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ACUTE EYE CARE

ACUTE EYE CARE. D R A HMED H ASSAN 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.

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ACUTE EYE CARE

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

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

  3. Optic Nerve • Young • Optic Neuritis • Older • Arteritis • Ischaemic

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

  5. PVD • Posterior Vitreous Detachment Weiss ring

  6. CRVO • BRVO

  7. CRAO • BRAO

  8. Central Visual Loss • ARMD • Diabetic Macular Oedema Pinhole

  9. Cataracts

  10. EYE INJURIES

  11. Conjunctiva • Sub-conjunctival Haemorrhage

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

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

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

  15. Microbial Keratitis • Corneal infiltrate • Hypopyon

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

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

  18. PAINFUL RED EYE

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

  20. Uveitis Uva (Latin): Grape

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

  22. Posterior Synechiae Keratic Precipitates Untreated Iritis

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

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

  25. Orbital septum

  26. Preseptal

  27. Orbital

  28. Optic nerve at risk

  29. Orbital CT: axial & coronal

  30. Meibomian Cyst • Stye

  31. Dacryocystitis

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

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