7. Red eye related to the Conjunctiva
• Subconjunctival Haemorrhage
• Conjunctivitis
– Bacterial
– Viral
– Allergic
• Conjuntivitis in infants
• Other conjunctival lesions
8. Subconjunctival Haemorrhage
•No pain or mild discomfort
• No disturbance of vision
• May be history of trauma –
exclude foreign body
• Well demarcated area
• No discharge
• Check for areas of other
bruising, history of anticoagulants
• (?Check BP, ? Anticoagulant status, ? FBC)
13. Conjunctivitis-infant
• Immature local immunity
• May result in serious
corneal disease/blindness
• May result in serious
systemic disease
• Ophthalmia neonatorum (<
1 month old) notifiable
disease
• May be contracted from
STD in mother at birth
• Causes bacterial,
Chlamydia, gonorrhea,
herpes
• Conjunctival scrapes and cultures ,
specialist care
15. Red eye related to the- Episclera
– pingueculum
– pterygium
– Episcleritis
16. Pinguecula
• A yellow-white deposit
on the bulbar conjunctiva
adjacent to the nasal or
temporal aspect of the
Limbus
• These may become inflamed
and cause an acute red eye
• Histological examination
shows degeneration of the
collagen fibres of the conjunctiva/episclera
• Rx Lubricants/ steroid
17. Pterygium
• Triangular sheet of
fibrovascular tissue
• Invades the cornea.
• Patients who have been
living in hot climates and
may represent a response
to chronic dryness and
exposure to the sun.
• These may become
inflamed and cause an
acute red eye.
18. Episcleritis
• Episcleral layer
• Blanch with
Phenylephrine 2.5%
• May have underlying
aetiology- e.g. rheumatoid factor (RhF)
• Lubricants, topical
steroid, oral NSAID (non steroidal antiinflammatory drugs)
19. Red eye related to the- Sclera
• Scleritis is frequently
bilateral and,
characteristically, associated
with severe pain.
• Purplish hue with
involvement of the deep
episcleral vessels
• Systemic diseases are
present in 50% of patients.
• Rx – NSAIDs or Steroids
20. Red eye related to the- Cornea
• Marginal Keratitis
• Bacterial Keratitis
• Viral Keratitis
• Amoebic Keratitis
• Abrasions / dry eye
30. Acute angle closure Glaucoma
• Hypermetropia
• Previous history
• Episodes of blurring pain or haloes
for an hour or two in some early
evenings for a few weeks
• Pain severe, radiating to forehead, with
vomiting
• Slight photophobia
• Watery secretion or discharge
• Visual acuity –reduced usually onset 2• 3 hours
• Systemic symptoms- Often prostration
• and vomiting because of pain
• Unilateral usually
• Age Usually 50 +
32. Orbit
• Thyroid eye disease
– proptosis
– pain/photophobia
– reduced VA
– lid retraction
– lid lag
– restriction of ocular
movement
– injection over muscle
insertions
– exposure keratopathy
33. Summary-assessment
• Onset
• Duration
• Pattern of redness
• Presence of discomfort/pain/photophobia
• Presence of discharge - watery/mucus/pus
• Systematic examination of the eye
