Ojo rojo

The Red Eye Challenge

lifeinthefastlane.com - August 2, 2010 by Chris Nickson

"Questions

Q1. There are many causes of ‘red eye’ — how can they broken down as an approach to diagnosis and management?
Q2. What are the causes of a painless red eye?
Q3. What are the causes of a painful red eye?
Q4. What 4 features usually suggest an internal cause of a red eye?
Q5. What 6 features on history and exam suggest an external cause for red eye?
Q6. What 7 features on exam should be present if the cause of a red eye is not serious?
Q7. What is the likely diagnosis of a red eye in a middle-aged woman with the following findings?

• Mid-dilated unreactive pupil, steamy cornea, peri-orbital pain , nausea/vomiting and increased intra-ocular pressure
• Small irregular pupil, deep-seated eye pain that is worse on eye movement and accomodation, consensual photophobia and positive slit lamp signs of flare and cells
• Deep-seated eye pain that is worse at rest and at night, pain on palpation of the eye and violaceous appearance of the sclera
• Proptosis, congested chemosis, painful external ophthalmoplegia, and visual loss with a relative afferent pupillary defect

Q9. What potentially serious causes of a red eye are suggested by the following features on history or examination?

• Severe eye aching
• Prominent photophobia
• Impaired vision
• Cloudy cornea
• Corneal opacification
• Circumcorneal conjunctival injection
• Cloudy anterior chamber
• Pain on eyeball palpation
• Proptosis
• Impaired, or painful, extraocular eye movements
• Fever, toxic appearance
• Hyperpurulent discharge from an “angry” eye
• Prominent nausea and vomiting
• Small, irregular, poorly-reactive pupil
• Fixed mid-dilated pupil
• Increased intra-ocular pressure
• History of connective tissue disease, or granulomatous disease"

http://lifeinthefastlane.com/the-red-eye-challenge/