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Optic Neuritis
Clinical Treatment / Management: Differential Diagnosis The differential diagnosis of optic neuritis includes the following conditions:
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Eye Trauma
Retrobulbar hemorrhage/ orbital compartment syndrome Pathology DDx Examination findings Management lateral canthotomy/ cantholysis The main steps in emergency ≈/ cantholysis are: Orbitozygomatic fractures/ Orbital blowout fracture Chemical Burn to eye
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Scleritis & Episcleritis
Feature Scleritis Episcleritis Definition Inflammation of the sclera, the white outer coating of the eye Inflammation of the episclera, the thin layer of tissue covering the sclera Cause Often associated with systemic autoimmune diseases (e.g., rheumatoid arthritis, lupus) Usually idiopathic; can be associated with mild systemic conditions (e.g., dry eye…
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Uveitis/Iritis
inflammation of the uveal tract. History Investigations may not be required if: Complications Management
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Acute Closed-Angle Glaucoma
Pathology of Raised Intraocular Pressure Primary Causes: Precipitating Factors: Secondary Causes: Risk Factors: History: Examination: Management
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Painful Eye
History Physical Examination Anatomic Assessment External Structures Conjunctiva Sclera Cornea Pupil Anterior Chamber Anterior Uvea Common Conditions and Management Emergent Ophthalmologic Diseases
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Conjunctivitis
Allergic conjunctivitis Age Children or adults Aetiology Local response to an allergen, including:– seasonal (typically spring and autumn)– perennial– contact hypersensitivity reactions (eg preservatives in eye drops, contact lens solutions). Clinical features In seasonal and perennial conjunctivitis- symptoms are usually bilateral. The primary diagnostic symptom– itch with watery eyes – usually…
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Keratitis
Types Common symptoms: examination Adenoviral Keratoconjunctivitis . Herpes simplex keratitis: all of which can be vision threatening. Management Contact lens wearers OR OR (if available) dendritic ulcer OR Herpes zoster ophthalmicus OR OR Adenovirus keratoconjunctivitis UV keratitis (welders Keratitis)
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Corneal foreign body/Corneal abrasion
History: Examination: Slit lamp exam and tonometry: Differentials Management: Follow up Complications
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Trichoma
Incubation period Infectious period Clinical presentation and outcome Differentials Examination WHO simplified grading system for trachoma Grade Signs Infectious TF Trachomatous inflammation- Follicular Presence of 5 or more follicles of >0.5mm in diameter on the upper tarsal conjunctiva TI Trachomatous inflammation – Intense Presence of pronounced inflammatory thickening of the…
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Eye lesions
Benign melanocytic lesions urgent referral if enlarging or suspicious Vascular lesions Infantile hemangioma/ strawberry hemangioma – usually resolve by 10yo, can cause ptosis, refractive error, amblyopia – refer to ophthalPort wine stains – if involving the eyelid can be associated with glaucoma – urgent refer SCC, BCC, actinic keratosis, keratoacnathoma,…
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Hyphaema & Hypopyon
Hypopyon causes: Hyphaema causes Rx: bedrest at 30 degrees, Topical corticosteroids If inc intraocular pressure 🡪 topical aqueous suppressants (beta-blockers and alpha-agonists)