ACUTE EYE CARE DR AHMED HASSAN MBBS FRANZCO

ACUTE EYE CARE DR AHMED HASSAN MBBS, FRANZCO OPHTHALMOLOGIST Monash Health Dandenong Eye Clinic

PAINLESS VISUAL LOSS Optic nerve – Pupils – Red desaturation Retina – Safe to Dilate Left RAPD

Optic Nerve • Young – Optic Neuritis • Older – Arteritis – Ischaemic

Retinal Detachment or 1. Myopia 2. Cataract Surgery • Flashes, ‘Curtain’ 6/6 Mac ON CF Mac OFF

PVD • Posterior Vitreous Detachment Weiss ring

CRVO • BRVO

CRAO • BRAO

Central Visual Loss • ARMD • Diabetic Macular Oedema Pinhole

Cataracts

EYE INJURIES

Conjunctiva • Sub-conjunctival Haemorrhage

Hyphaema • Re-bleed risk 5 days strict rest, no aspirin

Corneal foreign bodies • Local Anaesth drops: BNX, AME, OXY, TET. • 25 G needle

Subtarsal foreign body • ‘Look down, and keep looking down’

Microbial Keratitis • Corneal infiltrate • Hypopyon

Penetrating eye injury • Seidel test for leaks • • • No eyedrops Dont remove! Shield Keep fasted Prevent vomiting CT or Xray

Alkali burns 1. Anaesthetic drop 2. Flourescein drop 3. Evert & sweep fornices 4. Irrigate Prognosis? • Corneal Opacity • Clock hours of clear limbus

PAINFUL RED EYE

Herpetic disease • Dendritic (HSV) • Shingles (VZV)

Uveitis Uva (Latin): Grape

Iritis • Younger patient • Pupil & vision often normal 1. Anaesthetic drop: Pain unchanged 2. Torchlight Pain worse

Untreated Iritis • Posterior Synechiae • Keratic Precipitates

Acute Glaucoma • Older patient • Pupil & vision abnormal • Patient unwell ++ Anaesthetic drop: Pain unchanged • Don’t dilate • Diamox 500 mg stat if remote • Refer for Laser iridectomy

Orbital Cellulitis • Sinusitis ? Lids shut: Roll apart • Painful eye movements ?

Orbital septum

Preseptal

Orbital

Optic nerve at risk

Orbital CT: axial & coronal

Meibomian Cyst • Stye

Dacryocystitis

Conjunctivitis Acute Allergic • Chemosis • Itch Viral vs Chlamydia • Follicles in both • URTI – viral • Urethritis