Unilateral red eye: Difference between revisions
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**Scleral penetration^ | **Scleral penetration^ | ||
*No defect | *No defect | ||
**No pain relief with tropicamide | **No pain relief with [[tropicamide]] | ||
***[[Acute Angle Glaucoma]]^ | ***[[Acute Angle Glaucoma]]^ | ||
****dilated | ****dilated | ||
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***Anterior [[Uveitis]] | ***Anterior [[Uveitis]] | ||
****(hypopyon, cilliary flush) | ****(hypopyon, cilliary flush) | ||
**No pain '''OR''' pain relief with tropicamide | **No pain '''OR''' pain relief with [[tropicamide]] | ||
***Foreign body | ***Foreign body | ||
***[[Conjunctivitis]] | ***[[Conjunctivitis]] | ||
Revision as of 06:32, 17 August 2017
Background
Clinical Features
- Unilateral red/painful eye
Differential Diagnosis
Unilateral red eye
- Nontraumatic
- Acute angle-closure glaucoma^
- Anterior uveitis
- Conjunctivitis
- Corneal erosion
- Corneal ulcer^
- Endophthalmitis^
- Episcleritis
- Herpes zoster ophthalmicus
- Inflamed pinguecula
- Inflamed pterygium
- Keratoconjunctivitis
- Keratoconus
- Nontraumatic iritis
- Scleritis^
- Subconjunctival hemorrhage
- Orbital trauma
- Caustic keratoconjunctivitis^^
- Corneal abrasion, Corneal laceration
- Conjunctival hemorrhage
- Conjunctival laceration
- Globe rupture^
- Hemorrhagic chemosis
- Lens dislocation
- Ocular foreign body
- Posterior vitreous detachment
- Retinal detachment
- Retrobulbar hemorrhage
- Traumatic hyphema
- Traumatic iritis
- Traumatic mydriasis
- Traumatic optic neuropathy
- Vitreous detachment
- Vitreous hemorrhage
- Ultraviolet keratitis
^Emergent diagnoses ^^Critical diagnoses
Evaluation
- Evert lens and look for foreign body
- Remove contacts
- Photophobia suggests inflammation i.e. uveitis and abrasions
- Pupil: irregular with positive sidel's suggests penetrating injury
Diagnostic Algorythm
Traumatic
- Obvious Ruptured Globe^
- No obvious ruptured globe
- Epithelial defect
- Corneal Abrasion and Foreign Body
- Conjunctival laceration
- Corneal Ulcer^
- Caustic Keratoconjunctivitis^^
- Occult Ruptured Globe^
- (positive Sidel's)
- No defect
- Subconjunctival Hematoma
- Traumatic Iritis
- Hyphema^
- (?occult open globe)
- Endophthalmitis^
- (old occult open globe)
- Epithelial defect
Nontraumatic
- Epithelial defect
- Corneal Abrasion
- Corneal Ulcer^
- Herpes Zoster Ophthalmicus (dendrite)
- Corneal erosion
- (morning pain)
- UV keratitis
- (SPK)
- Scleral penetration^
- No defect
- No pain relief with tropicamide
- Acute Angle Glaucoma^
- dilated
- closed angle
- inc pressure
- Nontraumatic Iritis
- Scleritis^
- (localized; no move Q-tip)
- Anterior Uveitis
- (hypopyon, cilliary flush)
- Acute Angle Glaucoma^
- No pain OR pain relief with tropicamide
- Foreign body
- Conjunctivitis
- Keratoconjunctivits
- Episcleritis
- (localized; move with Q-tip)
- Non-uptake finding (no pain/pain relief with tropicamd)
- Subconjunctival Hematoma
- Inflamed pingueculum
- Inflamed Pterygium
- Keratoconus (protrude)
- No pain relief with tropicamide
^Emergent diagnosises
^^Critical diagnosises
Managment
- By diagnosis
See Also
References
- Rosen
- WMS Practic Guidelines 2000)