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2063758816340Episcleritis00Episcleritis30099008813165Painless; isolasted area; unilateral; NSAIDs; usually settles00Painless; isolasted area; unilateral; NSAIDs; usually settles15220968816340002178057366000Iritis (anterior uveitis)00Iritis (anterior uveitis)15144757362190Aetiology: collagen vascular diseases, sarcoidosis, inflammatory bowel disease, aortic stenosis, rheumatoid arthritis, TB, Lyme, herpes, toxoplasmosis, varicella, syphilis, leukaemia, lymphoma, malignant melanoma, Reiter syndrome, BehcetExamination: episcleral injection mostly around limbus, aching pain, photophobia (consensual), mild-mod ? visual acuity, small/normal/irregular pupil, usually unilateral, muddy iris, cell and flare in anterior chamber, posterior synechiae; maybe hypopyon over 2-3/7, keratic precipitatesManagement: opthalmology review; topical/PO steroids if severe and no evidence of corneal infection; dilate pupil (? pain, ? cell and protein release, break synechaie)00Aetiology: collagen vascular diseases, sarcoidosis, inflammatory bowel disease, aortic stenosis, rheumatoid arthritis, TB, Lyme, herpes, toxoplasmosis, varicella, syphilis, leukaemia, lymphoma, malignant melanoma, Reiter syndrome, BehcetExamination: episcleral injection mostly around limbus, aching pain, photophobia (consensual), mild-mod ? visual acuity, small/normal/irregular pupil, usually unilateral, muddy iris, cell and flare in anterior chamber, posterior synechiae; maybe hypopyon over 2-3/7, keratic precipitatesManagement: opthalmology review; topical/PO steroids if severe and no evidence of corneal infection; dilate pupil (? pain, ? cell and protein release, break synechaie)1514475697992075% anterior; also posterior and pan0075% anterior; also posterior and pan2178056983095Uveitis00Uveitis15144755587365002178055392420Keratitis00Keratitis30086305392420Inflammation of cornea whiteness, cells and flare in anterior chamber; hypopyon if severe; unilateral blurred vision, mild headache; ulcerative keratitis may permanently impair visionAetiology: staph aureus, strep pyogenes, strep pneumoniae, pseudomonas if contact lens, herpes simplex virus (dendritic branching), fungal, mycobacterial, acanthamoeba, UV (punctate keratopathy)Investigation: corneal scrapingManagement: topical ciprofloxacin; topical steroids once infection under control00Inflammation of cornea whiteness, cells and flare in anterior chamber; hypopyon if severe; unilateral blurred vision, mild headache; ulcerative keratitis may permanently impair visionAetiology: staph aureus, strep pyogenes, strep pneumoniae, pseudomonas if contact lens, herpes simplex virus (dendritic branching), fungal, mycobacterial, acanthamoeba, UV (punctate keratopathy)Investigation: corneal scrapingManagement: topical ciprofloxacin; topical steroids once infection under control15144754700905Usually spontaneous; associated with HTN; if traumatic - ?hyphema, globe rupture, basal skull # (no posterior limit)Management: none00Usually spontaneous; associated with HTN; if traumatic - ?hyphema, globe rupture, basal skull # (no posterior limit)Management: none2178054704715Subconjunctival haemorrhage00Subconjunctival haemorrhage2178053616325Herpes Zoster Ophthalmicus00Herpes Zoster Ophthalmicus30086303616324Usually monocular; vesicular rash in 5th nerve (cornea involved if tip of nose involved as nasociliary); keratitis and anterior uveitisManagement: systemic acyclovir00Usually monocular; vesicular rash in 5th nerve (cornea involved if tip of nose involved as nasociliary); keratitis and anterior uveitisManagement: systemic acyclovir15220953616325002178052753360Trachoma00Trachoma30099002750185Chlamydia trachomatis; especially in Aboriginal people; antibiotics and surgery00Chlamydia trachomatis; especially in Aboriginal people; antibiotics and surgery15144762753361002178051173480Conjunctivitis00Conjunctivitis15144751170306Aetiology: Adenovirus: good vision; minimal pain; bilatateral in 90%; whitish pseudomembrane and lash matting, pre-auricular lymphadenopathy, lasts 5-7/7 usually Herpes: may not be dendritic ulcer Purulent: strep; chlamydia (most likely if present for >1/12); gonococcal (copious discharge, especially in neonate, may be inflammatory membrane) Herpes; allergicManagement: if purulent, topical antibiotics, eye toilet; systemic antibiotics if gonococcal / chlamydia; if allergic, topical vasoconstrictors / NSAID, PO antihistamine00Aetiology: Adenovirus: good vision; minimal pain; bilatateral in 90%; whitish pseudomembrane and lash matting, pre-auricular lymphadenopathy, lasts 5-7/7 usually Herpes: may not be dendritic ulcer Purulent: strep; chlamydia (most likely if present for >1/12); gonococcal (copious discharge, especially in neonate, may be inflammatory membrane) Herpes; allergicManagement: if purulent, topical antibiotics, eye toilet; systemic antibiotics if gonococcal / chlamydia; if allergic, topical vasoconstrictors / NSAID, PO antihistamine246380539750Red Eye00Red Eye2146302580640Retrobulbar Haematoma00Retrobulbar Haematoma30924502580640Blood accumulates behind globe proptosis, ischaemia of optic nerve ( fixed dilated pupil), visual lossManagement: urgent lateral canthotomy00Blood accumulates behind globe proptosis, ischaemia of optic nerve ( fixed dilated pupil), visual lossManagement: urgent lateral canthotomy15113002580640002146301462405Lens Subluxation00Lens Subluxation29794201462405More common in Marfans; blurred vision if complete dislocation; quivering of iris when eye movedManagement: surgery00More common in Marfans; blurred vision if complete dislocation; quivering of iris when eye movedManagement: surgery1511300146240500214630474980Scleritis00Scleritis2979420474979Sectional redness with blue tinge; nodules; constant pain; associated with collagen vascular diseases; analgesia, topical steroids, cycloplegics; refer opthalmology00Sectional redness with blue tinge; nodules; constant pain; associated with collagen vascular diseases; analgesia, topical steroids, cycloplegics; refer opthalmology151130047497900 ................
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