1. Case 7

2. 45 year old
Male
Chief Complaint: Swelling of the Left Eye

3. Upper Respiratory Tract Infection Tearing of the Left Eye Eye Redness
One week
Upper Respiratory Tract Infection
Tearing of the Left Eye
Eye Redness
Lid swelling
No medication
Three days
Diplopia
Increase swelling of the Left Eye
High Grade Fever
One day
Persistence of symptoms
Blurring of Vision
Hence CONSULT

4. P.E. Visual acuity- 20/20 right eye, 20/200 left eye
Swelling of the left eye
Positive relative afferent pupillary defect left eye.
Intraocular pressure 19mm Hg both eyes
Cornea was clear, No lens opacity
Fundoscopy: +ROR, clear media, distinct disc margin, no hemorrhage, no exudates, AV 2:3, C/D 0.3, both eyes

6. Swelling of the Left Eye
Pertinent Data
45 y/o Male
20/20 right eye, 20/200 left eye
Swelling of the Left Eye
(+) RAPD left eye
Tearing of the Left Eye
IOP- 19 mmHg both eyes
Eye Redness
Lid swelling
No medication

7. DIFFERENTIAL DIAGNOSIS

8. “Red Eye” Viral conjunctivitis Allergic conjunctivitis
Bacterial conjunctivitis
Drug toxicity
Episcleritis, Scleritis
Iritis, Uveitis, Keratitis

10. Discharge ETIOLOGY SEROUS MUCOID MUCOPURULENT PURULENT Viral + -
Chlamydial
Bacterial
Allergic
Toxic

11. Upper Respiratory Tract Infection
Viral conjunctivitis
Chlamydia conjunctivitis
Gonococcal conjunctivitis

12. VIRAL CONJUNCTIVITIS

13. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Epidemic Keratoconjunctivitis
Herpes Simplex Virus Conjunctivitis
Newcastle Disease Conjunctivitis
Acute Hemorrhagic Conjunctivitis

14. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Caused by adenovirus type 3 (also 4 and 7)
Fever: C
Sore throat
Follicular conjunctivitis in one or both eyes
Bilateral or unilateral
Injection and tearing
Preauricular lymphadenopathy (nontender)
Epidemic Keratoconjunctivitis
Herpes Simplex Virus Conjunctivitis
Newcastle Disease Conjunctivitis
Acute Hemorrhagic Conjunctivitis

15. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Epidemic Keratoconjunctivitis
Caused by adenovirus types 8, 19, 29, 37
Usually bilateral
Injection, moderate pain, and tearing
Photophobia, epithelial keratitis, and round subepithelial opacities (5-14 days)
Acute phase: edema of te eyelids, chemosis, and conjunctival hyperemia
Pseudomembranes occur
Lasts 3-4 weeks at most
Herpes Simplex Virus Conjunctivitis
Newcastle Disease Conjunctivitis
Acute Hemorrhagic Conjunctivitis

16. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Epidemic Keratoconjunctivitis
Herpes Simplex Virus Conjunctivitis
caused by type 1 (most common) and type 2 (newborn)
Disease of young children
Unilateral injection
Irritation
Mucoid discharge
Pain
Mild photophobia
Newcastle Disease Conjunctivitis
Acute Hemorrhagic Conjunctivitis

17. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Epidemic Keratoconjunctivitis
Herpes Simplex Virus Conjunctivitis
Newcastle Disease Conjunctivitis
Burning, itching, pain, redness, tearing, blurring of vision
Occurs in small epidemics among poultry workers
Acute Hemorrhagic Conjunctivitis

18. VIRAL CONJUNCTIVITIS Pharyngoconjunctival Fever
Epidemic Keratoconjunctivitis
Herpes Simplex Virus Conjunctivitis
Newcastle Disease Conjunctivitis
Acute Hemorrhagic Conjunctivitis
Caused b enterovirus type 70 and coxsackievirus A24
Short incubation period and course
Pain, photophobia, foreign body sensation, copious tearing, redness, lid edema, subconjunctival hemorrhage
Preauricular lymphadenopathy