red eye rengin yildirim, prof. dr. cerrahpasa medical faculty
TRANSCRIPT
RED EYERED EYE
Rengin YILDIRIM, Prof. Dr.Rengin YILDIRIM, Prof. Dr.
Cerrahpasa Medical FacultyCerrahpasa Medical Faculty
RED EYERED EYETHE REASONS ?THE REASONS ?
SYMPTOMPS ?SYMPTOMPS ?
PATOGENESIS ?PATOGENESIS ?
SIGNS?SIGNS?
VASCULAR SYSTEM OF VASCULAR SYSTEM OF ANTERIOR SEANTERIOR SEGGMENTMENT
SUPERFICIAL
DEEP (CILIARY)
TYPES OF HYPEREMIATYPES OF HYPEREMIA
SUPERFICIAL DEEP MIXT
LOCALIZATION PERIFERY CENTRAL COMMON
REASON CONJ VESSELS CILIARY ARTERY BOTH
ETIOLOGY SUPERFICIAL INFECTIONS
SEVERE EYE DISEASES UVEITIS, GLAUCOMA
ALL OF THEM
PHENILEPHRINE TEST
PALE NOT PALE NOT PALE
PRESSURE PALE NOT PALE NOT PALE
MOVEMENT YES NO NO
COLOR LIGHT RED PURPLE PURPLE
COMMON CAUSES OF RED EYECOMMON CAUSES OF RED EYE
1- 1- INFECTIONSINFECTIONS
2-2- TRAUMA OF TRAUMA OF
ANTERIOR SEANTERIOR SEGGMENTMENT
3- A3- ACCUT GLUT GLAUCAUCOMOMAA CCRRYSISYSIS
4- 4- SYSTEMIC DISEASESSYSTEMIC DISEASES
PAINPAIN (+) (+)
11-- SUBCONJUNCTIVAL SUBCONJUNCTIVAL
HEMORRAHEMORRAGGIE IE
2-2-CHRONIC BLEPHARITISCHRONIC BLEPHARITIS
3-3- DRY EYE DRY EYE
PAINPAIN (-) (-)
INFECTIONS OF EYEINFECTIONS OF EYE
KERATITISKERATITIS
BLEPHARITISBLEPHARITIS
SCLERITISSCLERITIS
CONJONCTIVITISCONJONCTIVITIS
DACRIOCYSTITISDACRIOCYSTITISUVEITISUVEITIS
DIFFERANTION OF THE COMMON DIFFERANTION OF THE COMMON TYPES OF CONJONCTIVITISTYPES OF CONJONCTIVITIS
CLINICAL CLINICAL FINDINGSFINDINGS
VIRALVIRAL BACTERIALBACTERIAL CHLAMIDIALCHLAMIDIAL ALLERGICALLERGIC
ITCHINGITCHING MINIMALMINIMAL MINIMALMINIMAL MINIMALMINIMAL SEVERESEVERE
HYPEREMIAHYPEREMIA GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL
GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL
GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL
GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL
TEARINGTEARING PROFUSEPROFUSE MODERATEMODERATE MODERATEMODERATE MODERATEMODERATE
EXUDATIONEXUDATION MINIMALMINIMAL PROFUSEPROFUSE PROFUSEPROFUSE MINIMALMINIMAL
LAPLAP COMMONCOMMON UNCOMMONUNCOMMON COMMONCOMMON NONENONE
ACUT CONJONCTIVITIS ACUT CONJONCTIVITIS SYMPTOMSSYMPTOMS
FOREINFOREINGG BODY SENSATION BODY SENSATIONA SCRATCHINA SCRATCHINGG OR OR
BURNINBURNINGG SENSATION SENSATION
