Ophthalmology Book

Anterior Chamber Disorder

Eyelid Disorders

Miscellaneous

Painful Conditions

Vision Disorders

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Acute Red Eye

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  1. Differential Diagnosis
    1. Conjunctivitis (Infectious and Noninfectious)
    2. Narrow Angle Glaucoma
    3. Iritis or Uveitis
    4. Keratitis
    5. Episcleritis or Scleritis
    6. Eyelid abnormalities
      1. Entropion
      2. Lagophthalmos with globe exposure
      3. Trichiasis
      4. Molluscum Contagiosum
    7. Orbital disorders
      1. Preseptal and Orbital Cellulitis
      2. Idiopathic orbital inflammation
        1. Pseudotumor Cerebri
  2. Evaluation
    1. Evaluate Visual Acuity
      1. Normal Vision
        1. Conjunctivitis
        2. Corneal Abrasion
      2. Decreased Vision
        1. Narrow Angle Glaucoma
        2. Uveitis
      3. Acute Loss of Vision
        1. Optic Nerve disease
        2. Retinal Detachment
        3. Vitreous Hemorrhage
        4. Giant Cell Arteritis
        5. Central Retinal Artery Occlusion
    2. Determine Eye Anatomy involved
      1. Subconjunctival Hemorrhage
      2. Conjunctival Hyperemia
      3. Ciliary Flush
    3. Conjunctival Eye Discharge
      1. Present or Absent?
      2. Profuse or scant?
      3. Characteristics
        1. Serous (watery, clear or yellow tinged)
        2. Purulent (creamy white or yellowish)
        3. Mucoid (Scant, white, stringy exudate)
    4. Corneal Opacities or irregularities in surface
      1. Keratic precipitates
      2. Corneal edema
      3. Leukoma
      4. Irregular reflection
      5. Corneal Epithelium disruption (Fluorescein staining)
    5. Eye Pain
      1. Uveitis
      2. Acute Glaucoma
      3. Scleritis
      4. Corneal lesions (Keratitis, Corneal Ulcer)
    6. Anterior chamber abnormalities
      1. Narrow or shallow Anterior Chamber Depth
      2. Blood (Hyphema)
      3. Pus (Hypopyon)
    7. Other Findings
      1. Pupil Irregularity in size and reactivity
      2. Intraocular Pressure with Schiotz tonometer
        1. Omit for obvious infection
      3. Detect Proptosis
      4. Limited Extraocular Movements
  3. Indications for Ophthalmology Consultation
    1. Urgent Evaluation
      1. Red Flag Eye symptoms
        1. Eye Pain
        2. Blurred Vision with Photophobia
      2. Etiologies of worrisome eye symptoms
        1. Iritis
        2. Uveitis
        3. Glaucoma
        4. Keratitis
    2. Acute Evaluation
      1. Isolated Red Eye symptoms with other features
        1. No Eye Pain
        2. Blurred vision
        3. Eye Discharge
        4. Eye itching
      2. Etiologies of eye symptoms needing evaluation
        1. Episcleritis
        2. Dry eye
        3. Blepharitis
        4. Toxic exposure

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