RED EYE Rengin YILDIRIM, Prof. Dr. Cerrahpasa Medical Faculty

RED EYERED EYE

Rengin YILDIRIM, Prof. Dr.Rengin YILDIRIM, Prof. Dr.

Cerrahpasa Medical FacultyCerrahpasa Medical Faculty

RED EYERED EYETHE REASONS ?THE REASONS ?

SYMPTOMPS ?SYMPTOMPS ?

PATOGENESIS ?PATOGENESIS ?

SIGNS?SIGNS?

VASCULAR SYSTEM OF VASCULAR SYSTEM OF ANTERIOR SEANTERIOR SEGGMENTMENT

SUPERFICIAL

DEEP (CILIARY)

TYPES OF HYPEREMIATYPES OF HYPEREMIA

SUPERFICIAL DEEP MIXT

LOCALIZATION PERIFERY CENTRAL COMMON

REASON CONJ VESSELS CILIARY ARTERY BOTH

ETIOLOGY SUPERFICIAL INFECTIONS

SEVERE EYE DISEASES UVEITIS, GLAUCOMA

ALL OF THEM

PHENILEPHRINE TEST

PALE NOT PALE NOT PALE

PRESSURE PALE NOT PALE NOT PALE

MOVEMENT YES NO NO

COLOR LIGHT RED PURPLE PURPLE

COMMON CAUSES OF RED EYECOMMON CAUSES OF RED EYE

1- 1- INFECTIONSINFECTIONS

2-2- TRAUMA OF TRAUMA OF

ANTERIOR SEANTERIOR SEGGMENTMENT

3- A3- ACCUT GLUT GLAUCAUCOMOMAA CCRRYSISYSIS

4- 4- SYSTEMIC DISEASESSYSTEMIC DISEASES

PAINPAIN (+) (+)

11-- SUBCONJUNCTIVAL SUBCONJUNCTIVAL

HEMORRAHEMORRAGGIE IE

2-2-CHRONIC BLEPHARITISCHRONIC BLEPHARITIS

3-3- DRY EYE DRY EYE

PAINPAIN (-) (-)

INFECTIONS OF EYEINFECTIONS OF EYE

KERATITISKERATITIS

BLEPHARITISBLEPHARITIS

SCLERITISSCLERITIS

CONJONCTIVITISCONJONCTIVITIS

DACRIOCYSTITISDACRIOCYSTITISUVEITISUVEITIS

DIFFERANTION OF THE COMMON DIFFERANTION OF THE COMMON TYPES OF CONJONCTIVITISTYPES OF CONJONCTIVITIS

CLINICAL CLINICAL FINDINGSFINDINGS

VIRALVIRAL BACTERIALBACTERIAL CHLAMIDIALCHLAMIDIAL ALLERGICALLERGIC

ITCHINGITCHING MINIMALMINIMAL MINIMALMINIMAL MINIMALMINIMAL SEVERESEVERE

HYPEREMIAHYPEREMIA GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL

GENERALIZEDGENERALIZED-SUPERFICIAL-SUPERFICIAL



TEARINGTEARING PROFUSEPROFUSE MODERATEMODERATE MODERATEMODERATE MODERATEMODERATE

EXUDATIONEXUDATION MINIMALMINIMAL PROFUSEPROFUSE PROFUSEPROFUSE MINIMALMINIMAL

LAPLAP COMMONCOMMON UNCOMMONUNCOMMON COMMONCOMMON NONENONE

ACUT CONJONCTIVITIS ACUT CONJONCTIVITIS SYMPTOMSSYMPTOMS

FOREINFOREINGG BODY SENSATION BODY SENSATIONA SCRATCHINA SCRATCHINGG OR OR

BURNINBURNINGG SENSATION SENSATION

PHOTOPHOBIA AND PAIN PHOTOPHOBIA AND PAIN (IF CORNEA IS ALSO AFFECTED(IF CORNEA IS ALSO AFFECTED

ITCHINITCHINGG

ACUT CONJONCTIVITIS ACUT CONJONCTIVITIS SISIGGNSNS

HHYPEREMIA CHHEMOSIS

TEARINGG

EXUDATION

PSEUDOPTOSIS

PSEUDOMEMBRANES AND MEMBRANS

FOLLICLES

GGRANULOMAS

PAPILLARY HHYPERTROPY

PREAURICULAR LAP

VERNALISVERNALIS(ALLERGIC CONJONCTIVITIS)(ALLERGIC CONJONCTIVITIS)