PHOTOPHOBIA AND PAIN PHOTOPHOBIA AND PAIN (IF CORNEA IS ALSO AFFECTED(IF CORNEA IS ALSO AFFECTED
ITCHINITCHINGG
ACUT CONJONCTIVITIS ACUT CONJONCTIVITIS SISIGGNSNS
HHYPEREMIA CHHEMOSIS
TEARINGG
EXUDATION
PSEUDOPTOSIS
PSEUDOMEMBRANES AND MEMBRANS
FOLLICLES
GGRANULOMAS
PAPILLARY HHYPERTROPY
PREAURICULAR LAP
VERNALISVERNALIS(ALLERGIC CONJONCTIVITIS)(ALLERGIC CONJONCTIVITIS)
LIMBAL FORM OF VERNALIS
PALBEPRAL FORM OF VERNALIS
KERATITISKERATITIS
•ETIOLOGYETIOLOGYINFECTIONSINFECTIONS
• BACTERIAL• FUNGAL• VIRAL
•HYPERSENSITIVITYHYPERSENSITIVITY•NUTRICIONAL DISEASENUTRICIONAL DISEASE
KERATOMALACIAKERATOMALACIA•NEUROTROPHIC KERATITISNEUROTROPHIC KERATITIS
EXPOSURE KERATITISEXPOSURE KERATITIS•TRAUMATRAUMA
RADIATIONALRADIATIONALMECHANICALMECHANICALCHEMICALCHEMICAL
HYPOPION
VIRAL KERATITISVIRAL KERATITIS
DENDRITIC FORM GEOGRAPHIC FORM
PRIMARY INFECTION
DIFFUSE EPISCLERITIS NODULAR EPISCLERITIS
DIFFUSE SCLERITIS NODULAR SCLERITIS
NECROTIC SCLERITIS SCLEROMALACIA PERFORANCE
EPISCLERITIS - SCLERITISEPISCLERITIS - SCLERITIS
SUPERFICIAL HYPEREMIA
DEEP HYPEREMIA
DEEP HYPEREMIA
ACUT UVEITISACUT UVEITIS
•SEVERE PAIN,PHOTOPHOBIASEVERE PAIN,PHOTOPHOBIA
•MIXT (DEEP) HYPEREMIAMIXT (DEEP) HYPEREMIA
•SELF-LIMITED COURSE,OFTEN SELF-LIMITED COURSE,OFTEN
RECURRENCERECURRENCE
•PINPOINT KERATIC PRECIPITATSPINPOINT KERATIC PRECIPITATS
•IN AQUEOUS, MANY CELLS, SOMETIMES IN AQUEOUS, MANY CELLS, SOMETIMES
PROTEIN ACCUMULATIONSPROTEIN ACCUMULATIONS
•SINECHIA POSTERIOR, PUPILLARY SINECHIA POSTERIOR, PUPILLARY
DISTURBANCES, SECONDARY GLAUCOMADISTURBANCES, SECONDARY GLAUCOMA
•CAUSES: EXOGENEOUS &ENDOGENEOUSCAUSES: EXOGENEOUS &ENDOGENEOUS
BEHCET’S DISEASE
CLINIC FORMS OF UVEITISCLINIC FORMS OF UVEITIS
SINECHIA POSTERIORSINECHIA POSTERIOR
KERATIC PRECIPITATSKERATIC PRECIPITATS
DEEP (CILIARY) HYPEREMIA
SINECHIA POSTERIORSINECHIA POSTERIOR
FOREIGN BODIES OF FOREIGN BODIES OF CONJONCTIVAE OR CORNEACONJONCTIVAE OR CORNEA
SYMPTOMSSYMPTOMSFOREIGN BODY SENSATION, FOREIGN BODY SENSATION, TEARING, MINIMAL PAIN, TEARING, MINIMAL PAIN, BLURRED VISION, PHOTOPHOBIABLURRED VISION, PHOTOPHOBIA
( IF THERE IS A CORNEAL FOREIGN ( IF THERE IS A CORNEAL FOREIGN BODY, SYMPTOMS MORE SEVERE!)BODY, SYMPTOMS MORE SEVERE!)
