Eye Emergency: DR Abdelmoniem Saeed
Eye Emergency: DR Abdelmoniem Saeed
Eye Emergency: DR Abdelmoniem Saeed
Dr ABDELMONIEM SAEED
ANATOMY OF THE EYE
OCULAR INFECTIONS
PRESEPTAL CELLULITIS (PERIORBITAL CELLULITIS)
is an infection of the eyelids and periocular tissues that is anterior to the
orbital septum.
History
Upper respiratory symptoms, low-grade fever, redness tenderness and
swelling of the eyelid, and excessive tearing (epiphora) are signs and
symptoms of.
The eye itself is not involved, and visual acuity and pupillary reaction
are maintained, and full painless ocular motility is preserved in
preseptal cellulitis
Signs and symptoms are similar to a stye except that the pustule
occurs on the inner surface of the tarsal plate
EXTERNAL HORDEOLUM
CLINICAL PRESENTATION
edema,
is associated with a painless lump that develops in the lid or at the lid
margin,
occasionally with mild erythema.
antihistamine/decongestant drops,
and severe symptoms may justify use of topical steroids.
Eye involvement may take the form of epithelial keratitis, stromal keratitis,
uveitis, retinitis, and chorioiditis.
Choices include
acyclovir,800 milligrams five times a day,
famciclovir, 500 milligrams three times a day,
valacyclovir, 1000 milligrams three times a day.
Fungi and viruses have also become a more common cause of corneal ulcer
due to the widespread use of both topical and systemic immunosuppressant
medications.
DIAGNOSIS
The history of contact lenses use, previous ocular surgery,
injury, recent trauma presence or history of genital herpes.
Do not patch the eye because of the risk of Pseudomonas infection, which
can cause rapid, aggressive ulceration with corneal melting and perforation.
no discharge.
Slit lamp examination will reveal flare and cells in the anterior chamber,
culminating in a hypopyon with severe disease.
Cauases include
postsurgical, The most frequent cause
penetrating ocular injuries
rarely, hematogenous spread.
Initial symptoms
intense pain
foreign body sensation,
photophobia,
tearing.
Decreased visual acuity occur if the abrasion is in the central visual axis
Inspection
conjunctival injection,
tearing, and
lid swelling.
The corneal abrasion is often visible to the naked eye as an irregular area of light reflection
off the cornea.
TREATMENT
self-limited, treatment is aimed at relieving pain and preventing
infection
corneal abrasions may result from mechanical effect of hard, irregular glue
aggregates rubbing against the cornea with eye movement and blinking
Clumps of glue on the surface should begin to loosen. Remove only those
pieces that are easily removable.
Gentle traction may separate the lids. The glue will loosen and become
easier to remove in a few days.
Examination reveals
fixed,midposition pupil
hazy (cloudy/steamy) cornea with conjunctival injection, most
prominent at the limbus.
The affected eye is rock hard.
Increased intraocular pressure
Note the cloudy/steamy appearance of the cornea and the midposition dilated
pupil. Conjunctival injection is usually more prominent than in this case
ACUTE ANGLE-CLOSURE GLAUCOMA.
Caused by
multiple sclerosis
viral infection
Bacterial
Bell's Palsy
Horner Syndrome
CENTRAL RETINAL ARTERY OCCLUSION
is rare condition 1/10,000 ophthalmic visits. There are no data on ED
visits
Clinical Features
Sudden (occurring over seconds), profound, painless, monocular loss of vision
is characteristic of a central retinal artery occlusion
Note macular "cherry red spot" and retinal pallor as well as the
plaques visible in the retinal vessels
CENTRAL RETINAL VEIN OCCLUSION
Thrombosis of the central retinal vein causes retinal venous stasis, edema,
and hemorrhage.
The contralateral optic nerve and fundus generally are normal, which
helps distinguish it from papilledema, and the diffuse retinal hemorrhages
help distinguish it from optic neuritis
The disk margin is blurred, the veins are dilated and tortuous, and there is a large
amount of hemorrhage typical of the "blood and thunder fundus
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