toa specific allergena specific allergen


Signs:Signs:

1.1. Extreme redness of the Extreme redness of the conjunctivaconjunctiva

2.2. Profound conjunctival Profound conjunctival chemosis (glassy chemosis (glassy appearance) appearance)

3.3. Red, swollen and Red, swollen and edematous eyelids edematous eyelids


Symptoms:Symptoms:

1.1. Sudden Sudden intense itching intense itching and tearingand tearing2.2. Ocular burningOcular burning3.3. PhotophobiaPhotophobia


1.1. Identify and removeIdentify and remove offending allergen asapoffending allergen asap2.2. Cold compresses for eyelid Cold compresses for eyelid

swellingswelling3.3. OTC oral antihistamine OTC oral antihistamine

such as Benadryl such as Benadryl 4.4. Prescription allergy and/or Prescription allergy and/or

anti-inflammatory dropsanti-inflammatory drops


Bacterial Bacterial ConjunctivitisConjunctivitis

Highly contagiousHighly contagious infection of the infection of the conjunctivaconjunctiva caused by acaused by a multitude ofmultitude of bacterial strainsbacterial strains


Signs:Signs:

1.1. Reddish “Pink” eye that Reddish “Pink” eye that usually starts in one eye, but usually starts in one eye, but often moves to the other often moves to the other (Highly contagious)(Highly contagious)

2.2. Yellowish-green Yellowish-green dischargedischarge


Symptoms:Symptoms:

1.1. Eyelids feel “glued shut” Eyelids feel “glued shut” in the morningin the morning

2.2. Buildup of yellowish green Buildup of yellowish green discharge through the daydischarge through the day

3.3. Mild to moderate irritationMild to moderate irritation4.4. Patient is usually “sick”Patient is usually “sick”



1.1. Topical antibiotic eye Topical antibiotic eye drops or ointmentdrops or ointment2.2. Oral prescription Oral prescription

antibioticsantibiotics3.3. Hot compressesHot compresses


Contact Lens Contact Lens Associated Red Eye Associated Red Eye (CLARE)(CLARE)

Signs:Signs:Redness around theRedness around the

limbus usually due tolimbus usually due to over wear of CLs orover wear of CLs or solution intolerancesolution intolerance


Symptoms:Symptoms:

1.1. Mild to moderate Mild to moderate pain especiallypain especially when wearing CLswhen wearing CLs

2.2. TearingTearing

3.3. Photophobia Photophobia



1.1. Discontinuing CL wear Discontinuing CL wear (Usually temporarily)(Usually temporarily)

2.2. OTC or Rx. Eye dropsOTC or Rx. Eye drops3.3. Refit to other type of CL Refit to other type of CL4.4. Change CL solution Change CL solution

Which of the Which of the RED Eye RED Eye conditions of conditions of the Conjunctiva are True the Conjunctiva are True

Emergencies?Emergencies?

Subconjuntival HemmorrhageSubconjuntival HemmorrhagePingueculaPingueculaPterygiumPterygiumSeasonal AllergySeasonal AllergyAcute AllergyAcute AllergyBacterial ConjunctivitisBacterial ConjunctivitisCLARECLARE

RED EYERED EYE associated with associated with Corneal Problems…Most Corneal Problems…Most

Common ConditionsCommon Conditions

Foreign BodyForeign BodyAbrasionAbrasionRecurrent ErosionRecurrent ErosionDry EyeDry EyeCorneal InfiltrateCorneal InfiltrateChemical or UV DamageChemical or UV DamageCorneal TraumaCorneal Trauma

RED EYERED EYE associated with associated with Corneal ProblemCorneal Problem

Corneal Foreign Corneal Foreign BodyBody

Signs:Signs:1.1. Foreign object in eyeForeign object in eye usually metal, woodusually metal, wood drywall, etc.drywall, etc.2.2. Unable to open eyeUnable to open eye3.3. Light sensitiveLight sensitive


Symptoms:Symptoms:

1.1. ModerateModerate to extreme painto extreme pain2.2. Feels like Feels like something issomething is in the eyein the eye3.3. DiscomfortDiscomfort4.4. PhotophobiaPhotophobia


Treatment: Treatment:

1.1. Removal of foreign bodyRemoval of foreign body

2.2. Topical antibioticsTopical antibiotics 3.3. Bandage CL using a Bandage CL using a continuous wear CLcontinuous wear CL