LIMBAL FORM OF VERNALIS

PALBEPRAL FORM OF VERNALIS

KERATITISKERATITIS

•ETIOLOGYETIOLOGYINFECTIONSINFECTIONS

• BACTERIAL• FUNGAL• VIRAL

•HYPERSENSITIVITYHYPERSENSITIVITY•NUTRICIONAL DISEASENUTRICIONAL DISEASE

KERATOMALACIAKERATOMALACIA•NEUROTROPHIC KERATITISNEUROTROPHIC KERATITIS

EXPOSURE KERATITISEXPOSURE KERATITIS•TRAUMATRAUMA

RADIATIONALRADIATIONALMECHANICALMECHANICALCHEMICALCHEMICAL

HYPOPION

VIRAL KERATITISVIRAL KERATITIS

DENDRITIC FORM GEOGRAPHIC FORM

PRIMARY INFECTION

DIFFUSE EPISCLERITIS NODULAR EPISCLERITIS

DIFFUSE SCLERITIS NODULAR SCLERITIS

NECROTIC SCLERITIS SCLEROMALACIA PERFORANCE

EPISCLERITIS - SCLERITISEPISCLERITIS - SCLERITIS

SUPERFICIAL HYPEREMIA

DEEP HYPEREMIA

DEEP HYPEREMIA

ACUT UVEITISACUT UVEITIS

•SEVERE PAIN,PHOTOPHOBIASEVERE PAIN,PHOTOPHOBIA

•MIXT (DEEP) HYPEREMIAMIXT (DEEP) HYPEREMIA

•SELF-LIMITED COURSE,OFTEN SELF-LIMITED COURSE,OFTEN

RECURRENCERECURRENCE

•PINPOINT KERATIC PRECIPITATSPINPOINT KERATIC PRECIPITATS

•IN AQUEOUS, MANY CELLS, SOMETIMES IN AQUEOUS, MANY CELLS, SOMETIMES

PROTEIN ACCUMULATIONSPROTEIN ACCUMULATIONS

•SINECHIA POSTERIOR, PUPILLARY SINECHIA POSTERIOR, PUPILLARY

DISTURBANCES, SECONDARY GLAUCOMADISTURBANCES, SECONDARY GLAUCOMA

•CAUSES: EXOGENEOUS &ENDOGENEOUSCAUSES: EXOGENEOUS &ENDOGENEOUS

BEHCET’S DISEASE

CLINIC FORMS OF UVEITISCLINIC FORMS OF UVEITIS

SINECHIA POSTERIORSINECHIA POSTERIOR

KERATIC PRECIPITATSKERATIC PRECIPITATS

DEEP (CILIARY) HYPEREMIA

SINECHIA POSTERIORSINECHIA POSTERIOR

FOREIGN BODIES OF FOREIGN BODIES OF CONJONCTIVAE OR CORNEACONJONCTIVAE OR CORNEA

SYMPTOMSSYMPTOMSFOREIGN BODY SENSATION, FOREIGN BODY SENSATION, TEARING, MINIMAL PAIN, TEARING, MINIMAL PAIN, BLURRED VISION, PHOTOPHOBIABLURRED VISION, PHOTOPHOBIA

( IF THERE IS A CORNEAL FOREIGN ( IF THERE IS A CORNEAL FOREIGN BODY, SYMPTOMS MORE SEVERE!)BODY, SYMPTOMS MORE SEVERE!)

