1. RED EYE SYNDROM

2. AIM
To acquaint students with the primary goals of preventive maintenance of the given diseases and their complications.
To stop also on modern laboratory methods of diagnostics. It is necessary to focus attention of students that now there are eyeball ultrasonics, «А/В scan» of vitreous body and retina. In connection with the above-stated it is necessary to specify that the doctor of any speciality should be able to render first aid to a patient suffering syndrome of a red eye, and also under indications to isolate patients or to direct patients to the oculist, to avoid possible heavy complications

3. GOALS The student should know:
peculiarities of the structures of eyelids and classification of their diseases;
Clinic and treatment of diseases of eyelids;
Features of a structure of lacrimal apparatus;
The student should be able:
Practical skill – external examination of an eyeball, simple eversion of an eyelid, lateral illumination

4. RED EYE
Red eye is a common symptom of various pathologies encountered doctor. 
Inflammation of the eyes may indicate a lung disease or severe sight-threatening problem that requires rapid diagnosis and treatment.

5. RED EYE DIAGNOSIS
When the diagnosis algorithm is used which consists of questions that should be asked:
Redness -?
Drainage -?
Pain -?
Pupil -?
Pressure -?

6. RED EYE DIAGNOSIS Redness Eyes red (pink)?
(Redness called injection due to the blood vessels of the eye)
Injection in the region of the ciliary body called the ciliary injection Generalized conjunctival injection called diffuse injection
Sectorial
Diffuse
Red eye
Ciliary

7. RED EYE DIAGNOSIS Redness
Ciliary injection means inflammation within the anterior part of the eye (cornea, iris and ciliary body).

8. RED EYE DIAGNOSIS
Diffuse injection is characterized by inflammation of the conjunctiva surface.
As an exception involving the injection of sectoral and superficial and deep vessels, accompanied episcleritis.
In dry eye injections can not be observed.

9. RED EYE DIAGNOSIS
Normal eye

10. RED EYE DIAGNOSIS
Diffuse conjunctival injection (generally refers to inflammation of the conjunctiva surface - conjunctivitis)

11. RED EYE DIAGNOSIS
Ciliary injection (has a higher intensity closer to the cornea, in the limbal area directly above the ciliary body)

12. RED EYE DIAGNOSIS Discharge: No Yes : mucous purulent watery Discharge
(bacteries)
mucous
(virus)
watery
(allergy)

13. RED EYE DIAGNOSIS
Diffuse injection with mucous discharge and the involvement of the lower eyelid conjunctival follicles indicates a viral or adenoviral conjunctivitis.
Injection with diffuse purulent indicating bacterial conjunctivitis, especially if the patient indicates the need eye rinsing water after sleeping, in order to open them.

14. RED EYE DIAGNOSIS
Ciliary injection, accompanied by lacrimation, pain in the eye, indicating inflammation of the iris and ciliary body
Diffuse injection with watery discharge and itching indicates allergic conjunctivitis.

15. RED EYE DIAGNOSIS
Do purulent discharge in the eye? Think how you would describe it. With red eyes on the type of the ciliary injection of fluid is usually not. Diagnostic algorithm to determine the discharge from the eyes is presented in the previous slides. Remember that the purulent discharge is usually a sign of a bacterial infection.

16. RED EYE DIAGNOSIS Pain Is there pain? If there is, as it is described?
Severe
Dull
nagging
Burning
scratching
itch

17. RED EYE DIAGNOSIS Pupil
How does the pupil? Diffuse injection of normal eyes and pupils usually accompany conjunctivitis
Зрачок
Норма
Патология
Большой, с
неровными краями
(глаукома)
конъюнктивит
Маленький
(ирит)

18. RED EYE DIAGNOSIS Pressure
What is intraocular pressure? Low or normal pressure and a small pupil is usually encountered in iritah or uveitis High blood pressure is defined by closed angle glaucoma
Норма
Давление
Высокое
(глаукома)
Низкое
(ирит, увеит)

19. RED EYE DIAGNOSIS
Diagnostic algorithm presents questions in a logical order:
Where redness?
Is there a discharge?
How would you describe it?
What the pupil? What is intraocular pressure?

20. RED EYE DIAGNOSIS
Answers to these questions will help you to differentiate between the causes of red eye: Conjunctivitis: bacterial, viral, allergic
Inflammation: episcleritis, anterior uveitis
Keratitis: corneal ulcers, herpetic keratitis
Glaucoma: zakratougolnaya
Dry eyes keratoconjunctivitis sicca

21. Discomfort in the eye Dryness in the eye (syndrome Sjogren)
blepharitis
barley
boil
abscess

22. RED EYE Conjunctivitis
There are three types of conjunctivitis:
1) Bacterial conjunctivitis
2) Viral conjunctivitis
3) Allergic Conjunctivitis

23. Conjunctivitis Bacterial conjunctivitis
Characterized by muco-purulent discharge, which during sleep can be glued together forever (patients describe the complexity of opening the eyes in the morning).
causing infections are most often Gram positive bacteria.

24. Conjunctivitis Viral conjunctivitis
Characterized by the appearance of follicles (follicles) (hypertrophy of lymphoid follicles on the surface of the conjunctiva of the lower eyelid), and may be accompanied by periauricular
lymphadenopathy.
Can be slimy exudate, but its amount is usually less than in bacterial conjunctivitis.

25. Conjunctivitis Allergic
Watery discharge, usually accompanied by severe itching and swelling of the conjunctiva often (called "chemosis").

26. Conjunctivitis
Bacterial - antibiotics effective against common Gram positive microorganisms (bacitracin, erythromycin, trimethoprim polymyxin)
Viral - symptomatic (artificial tears, decongestants)
Allergic - antihistamine drops (antazoline), NSAIDs (ketoralak) prevent antigen. Avoid taking steroids - only under the supervision of an ophthalmologist.

27. Treatment
Note that patients with bacterial or viral conjunctivitis on the importance of hygiene (hand washing).
Do not use steroids in the treatment of allergic conjunctivitis. Treatment with steroids should conduct an ophthalmologist.

28. Treatment
In the treatment of steroids can cause serious side effects, so treatment with these drugs should be under the supervision of an ophthalmologist.
These side effects are
1) the accession of secondary infection;
2) delayed wound healing of the cornea, leading to its softening and perforations;
3) formation of cataracts;
4) The constant increase of intraocular pressure - glaucoma.

29. Clinical case 1
20-year-old student. Redness of the eyes in the last 2 days. Eyes stick together in the morning.
Hyperemiya- diffuse. Discharge- mucopurulent.
Large itching.
Pupil - normal.
IOP- norm.