Eye tutorial red painful eye painless loss of vision. February 2017

Video presentation From BML learning. http://learning.bmj.com/learning/modules/fl ow/review/RRR.html?execution=e1s2&_flowI d=RRR&moduleId=10051483&page=1&isFrm RA=true&status=LIVE&locale=en_GB&session TimeoutInMin=90&shouldStartAtQuestionSec tion=false&elucidatModuleType=&action=rev iew

Red eye – true or false Uveitis is painful and does not cause redness. Uveitis can be caused by trauma as well as associated with HLA-B27. HSV keratitis causes corneal hypersensitivity Visual inspection of the fundus is difficult in acute (closed angle) glaucoma Pre-septal cellulitis causes pain with eye movements. FTFTF

Conjunctivitis – true or false Delayed antibiotic prescribing can reduce antibiotic use and re-attendance. Itch is a prominent feature of infective conjunctivitis Viral conjunctivitis often presents with watery eyes, mild photophobia and eyelid swelling. It is necessary to exclude infants with conjunctivitis from nursery schools. Contact lens wearers should just be treated with chloramphenicol. TFTFF

What is this ? A 38 year old man who wears soft contact lenses presents with a one day history of pain and blurred vision in his eye. What could you do to help with the diagnosis.

What is this Use a blue filter on a pen torch to create cobalt blue light.

What is this diagnosis A 26 year old man comes in wearing sunglasses. He is reluctant to remove them due a painful watering eye. What can you see and what test can you do ?

What is this ? This is a more advanced case of uveitis. What is the main treatment for anterior uveitis.

What is this ? This 70 year old lady attended with headaches and also mentioned haloes around lights over the last few days. What is a simple test you can do?

What has happened here Patient presented before with ACAG.

What is this? A 45 year old gardener presents with a grossly swollen left upper eyelid. He had been scratched on his eyelid by a twig three days earlier. On examination the upper lid is tender and very red. The lower lid is mildly swollen but not red. The conjunctiva is mildly injected. Eye movements and visual acuity are normal

What is this ? This young girl was febrile and unwell …. There was clear swelling around the left eye. What speciality do you refer to ?

What is this What can you see. What clinical sign is evident here ?

What is this ? What would you need to check here ?

What is the diagnosis here? Is it painful ? What treatment would you use.

This is a common presentation This 16 yr old girl presents with a sticky eye. Worse this morning and affected vision.

What is this? Is this the same ? Now been about 1 week and unresponsive to otc chloramphenicol drops.

Loss of vision Painful Corneal ulcer Glaucoma Scleritis Iritis Orbital cellulitis Painless. Retinal vein occlusion. Central retinal artery occlusion. Retinal detachment. GCA Stroke Optic neuritis Often associated with red eye (s) External eye exam normal.

Painless loss of vision – T/F A stroke in the left visual cortex will cause a right homonymous hemianopia. Temporal arteritis should always be considered if over 50 years of age. The prognosis for a branch retinal vein occlusion is poor. The eye in a retinal artery occlusion will be poorly reactive to light and will have an abnormal consensual light reflex. All sudden loss of vision should be referred to HES within 24 hours.

What has happened here ? You do fundoscopy in a man who has sudden blurring of vision.

Is this the same ? What is the prognosis here ?

What has happened here ? This man had dramatic sudden visual loss in his left eye. Would you dilate his pupil ? What would you use ? White retina and ‘cherry red spot’

What has happened here ? This man has noticed a disturbance of his peripheral vision. Described as a “curtain”.

fundoscopy What is this ? normal

What is this A 30 year old lady walks in visual disturbance in one eye and a dull ache in the eye region.

And what about this ?