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Red Flag

Red flag eye symptom

Uploaded by

Asem Almeerabi
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© © All Rights Reserved
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7 views

Red Flag

Red flag eye symptom

Uploaded by

Asem Almeerabi
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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red flag on ophthalmology

evidence shows that 50% of


sight loss could be avoided
This presenta on examines common cases in through improved eye care
ophthalmology and suggest some important and early detection
‘red flags’ in each which merit urgent
a en on
Ptosis may be a completely benign and
gradual process of ageing but it may also be
a sign of more sinister pathology

THE UPPER EYELID IS ELEVATED


MAINLY BY

the levator palpebrae superioris


(innervated by the 3rd cranial nerve),

partly by Müller’s muscle


(sympathetic innervation)
Lesions to either nerve pathway may
THE PATIENT cause a ptosis

WITH PTOSIS
Therefore , sudden onset of ptosis should search
for the signs of
Horner’s may be caused by any interruption
of the sympathetic pathway from brainstem
to Muller’s muscle,
but the most immediately dangerous cause
is a , while another life-
threatening cause may be an
may be caused by a
–a
potentially fatal disorder
a compressive (surgical) lesion to the nerve
is more likely to affect pupillary function than
a microvascular (medical) lesion to the
nerve. In reality this is an unreliable sign
If you suspect a 3rd nerve palsy, urgent neuroimaging
may be required even if there is no pupil involvement
The older patient with
headache and visual symptoms

In patients over 50, any presentation of


headache and visual symptoms should
prompt a search for giant cell arteritis (GCA) –
the familiar symptoms of jaw claudication,
scalp tenderness, headache/neck pain, and
systemic malaise.
The patient with nausea and
vomiting
– and a painful eye
Acute angle closure glaucoma (AACG) typically
presents with an acutely painful red eye with a
sudden drop in Vision
 AACG cause profound systemic upset
including nausea and vomiting, headache
and photophobia, and a stress reaction
including tachycardia and hypertension.

 Do not ignore sudden loss of vision in an eye


even if the main symptoms seem to be
gastrointestinal
Is it orbital or periorbital

cellulitis?
Infections which affect the soft
tissue in front of the orbital septum
are limited to the tissues around the
eye, and is known as periorbital  Ophthalmoplegia (abnormal eye
movements)
cellulitis.
 Pain on eye movements
This is extremely common in  Red desaturation
children,  RAPD (Relative Afferent Pupilllary
relatively benign condition and can Defect)
be treated with oral antibiotics  Visual loss
 Proptosis
 Extremely congested, chemosed
eye
Is it orbital or periorbital

cellulitis?
Infection that penetrates the septum is much more
serious. This is known as orbital cellulitis
soft tissue swelling can cause compression of the
optic nerve and ophthalmic vessels, leading to
blindness from nerve or retinal ischaemia.
Spread along the vessels and dural sheath can
also occur, leading to meninigitis, cavernous sinus
thrombosis, and death.
Distinguishing orbital from periorbital cellulitis is
therefore extremely important.
patients with orbital cellulitis must be referred
urgently to the main emergency department and
receive an ophthalmology and medical consult.
RETINOBLASTOMA
LEUKOCORIA
A WHITE PUPILLARY REFLEX
COATS DISEASE

PEDIATRIC CATARACT

RETINOPATHY OF PREMATURITY
(ROP)

RETINAL DETACHMENT

OTHERS
The unilateral red eye and the

contact lens wearer

be cautious of dismissing a red eye in a


contact lens wearer, especially if
unilateral. Contact lens (CL) users are
significantly more likely than non-
contact lens wearer to develop
microbial keratitis (corneal ulcer)
 A unilateral red eye
 Photophobia
 visual change
 foreign-body like pain
The patient with Vernal
keratoconjunctivitis and continuous
drop of vision

recurrent bilateral disorder


It primarily affects boys and onset is
generally from about the age of 5
years onwards.
persistent eye rubbing lead to
CORNEAL ECTASIA(Keratoconus)
I. impairment of vision
II. progressive myopia and astigmatism
III. High K-reading
THANK YOU FOR
LISTENING

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