Unilateral red eye: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Unilateral red/painful eye | *Unilateral red/painful eye | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
===Traumatic=== | ==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== | |||
*[[Ruptured Globe]]^ | |||
*[[Corneal Abrasion and Foreign Body]] | |||
*[[Conjunctival laceration]] | |||
*[[Corneal Ulcer]]^ | |||
*[[Caustic Keratoconjunctivitis]]^^ | |||
*[[Subconjunctival Hematoma]] | |||
*[[Traumatic Iritis]] | |||
*Hypema^ | |||
*[[Endophthalmitis]]^ | |||
*[[Corneal Abrasion]] | |||
*[[Corneal Ulcer]]^ | |||
*[[Herpes Zoster Ophthalmicus]] (dendrite) | |||
*Corneal erosion | |||
*[[UV keratitis]] | |||
*[[Acute Angle Glaucoma]]^ | |||
*[[Nontraumatic iritis]] | |||
*[[Scleritis]]^ | |||
* Anterior [[Uveitis]] | |||
*[[Ocular foreign body]] | |||
*[[Conjunctivitis]] | |||
*[[Keratoconjunctivits]] | |||
*[[Episcleritis]] | |||
* [[Subconjunctival Hematoma]] | |||
* Inflamed pingueculum | |||
* Inflamed [[Pterygium]] | |||
* Keratoconus | |||
==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]]^ | * Obvious [[Ruptured Globe]]^ | ||
* No obvious ruptured globe | * No obvious ruptured globe | ||
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**** (old occult open globe) | **** (old occult open globe) | ||
===Nontraumatic=== | ====Nontraumatic==== | ||
* Epithelial defect | * Epithelial defect | ||
** [[Corneal Abrasion]] | ** [[Corneal Abrasion]] | ||
| Line 30: | Line 72: | ||
** Corneal erosion | ** Corneal erosion | ||
***(morning pain) | ***(morning pain) | ||
** UV | ** [[UV keratitis]] | ||
*** (SPK) | *** (SPK) | ||
** Scleral penetration^ | ** Scleral penetration^ | ||
| Line 47: | Line 89: | ||
*** Foreign body | *** Foreign body | ||
*** [[Conjunctivitis]] | *** [[Conjunctivitis]] | ||
*** Keratoconjunctivits | *** [[Keratoconjunctivits]] | ||
*** [[Episcleritis]] | *** [[Episcleritis]] | ||
****(localized; move w/ Q-tip) | ****(localized; move w/ Q-tip) | ||
| Line 59: | Line 101: | ||
^^Critical diagnosises | ^^Critical diagnosises | ||
==Managment== | ==Managment== | ||
Revision as of 13:14, 24 May 2015
Background
Clinical Features
- Unilateral red/painful eye
Differential Diagnosis
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
- Ruptured Globe^
- Corneal Abrasion and Foreign Body
- Conjunctival laceration
- Corneal Ulcer^
- Caustic Keratoconjunctivitis^^
- Subconjunctival Hematoma
- Traumatic Iritis
- Hypema^
- Endophthalmitis^
- Corneal Abrasion
- Corneal Ulcer^
- Herpes Zoster Ophthalmicus (dendrite)
- Corneal erosion
- UV keratitis
- Acute Angle Glaucoma^
- Nontraumatic iritis
- Scleritis^
- Anterior Uveitis
- Ocular foreign body
- Conjunctivitis
- Keratoconjunctivits
- Episcleritis
- Subconjunctival Hematoma
- Inflamed pingueculum
- Inflamed Pterygium
- Keratoconus
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
Source
- Rosen
- WMS Practic Guidelines 2000)