C I - N S W · Examination Eyelids Visual acuity – Very important Extra ocular movements Pupils...
Transcript of C I - N S W · Examination Eyelids Visual acuity – Very important Extra ocular movements Pupils...
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ECIN
SW
Acute Eye Problems
C NI - S W
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Overview for red eye History Examination Cases Specific problems by anatomy When to refer
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History When did it start? Precipitating event? Visual changes? Painful, painless or photophobic? Discharge? Previous episodes? Contact lenses? Other eye and medical history.
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Examination Eyelids Visual acuity – Very important Extra ocular movements Pupils – Accommodation, Light and RAPD Conjunctiva Slit Lamp + Fundoscopy
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JMO Teaching 2012
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Emergency Care lnstitut NfW SOUrH WALE.~
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Case - IB 22 year old Feeling unwell for few weeks. Several courses antibiotics from GP for sinus
problems. Now severe pain to eye and difficulty seeing Some discharge
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NF\V !;rJUrH ~At F.<i
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Case - FC 32 year old builder Spilled some cement powder into eye 1/7 ago. Pain and burning to eye Went to pub and ‘drank through it’
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Examination Tears streaming down face Looks miserable and unhappy VA, Fields, Movements – unable to give due to
pain on opening eye What next?
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Emergency Care lnstitut
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Case – PW 64 year old retired accountant Presents at 1800 Severe pain to eye and vomiting Hazy vision and headache
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Emergency Care lnstitut NFW Sr>!JTH Y..Al F.~
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Eyelids
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NFW Sr>!JTH Y..Al F.~
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Conjunctiva and Sclera
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Emergency Care lnstitut NF\V !;rJUrH ~At F.<i
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut
_N_E_IV-S0-11-rH-WA_L_E.<......I
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Cornea
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NF\V !;rJUrH ~At F.<i
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Trauma
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Emergency Care lnstitut NfW SOUrH WALE.~
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Emergency Care lnstitut NfW SOUrH WALE.~
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Case – Miss BG 28 year old shop assistant Tripped and hit face on door C/O pain to face Thoughts?
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JMO Teaching 2012
Emergency Care lnstitut NfW SOUrH WALE.~
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Examination Tender around eye and cheek Pain on eye movements Double vision on some movements Lip feels different Thoughts?
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Emergency Care lnstitut NfW SOUrH WALE.~
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Penetrating injuries Burns Decreased VA,
sudden or contact lens wearer
Cloudy cornea RAPD Cellulitis Acute glaucoma
Dendritic ulcers (Start Rx in ED)
Scleritis Episcleritis Iritis Keratitis (not cloudy) Foreign bodies Rust rings
OP follow up
Referral Immediate
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Routine Referrals BCC Chalazions Dry eye
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?
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Summary Which bit of the eye is red? Is vision affected? Does treatment need starting in ED? What follow up?
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Thanks to: Dr Dane Chalkley EDSS POW Hospital, NSW