SIGNSSIGNSFOREIGN BODY,SUPERFICIAL FOREIGN BODY,SUPERFICIAL (CONJONTIVAL)HYPEREMIA(CONJONTIVAL)HYPEREMIA
TREATMENTTREATMENTREMOVAL OF FOREIGN BODY AND REMOVAL OF FOREIGN BODY AND OCCLUSION OF EYE FOR 1 DAY OCCLUSION OF EYE FOR 1 DAY
ACUT GLAUCOMA CRISISACUT GLAUCOMA CRISIS
PRECIPITATING PRECIPITATING FACTORSFACTORS•PHYSIOLOGIC PUPILLARY PHYSIOLOGIC PUPILLARY BLOCKBLOCK
•INCREASED SIZE OF THE INCREASED SIZE OF THE LENSLENS
•(RELATIVE PUPILLARY (RELATIVE PUPILLARY BLOCK)BLOCK)
•PLATEAU IRISPLATEAU IRIS
FIXED PUPILLA
GLAUCOMA FLECKEN
ACUT GLAUCOMA CRISIS ACUT GLAUCOMA CRISIS PATHOGENESISPATHOGENESIS
ANTERIOR CHAMBER ANGLE OF EYE
GRADING SYSTEM OF ANGLE
CLOSED ANGLE
ACUT GLAUCOMA CRISISACUT GLAUCOMA CRISIS
SYMPTOMS AND SIGNSSYMPTOMS AND SIGNS• SUDDEN ONSET OF BLURRED VISIONSUDDEN ONSET OF BLURRED VISION
• FOLLOWED BY SEVERE HEADACHE AND PAIN IN THE EYEFOLLOWED BY SEVERE HEADACHE AND PAIN IN THE EYE
• RAINBOW COLORED HALOS AROUND LIGHTSRAINBOW COLORED HALOS AROUND LIGHTS
• NAUSEA,VOMITINGNAUSEA,VOMITING
• MARKEDLY INCREASED IOPMARKEDLY INCREASED IOP
• A SHALLOW ANTERIOR CHAMBERA SHALLOW ANTERIOR CHAMBER
• AN OEDEMATOUS CORNEAAN OEDEMATOUS CORNEA
• A FIXED,MODERATELY DILATED PUPILLAA FIXED,MODERATELY DILATED PUPILLA
• CILIARY (DEEP) HYPEREMIACILIARY (DEEP) HYPEREMIA
ACUT GLAUCOMA CRISISACUT GLAUCOMA CRISIS
TREATMENT MUST BE TREATMENT MUST BE
URGENTLY!!URGENTLY!!
IOP MUST BE LOWER WITHIN 48 – IOP MUST BE LOWER WITHIN 48 –
72 HOURS72 HOURS
IF NO TREATMENT ; IF NO TREATMENT ;
BLINDNESS !!BLINDNESS !!
PROFLAXYPROFLAXYYAG LASER IRIDOTOMYYAG LASER IRIDOTOMY
SUBCONJONCTIVAL HEMORAGIESUBCONJONCTIVAL HEMORAGIE
•USUALLY IN ONLY ONE EYE, USUALLY IN ONLY ONE EYE,
IN ANY AGE GROUP IN ANY AGE GROUP
•OCCUR SPONTANEOUSLYOCCUR SPONTANEOUSLY
•SUDDEN ONSETSUDDEN ONSET
•CAUSE: CAUSE:
•THE RUPTURE OF A SMALL THE RUPTURE OF A SMALL
CONJONCTIVAL VESSELS CONJONCTIVAL VESSELS
( SOMETIMES PRECEEDED BY ( SOMETIMES PRECEEDED BY
ABOUT OF SEVERE CAUGHING ABOUT OF SEVERE CAUGHING
OR SNEEZING)OR SNEEZING)
•NO TREATMENT,NO TREATMENT, SPONTANEOUSLY SPONTANEOUSLY
RESOLUTION WITHIN 2 -3 WEEKS RESOLUTION WITHIN 2 -3 WEEKS