Corneal AbrasionCorneal Abrasion Loss of surfaceLoss of surface cells on the front cells on the front surface of thesurface of the cornea cornea


Signs:Signs:

1.1. Unable to open eyeUnable to open eye2.2. Extremely light sensitiveExtremely light sensitive3.3. Appearance of scratchAppearance of scratch or section of cornea or section of cornea removedremoved

http://img.medscape.com/pi/emed/ckb/ophthalmology/1189694-1193217-1195402-1428506.jpg


Symptoms:Symptoms:

1.1. Moderate to extremeModerate to extreme pain pain 2.2. Feels like something Feels like something is in the eyeis in the eye


Treatment:Treatment:1.1. Topical antibiotic Topical antibiotic

eye dropseye drops2.2. Fitting of a bandage Fitting of a bandage

CL until resolvesCL until resolves3.3. Prophylactic nightly Prophylactic nightly

use of lubricating use of lubricating eye ointmentseye ointments


Recurrent Corneal Recurrent Corneal ErosionErosion

Recurrence of the removal of Recurrence of the removal of the front surface cells of thethe front surface cells of the cornea after previous cornealcornea after previous corneal abrasion (Basically rippingabrasion (Basically ripping off of the previously off of the previously damaged cells)damaged cells)


Signs:Signs:1.1. Redness upon awakeningRedness upon awakening2.2. Watering and tearing of the eyeWatering and tearing of the eye

Symptoms:Symptoms:1.1. Pain and irritation upon awakening Pain and irritation upon awakening 2.2. Feels like something is in the eyeFeels like something is in the eye3.3. Light sensitiveLight sensitive

Treatment:Treatment: Prophylactic use of lubricating eye gels or ointments at Prophylactic use of lubricating eye gels or ointments at

bedtime to minimize future erosionsbedtime to minimize future erosions


Dry Eye SyndromeDry Eye Syndrome

Chronic lack of Chronic lack of lubrication and lubrication and moisture of the eye moisture of the eye due to many factors due to many factors including low tear including low tear production, poor tear production, poor tear quality and other quality and other eyelid issueseyelid issues


Signs:Signs:

1.1. Mild to severe Mild to severe interpalpebral rednessinterpalpebral redness

2.2. Mild to severeMild to severe corneal stainingcorneal staining


Symptoms:Symptoms:

1.1. Burning & stingingBurning & stinging2.2. Grittiness & ScratchinessGrittiness & Scratchiness3.3. Foreign Body sensationForeign Body sensation4.4. PhotophobiaPhotophobia5.5. Intermittent blurred visionIntermittent blurred vision6.6. Watering and tearing Watering and tearing



1.1. OTC artificial tearsOTC artificial tears (Refresh Optive, (Refresh Optive,

Systane Ultra or Balance, Systane Ultra or Balance, Soothe XP)Soothe XP)

2.2. Rx. anti-inflammatory Rx. anti-inflammatory eye drops (Restasis)eye drops (Restasis)

3.3. Rx. anti-inflammatory Rx. anti-inflammatory eye drops (Steroid)eye drops (Steroid)


Other Treatment:Other Treatment:1.1. Omega -3Omega -3

Salmon, TSalmon, Tuna,una,mackerel, herring,mackerel, herring,trout, sardines ortrout, sardines orhalibuthalibut

2.2. Ocular SupplementsOcular Supplements1000-2000 mg/Day1000-2000 mg/Day


Corneal InfiltrateCorneal InfiltrateSmall hazy greySmall hazy greyareas of areas of inflammationinflammationusually near theusually near thelimbuslimbus


Signs:Signs:1.1. Redness Redness 2.2. TearingTearingSymptoms:Symptoms:1.1. Foreign body sensationForeign body sensation2.2. Mild to severe irritationMild to severe irritation3.3. Light sensitiveLight sensitiveTreatment:Treatment:1.1. Topical antibiotic-steroid dropsTopical antibiotic-steroid drops


Chemical /UV DamageChemical /UV DamageDamage of theDamage of thecornea caused bycornea caused bychemical solution orchemical solution orUV exposureUV exposure

Signs:Signs:1.1. RednessRedness2.2. Chemosis of ConjunctivaChemosis of Conjunctiva3.3. Corneal StainingCorneal Staining


Chemical Solution / UV DamageChemical Solution / UV Damage

Symptoms:Symptoms:1.1. Pain and discomfort Pain and discomfort 2.2. Tearing, burning and stingingTearing, burning and stinging3.3. Foreign body sensationForeign body sensation

Treatment:Treatment:1.1. Artificial tearsArtificial tears2.2. Antibiotic / steroid dropsAntibiotic / steroid drops3.3. Change of CL solutionChange of CL solution4.4. Advise against tanning bed useAdvise against tanning bed use5.5. Sun protection when outsideSun protection when outside


Corneal TraumaCorneal Trauma

Which of the Which of the RED EYERED EYE conditions conditions of the Cornea are True of the Cornea are True

Emergencies??Emergencies??

