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Opthalmology - Summary
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Opthalmology - Summary Table of all eye conditions organised by history findings, examination findings, investigation findings and management according to Australian guidelines.
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InfectionInfo History/RF Examination Investigation Management
Conjunctivitis Viral – unilateral or Viral – conjunctival Conjunctival swab Viral
Pathophys – Viral (adenovirus); Bacterial bilateral (sequential), injection, chemosis, Bacterial MCS Supportive – cool
(strep pneumoniae, staph aureus, staph watery discharge, recent watering, follicles (upper Viral PCR compresses, lubricants,
epidermidis, H. influenzae, gonococcal, URTI (runny nose, sore lid), pre-auricular contact precautions
chlamydia); allergic – hypersensitivity throat, sick contacts etc) lymphadenopathy Chlamydia, gonnorrhea PCR Bacterial – Abx drops,
reaction precipitated by allergen Bacterial – conjunctival chlorisg QID
Bacterial – unilateral or infection, chemosis,
bilateral, purulent/sticky sticky/purulent discharge, Allergic – avoid allergens,
discharge, eyelashes stuck pre-auricular antihistamine drops, oral
together in AM lymphadenopathy anti-histamines
Allergic – bilateral, papillae,
Allergic – usually bilateral, periocular swelling and Azithromycin PO 1g stat –
itchy eyes, periocular lid erythema for chlamydial/gonorrhea
swelling, atopy – eczema, Clinical Dx
hayfever, asthma
Blepharitis +
stye + pre-
septal cellulitis
Keratitis
Inflammatory eye conditions
Info History/RF Examination Investigation Management
Uveitis
Episcleritis
Other eye conditions
Info History/RF Examination Investigation Management
Cataracts Gradual decline in vision White eye Refer for cataract surgery
over a period of time Yellowish hue to lens
Pathophys – Normal part of ageing; Difficulty reading, driving, (normally clear)
stiffening of central lens material as new watching TV
layers of fibres proliferate; abnormal Glare with lights If very dense, can be
changes in lens proteins (crystallins), leads brunescent or white
to loss of transparency Middle aged to elderly pts
In young pts – trauma or Clinical Dx
steroid induced
Glaucoma Primary open angle Primary open angle Primary open angle glaucoma Primary open angle
Pathophys – glaucoma – asymptomatic glaucoma – high intra ocular – visual fields, optic nerve glaucoma –
Primary open-angle glaucoma – not fully until late disease pressure (>21mmHg), imaging IOP lowering drops
understood; abnormalities in trabecular cupped optic disc
meshwork lead to aqueous outflow Acute angle-closure Acute angle-closure Acute angle-closure
, obstruction; Primary acute-angle closure glaucoma – eye pain, Acute angle-closure glaucoma – Clinical Dx glaucoma –
glaucoma – anterior displacement of redness, photophobia, glaucoma – high IOP, red IOP lowering drops
peripheral iris→ iridotrabecular contact blurred vision, haloes eye, shallow anterior PO/IV acetazolamide
(angle closure) → obstruction to aqueous around lights, headache, chamber, fixed, mid dilated Pilocarpine drops (miotic)
outflow drainage pathway) N/V pupil, cloud cornea Laser peripheral iridotomy
– constrict pupil, laser to
make small whole in
peripheral iris that allows
fluid to flow from posterior
chamber to anterior
chamber equalizing the
pressure gradientopening
the angle
Do not dilate – worsens
angle closure
Retinal
detachment
Approaching a Pt w/ unilateral red eye
FBS – foreign body sensation
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