Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye...
Transcript of Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye...
![Page 1: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/1.jpg)
Family Medicine Eye Workshop
• Red Eyes• Ocular Emergencies• Ophthalmoscopy
![Page 2: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/2.jpg)
2
Refer to Ophthalmologist
Traumatic injury to eyeLoss of visionExtreme eye pain not explained by pathologyKeratitisSuspected uveitis or glaucomaChemical injury (esp. alkali)Corneal abrasion not healing
![Page 3: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/3.jpg)
Anatomy of eyelid
![Page 4: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/4.jpg)
Staphylococcal Blepharitis
![Page 5: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/5.jpg)
5
Staphyloccal Blepharitis
Warm, moist packsBaby shampoo scrubsErythromycin ointment HS
![Page 6: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/6.jpg)
Discharge with Staphyloccocal Blepharitis
![Page 7: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/7.jpg)
Seborrheic Blepharitis
![Page 8: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/8.jpg)
8
Seborrheic Blepharitis
Warm, moist packsBaby shampoo scrubs
![Page 9: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/9.jpg)
Hordeolum (external)
![Page 10: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/10.jpg)
External hordeolum
![Page 11: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/11.jpg)
11
Hordeolum
Warm, moist compressesTreat blepharitis if present
![Page 12: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/12.jpg)
Chalazion
![Page 13: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/13.jpg)
Chalazion
![Page 14: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/14.jpg)
Chalazion
1
![Page 15: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/15.jpg)
Orbital Cellulitis
![Page 16: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/16.jpg)
Orbital Cellulitis
![Page 17: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/17.jpg)
Orbital Cellulitis
• Hospitalize• CT Orbits• CT Sinus• Blood Cultures• ENT Consult• Ophthalmology Consult
![Page 18: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/18.jpg)
Viral Keratitis
![Page 19: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/19.jpg)
19
Dendritic keratitis
Fluorescein stain
![Page 20: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/20.jpg)
Subconjunctival Hemorrhage
![Page 21: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/21.jpg)
Conjunctiva Anatomy
![Page 22: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/22.jpg)
Viral conjunctivitis
![Page 23: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/23.jpg)
23
Viral Conjunctivitis
Usually starts in one eye and frequently spreads to other eyeProfuse watery dischargeOften seen in epidemics
![Page 24: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/24.jpg)
Bacterial Conjunctivitis
![Page 25: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/25.jpg)
25
Bacterial Conjunctivitis
Often in one eyePurulent discharge
![Page 26: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/26.jpg)
Allergic Conjunctivitis
![Page 27: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/27.jpg)
27
Allergic Conjunctivitis
Usually in both eyesItchy eyesMucoid dischargeOften accompanies allergic rhinitis
![Page 28: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/28.jpg)
Upper eyelid eversion
![Page 29: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/29.jpg)
Foreign Body – Upper Eyelid
![Page 30: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/30.jpg)
Corneal Abrasion
• Symtoms: Tearing, Pain, Photophobia• Causes: Trauma, Welding Burn, Contact
Lens Overwear
![Page 31: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/31.jpg)
Fluorescein stain
![Page 32: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/32.jpg)
Corneal abrasion
![Page 33: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/33.jpg)
Corneal Abrasion Treatment
• Antibiotic drops• Consider NSAID topical (Ketoralac)• No evidence that patching is beneficial
(patching may cause harm, in fact)• Re-examine patient the following day• Refer if corneal abrasion is not healing
![Page 34: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/34.jpg)
Normal retina
![Page 35: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/35.jpg)
Ophthalmoscope exam
![Page 36: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/36.jpg)
36
Conventional vs. Panoptic
14 magnifications50 field of view
18 magnifications250 field of view
![Page 37: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/37.jpg)
37
Ophthalmoscope Apertures
Small: Undilated pupilLarge: Dilated pupilSlit: Look for retinal elev./depressionCobalt Blue light: Fluorescein examGreen light: Retinal hemorrhageRed-Free filter: excl. red raysHalf-Moon: Combination of depth perception and field of view
![Page 38: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/38.jpg)
Red reflex
![Page 39: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/39.jpg)
Cataract
![Page 40: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/40.jpg)
Papilledema
![Page 41: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/41.jpg)
HTN Retinopathy
![Page 42: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/42.jpg)
Diabetic Retinopathy
![Page 43: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/43.jpg)
Macular Degeneration
![Page 44: Red Eyes • Ocular Emergencies • Ophthalmoscopywichita.kumc.edu/Documents/wichita/familymed/eye workshop.pdf · • Ophthalmoscopy. 2 Refer to Ophthalmologist Traumatic injury](https://reader036.fdocuments.us/reader036/viewer/2022071113/5fe91b88f2ca2e1b833be3be/html5/thumbnails/44.jpg)
Retinal Detachment