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afya Ophthalmology

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20160425222547 Ben  
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Uveitis - can effect whole uveal body (Panuveitis) but most commonly anterior (Iritis)
think HLA B12 (often RA) but also RhF -ve - esp ank spond
Main Sx Photophobia (red painful eye)
 
If red painful eye is sticky / gritty ?discharge then chloarmphenicol
If with pre-auricular LN - think adenovirus
If red photophobic - think Uveitis or Herpes Simplex - dilate (relieves pain) and to eye clinic
 
To look at anterior of eye - use ophthalmoscope at 10+
Note long sighted glasses - magnify image when normal looks through while short sited minify image
To dilate eye - use tropicamide and/or phenylephrine (only 1 needed in younger person)
If referred with cataract - think if surgery will alter daily life (drive ? work ?) ie consider function
 
Herpes Simplex
stain with orange and look with blue light
green dendritic ulcer
Don't use steroids but do give topical acyclovir (5x/day)
LA eyedrops - stops epithelium healing so avoid
 
Optic Neuritis
Pain, white eye
Check visual fields, acuity, red desaturation, relative afferent pupillary defect
think MS
episode lasts about 6/52
 
Flash - vitreous detachment
"like line, light on and off", uniocular
Normal ageing process but be careful as may have associated retinal detachment
 
Ophthalmic Herpes Zoster - rash on tip of nose