Foreign BodyForeign BodyAbrasionAbrasionRecurrent ErosionRecurrent ErosionDry EyeDry EyeCorneal Infiltrate Corneal Infiltrate Chemical or UV damageChemical or UV damageCornea TraumaCornea Trauma

Once the doctor examines the Once the doctor examines the Red Red EyeEye Patient…how do YOU come Patient…how do YOU come

back in the picture?back in the picture?

Exam room Exam room assistanceassistance Patient educationPatient education Follow-up careFollow-up care

Can you identify Can you identify THIS THIS Red EYE Red EYE ??

• Woke up with itWoke up with it• No painNo pain• No discomfortNo discomfort• No blurred visionNo blurred vision

Is that your Final Answer?Is that your Final Answer?

A.A. ChalazionChalazion

B.B. Allergic ConjunctivitisAllergic Conjunctivitis

C.C. Subconjunctival HemmorhageSubconjunctival Hemmorhage

D.D. BlepharitisBlepharitis


• ItchinessItchiness• ScratchinessScratchiness• BurningBurning• IrritationIrritation• Frequently rubs Frequently rubs

eyeseyes



B.B. BlepharitisBlepharitis

C.C. Foreign BodyForeign Body

D.D. MeibomianitisMeibomianitis


• Toddlers fingerToddlers fingerscratched eyescratched eye

• PainPain• TearingTearing• Hard to openHard to open• Blurred VisionBlurred Vision


A.A. Dry EyeDry Eye

B.B. PingueculaPinguecula

C.C. Corneal AbrasionCorneal Abrasion

D.D. Corneal Foreign BodyCorneal Foreign Body


• BurningBurning• ItchingItching• WateringWatering• GrittinessGrittiness• IrritationIrritation• Eye strainEye strain• Eye FatigueEye Fatigue


A.A. Dry EyeDry Eye

B.B. CLARECLARE

C.C. Foreign BodyForeign Body

D.D. Seasonal AllergySeasonal Allergy


• Red Bump on LidRed Bump on Lid• Moderate Moderate

SorenessSoreness• Tender to Tender to

the touchthe touch



B.B. Corneal InfiltrateCorneal Infiltrate

C.C. HordeolumHordeolum

D.D. TrichiasisTrichiasis


• Woke up with eyes Woke up with eyes “glued” shut“glued” shut

• Yellowish matter Yellowish matter through the daythrough the day

• Mild irritationMild irritation• Had a cold last Had a cold last

weekweek


A.A. Acute Allergic ConjunctivitisAcute Allergic Conjunctivitis

B.B. PterygiumPterygium

C.C. Dry EyeDry Eye

D.D. Bacterial ConjunctivitisBacterial Conjunctivitis


• Yellow raised bump Yellow raised bump on white part of the on white part of the eyeeye

• Seems to look Seems to look worse after being worse after being outside in sun and outside in sun and windwind

• Mild occasional Mild occasional irritationirritation


A.A. Subconjunctival HemorrageSubconjunctival Hemorrage

B.B. PingueculaPinguecula

C.C. PterygiumPterygium

D.D. Bacterial ConjunctivitisBacterial Conjunctivitis


• ItchingItching• Always rubbing Always rubbing

at eyesat eyes• WateringWatering• SneezingSneezing• Allergies Allergies


A.A.Foreign BodyForeign Body

B.B.CLARECLARE

C.C.Acute Allergic ConjunctivitisAcute Allergic Conjunctivitis

D.D.Seasonal Allergic ConjunctivitisSeasonal Allergic Conjunctivitis

Questions on Questions on RED EYE??RED EYE??

Thank youThank you…it has been a pleasure …it has been a pleasure spending the past few hours with you!spending the past few hours with you!

I hope you feel that you have learned I hope you feel that you have learned more about your more about your RED EYE RED EYE patients. patients.

Have a fantastic conference … Have a fantastic conference …

Dr. Kris Kerestan GarbigDr. Kris Kerestan [email protected]@fuse.net

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