SIGNSSIGNSFOREIGN BODY,SUPERFICIAL FOREIGN BODY,SUPERFICIAL (CONJONTIVAL)HYPEREMIA(CONJONTIVAL)HYPEREMIA

TREATMENTTREATMENTREMOVAL OF FOREIGN BODY AND REMOVAL OF FOREIGN BODY AND OCCLUSION OF EYE FOR 1 DAY OCCLUSION OF EYE FOR 1 DAY

ACUT GLAUCOMA CRISISACUT GLAUCOMA CRISIS

PRECIPITATING PRECIPITATING FACTORSFACTORS•PHYSIOLOGIC PUPILLARY PHYSIOLOGIC PUPILLARY BLOCKBLOCK

•INCREASED SIZE OF THE INCREASED SIZE OF THE LENSLENS

•(RELATIVE PUPILLARY (RELATIVE PUPILLARY BLOCK)BLOCK)

•PLATEAU IRISPLATEAU IRIS

FIXED PUPILLA

GLAUCOMA FLECKEN

ACUT GLAUCOMA CRISIS ACUT GLAUCOMA CRISIS PATHOGENESISPATHOGENESIS

ANTERIOR CHAMBER ANGLE OF EYE

GRADING SYSTEM OF ANGLE

CLOSED ANGLE


SYMPTOMS AND SIGNSSYMPTOMS AND SIGNS• SUDDEN ONSET OF BLURRED VISIONSUDDEN ONSET OF BLURRED VISION

• FOLLOWED BY SEVERE HEADACHE AND PAIN IN THE EYEFOLLOWED BY SEVERE HEADACHE AND PAIN IN THE EYE

• RAINBOW COLORED HALOS AROUND LIGHTSRAINBOW COLORED HALOS AROUND LIGHTS

• NAUSEA,VOMITINGNAUSEA,VOMITING

• MARKEDLY INCREASED IOPMARKEDLY INCREASED IOP

• A SHALLOW ANTERIOR CHAMBERA SHALLOW ANTERIOR CHAMBER

• AN OEDEMATOUS CORNEAAN OEDEMATOUS CORNEA

• A FIXED,MODERATELY DILATED PUPILLAA FIXED,MODERATELY DILATED PUPILLA

• CILIARY (DEEP) HYPEREMIACILIARY (DEEP) HYPEREMIA


TREATMENT MUST BE TREATMENT MUST BE

URGENTLY!!URGENTLY!!

IOP MUST BE LOWER WITHIN 48 – IOP MUST BE LOWER WITHIN 48 –

72 HOURS72 HOURS

IF NO TREATMENT ; IF NO TREATMENT ;

BLINDNESS !!BLINDNESS !!

PROFLAXYPROFLAXYYAG LASER IRIDOTOMYYAG LASER IRIDOTOMY

SUBCONJONCTIVAL HEMORAGIESUBCONJONCTIVAL HEMORAGIE

•USUALLY IN ONLY ONE EYE, USUALLY IN ONLY ONE EYE,

IN ANY AGE GROUP IN ANY AGE GROUP

•OCCUR SPONTANEOUSLYOCCUR SPONTANEOUSLY

•SUDDEN ONSETSUDDEN ONSET

•CAUSE: CAUSE:

•THE RUPTURE OF A SMALL THE RUPTURE OF A SMALL

CONJONCTIVAL VESSELS CONJONCTIVAL VESSELS

( SOMETIMES PRECEEDED BY ( SOMETIMES PRECEEDED BY

ABOUT OF SEVERE CAUGHING ABOUT OF SEVERE CAUGHING

OR SNEEZING)OR SNEEZING)

•NO TREATMENT,NO TREATMENT, SPONTANEOUSLY SPONTANEOUSLY

RESOLUTION WITHIN 2 -3 WEEKS RESOLUTION WITHIN 2 -3 WEEKS

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RED EYE Rengin YILDIRIM, Prof. Dr. Cerrahpasa Medical Faculty