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D. D. of OPH sy. & sg.

By;

Mohammed Fotouh El-Ashri

Ophthalmologist

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Acute Red eye

  • Acute conjunctivitis
  • Acute keratitis
  • ACG
  • Acute iridocyclitis
  • Sub-conjunctival hemorrhage

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Sudden (Rapid-Acute) visual loss

  • Painless
  • Papilledema
  • CRAO (BRAO)
  • CRVO (BRVO)
  • Vitreous hemorrhage
  • RD
  • Amarosis
  • Migraine
  • Post. Uvietis
  • Cortical
  • Hysterical
  • Painful:
  • Acute hydrops
  • Bollous keratopathy
  • Acute keratitis
  • Acute irido-cyclitis
  • ACG
  • Optic neuritis

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Gradual visual loss

  • Media:
  • Corneal degeneration
  • Corneal dystrophies
  • keratoconus
  • Cataract
  • Vitreous hemorrhage

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  • Retina:
  • Macula;
  • Macular dystrophies(day)
  • Macular edema
  • Retinitis (dark)
  • Disc;

1.Congenital optic neuropathy

2. Compressive optic neuropathy

3. Optic atophy

4. Glaucoma

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Watery eye

Increased secretion:

    • Pro-secretory drugs (pilocarpine)
    • Refelex lacrimation due to

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Pump failure:

    • Lid laxity
    • 7th n palsy
    • Ectropion

Decreased drainage:

    • Punctal
    • Canalicular
    • Duct

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Flashes & Floaters

  • PVD
  • Retinal tear
  • RD
  • Choroidal tumours

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Headache

  • Incresed intra-cranial pressure
  • Accelerated HTN
  • ACG
  • Refractive error
  • Strabismus
  • Migraine
  • Sinusitis
  • Neuralgia

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Diplopia

  • Monocular:
  • Cornea
  • Iris
  • Lens
  • IOL
  • Binocular:
  • MG
  • INO
  • Decompensating Phoria
  • Nerve palsy
  • Muscle entrapment

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Anisocoria

Conistricted

Dilated

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synechiae

Sphincterotomy

operative

Traumatic

Horner syndrome

3rd nerve palsy

Neurological

Pilocarpine

Atropine

pharmacological

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Proptosis

  • Congenital cyst
  • Infection: orbital cellulitis
  • Inflammation: thyroid eye disease, idiopathic orbital
  • Tumors: capillary hemangioma, lymphangioma, optic nerve
  • Vascular anomalies: orbital varices, carotid–cavernous fistula
  • Pseudoproptosis: ipsilateral large globe or lid retraction;
  • contralateral enophthalmos or ptosis; facial asymmetry

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Lid

  • Madarosis:
  • Local: cicatrizing conjunctivitis,
  • iatrogenic (cryotherapy, radiotherapy, surgery)
  • Systemic: alopecia
  • psoriasis,
  • hypothyroidism,
  • leprosy
  • Poliosis:
  • Local: chronic lid margin disease
  • Systemic: sympathetic ophthalmia, Vogt–Koyanagi-Harada syndrome, Waardenburg syndrome

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Lid mass

  • stye,
  • cyst of Moll,
  • cyst of Zeis,
  • xanthelasma,
  • papilloma,
  • basal cell carcinoma,
  • squamous cell carcinoma,
  • malignant melanoma,
  • internal hordeolum (chalazion),
  • pyogenic granuloma,
  • sebaceous gland carcinoma

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Conjunctival discharge

  • Purulent: bacterial conjunctivitis
  • Mucopurulent: bacterial or chlamydial conjunctivitis
  • Mucoid: vernal conjunctivitis, dry eye syndrome
  • Watery: viral or allergic conjunctivitis

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Conjunctiva

  • Follicles:
  • Viral conjunctivitis,
  • Chlamydial conjunctivitis,
  • Drop hypersensitivity,
  • Papillae:
  • Bacterial conjunctivitis,
  • Allergic conjunctivitis,
  • Blepharitis
  • floppy eyelid syndrome,
  • superior limbic keratoconjunctivitis,
  • contact lens
  • Vernal keratoconjunctivitis,
  • exposed suture, prosthesis,

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Iris

  • Rubeosis irides:
  • Retinal vein occlusion (ischemic),
  • proliferative diabetic retinopathy,
  • Ocular ischemic syndrome,
  • CRAO,
  • Long standing retinal detachment,

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Cherry red spot

  • CRAO
  • Commotio retinae
  • Macular hole
  • Niemann Pick disease

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