Unilateral red eye: Difference between revisions
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===Diagnostic Algorythm=== | ===Diagnostic Algorythm=== | ||
====Traumatic==== | ====Traumatic==== | ||
* Obvious [[Ruptured Globe]]^ | *Obvious [[Ruptured Globe]]^ | ||
* No obvious ruptured globe | *No obvious ruptured globe | ||
** Epithelial defect | **Epithelial defect | ||
*** [[Corneal Abrasion and Foreign Body]] | ***[[Corneal Abrasion and Foreign Body]] | ||
***[[Conjunctival laceration]] | ***[[Conjunctival laceration]] | ||
*** [[Corneal Ulcer]]^ | ***[[Corneal Ulcer]]^ | ||
*** [[Caustic Keratoconjunctivitis]]^^ | ***[[Caustic Keratoconjunctivitis]]^^ | ||
*** Occult [[Ruptured Globe]]^ | ***Occult [[Ruptured Globe]]^ | ||
****(positive Sidel's) | ****(positive Sidel's) | ||
** No defect | **No defect | ||
*** [[Subconjunctival Hematoma]] | ***[[Subconjunctival Hematoma]] | ||
*** [[Traumatic Iritis]] | ***[[Traumatic Iritis]] | ||
*** Hypema^ | ***Hypema^ | ||
****(?occult open globe) | ****(?occult open globe) | ||
*** [[Endophthalmitis]]^ | ***[[Endophthalmitis]]^ | ||
**** (old occult open globe) | ****(old occult open globe) | ||
====Nontraumatic==== | ====Nontraumatic==== | ||
* Epithelial defect | *Epithelial defect | ||
** [[Corneal Abrasion]] | **[[Corneal Abrasion]] | ||
** [[Corneal Ulcer]]^ | **[[Corneal Ulcer]]^ | ||
** [[Herpes Zoster Ophthalmicus]] (dendrite) | **[[Herpes Zoster Ophthalmicus]] (dendrite) | ||
** Corneal erosion | **Corneal erosion | ||
***(morning pain) | ***(morning pain) | ||
** [[UV keratitis]] | **[[UV keratitis]] | ||
*** (SPK) | ***(SPK) | ||
** Scleral penetration^ | **Scleral penetration^ | ||
* No defect | *No defect | ||
** No pain relief w/ tropicamide | **No pain relief w/ tropicamide | ||
*** [[Acute Angle Glaucoma]]^ | ***[[Acute Angle Glaucoma]]^ | ||
****dilated | ****dilated | ||
****closed angle | ****closed angle | ||
****inc pressure | ****inc pressure | ||
*** Nontraumatic Iritis | ***Nontraumatic Iritis | ||
*** [[Scleritis]]^ | ***[[Scleritis]]^ | ||
****(localized; no move Q-tip) | ****(localized; no move Q-tip) | ||
*** Anterior [[Uveitis]] | ***Anterior [[Uveitis]] | ||
****(hypopyon, cilliary flush) | ****(hypopyon, cilliary flush) | ||
** No pain OR pain relief w/ tropicamide | **No pain OR pain relief w/ tropicamide | ||
*** Foreign body | ***Foreign body | ||
*** [[Conjunctivitis]] | ***[[Conjunctivitis]] | ||
*** [[Keratoconjunctivits]] | ***[[Keratoconjunctivits]] | ||
*** [[Episcleritis]] | ***[[Episcleritis]] | ||
****(localized; move w/ Q-tip) | ****(localized; move w/ Q-tip) | ||
** Non-uptake finding (no pain/pain relief w/ tropicamd) | **Non-uptake finding (no pain/pain relief w/ tropicamd) | ||
*** [[Subconjunctival Hematoma]] | ***[[Subconjunctival Hematoma]] | ||
*** Inflamed pingueculum | ***Inflamed pingueculum | ||
*** Inflamed [[Pterygium]] | ***Inflamed [[Pterygium]] | ||
*** Keratoconus (protrude) | ***Keratoconus (protrude) | ||
^Emergent diagnosises | ^Emergent diagnosises | ||
Revision as of 19:04, 4 July 2016
Background
Clinical Features
- Unilateral red/painful eye
Differential Diagnosis
Unilateral red eye
- Nontraumatic
- Acute angle-closure glaucoma^
- Anterior uveitis
- Conjunctivitis
- Corneal erosion
- Corneal ulcer^
- Endophthalmitis^
- Episcleritis
- Herpes zoster ophthalmicus
- Inflamed pinguecula
- Inflamed pterygium
- Keratoconjunctivitis
- Keratoconus
- Nontraumatic iritis
- Scleritis^
- Subconjunctival hemorrhage
- Orbital trauma
- Caustic keratoconjunctivitis^^
- Corneal abrasion, Corneal laceration
- Conjunctival hemorrhage
- Conjunctival laceration
- Globe rupture^
- Hemorrhagic chemosis
- Lens dislocation
- Ocular foreign body
- Posterior vitreous detachment
- Retinal detachment
- Retrobulbar hemorrhage
- Traumatic hyphema
- Traumatic iritis
- Traumatic mydriasis
- Traumatic optic neuropathy
- Vitreous detachment
- Vitreous hemorrhage
- Ultraviolet keratitis
^Emergent diagnoses ^^Critical diagnoses
Diagnosis
- Evert lens and look for foreign body
- Remove contacts
- Photophobia suggests inflammation i.e. uveitis and abrasions
- Pupil: irregular with positive sidel's suggests penetrating injury
Diagnostic Algorythm
Traumatic
- Obvious Ruptured Globe^
- No obvious ruptured globe
- Epithelial defect
- Corneal Abrasion and Foreign Body
- Conjunctival laceration
- Corneal Ulcer^
- Caustic Keratoconjunctivitis^^
- Occult Ruptured Globe^
- (positive Sidel's)
- No defect
- Subconjunctival Hematoma
- Traumatic Iritis
- Hypema^
- (?occult open globe)
- Endophthalmitis^
- (old occult open globe)
- Epithelial defect
Nontraumatic
- Epithelial defect
- Corneal Abrasion
- Corneal Ulcer^
- Herpes Zoster Ophthalmicus (dendrite)
- Corneal erosion
- (morning pain)
- UV keratitis
- (SPK)
- Scleral penetration^
- No defect
- No pain relief w/ tropicamide
- Acute Angle Glaucoma^
- dilated
- closed angle
- inc pressure
- Nontraumatic Iritis
- Scleritis^
- (localized; no move Q-tip)
- Anterior Uveitis
- (hypopyon, cilliary flush)
- Acute Angle Glaucoma^
- No pain OR pain relief w/ tropicamide
- Foreign body
- Conjunctivitis
- Keratoconjunctivits
- Episcleritis
- (localized; move w/ Q-tip)
- Non-uptake finding (no pain/pain relief w/ tropicamd)
- Subconjunctival Hematoma
- Inflamed pingueculum
- Inflamed Pterygium
- Keratoconus (protrude)
- No pain relief w/ tropicamide
^Emergent diagnosises
^^Critical diagnosises
Managment
- By diagnosis
See Also
References
- Rosen
- WMS Practic Guidelines 2000)