Talk:Red eye (medicine)

The following information was moved here from the article The Red Eye. It appears to be someone's lecture notes, so I have not incorporated into this article. Edwardian 07:14, 3 December 2005 (UTC)Reply

The Red Eye R.F. Multack, O.D., D.O. Department of Ophthalmology Midwestern University Chicago College of Osteopathic Medicine

Everyone is bothered by a red eye at sometime or another. Often some of these experiences are called by the generic term Pink Eye or Red Eye. In many instances these experiences are not of serious concern. Many times these conditions go away by themselves. Sometimes these conditions are very serious and vision threatening. In this article we will explore the various causes and treatments for the Red Eye.

Anatomy and Pathophysiology of the Red Eye

To understand the red eye we must first understand some of the basic medical issues involved in the process. Inflammation, defines the pathophysiologic mechanism involved in injury, infection and other immune based conditions involving the body. Inflammation consists of bodily responses to these conditions and involves the necessary presence of blood vessels in the area. Inflammation is characterized by, redness, swelling, pain, heat and loss of function of the inflamed area. The area inflamed is named by adding the ending -itis. The red eye involves inflammation of several of the anatomical parts of the eye. The conjunctiva (conjunctivitis) is the transparent skin covering the eyeball and the insides of the lids. Eye skin is like a brick wall. The epithelium is the layered bricks, the basement membrane is the mortar, and the stroma defines the foundation. Important service elements such as nerves and blood vessels move through the stroma similarly to pipes and electrical conduits move through the foundation of a wall. Inflammation of the conjunctiva may be caused by bacteria, virus, allergy and autoimmune processes. The Cornea (keratitis) is the clear dome covering the colored part of the eye and pupil. The cornea is shaped like half of a basketball or with two curves like one half of a football in cases of astigmatism. The cornea is transparent because its foundation the stroma is built of parallel layers of material oriented at 90 degree angles. Any disruption to this relationship such as swelling causes loss of transparency. The cornea does not have its own blood vessels but uses the vessels near it. The epithelium of the conjunctiva continues onto and becomes the epithelium of the cornea. The cornea may be involved in infection, immunological conditions, and hereditary conditions. The Iris (Iritis/Uveitis) is the colored part of your eye. In the center of the iris is the pupil. The pupil is a hole or absence of iris. The iris is made of many blood vessels, pupil movement muscles, nerves, and pigment. The iris may be involved in infection, immunologic conditions, and hereditary conditions. Episclera/Sclera, (Episcleritis/Scleritis) The episclera is a thin pre- foundation under the conjunctiva or skin of the eyes. Its job is to support the Sclera which is the white part of the eye and the basic foundation of the eye. The sclera is connected to the stroma of the cornea and becomes transparent as it changes location. The sclera has very few blood vessels and relies on the vessels of the episclera for nourishment. The episclera and sclera are more often involved in immunologic conditions. The trabecular meshwork, (Glaucoma) is an angular area between the inside base of the cornea and iris. It is Swiss cheese like in nature. It empties into a large drainage canal (Schleme's) and serves as the internal drain of the eye. This system is like a bathtub drain and can become clogged over time causing open angle glaucoma. The structure connected to the iris called the ciliary body makes fluid which circulates from behind the iris through the pupil to drain out the trabecular meshwork in the drainage angle. The red eye condition associated with this area is acute angle closure glaucoma where the drain becomes physically clogged by the structure of the iris or other obstructing materials.

Clinical Presentation of the Red Eye,

Conjunctiva:

Subconjunctival hemorrhage, a bruise or bleeding under the transparent skin of the eye. This condition is very scary because the patient sees areas of bright red blood. Most of the time the cause is accidental bumping or rubbing of the eye. This condition is not considered serious unless associated with very high blood pressure or blood clotting disorders. The body heals this and no treatment is necessary. It is important to look into the cause. Bacterial conjunctivitis, characterized by discharge or pus, redness, discomfort or pain. Requires the use of the appropriate antibiotic for treatment. This is not a very common condition of adults. Viral conjunctivitis. Characterized by a watery discharge, burning or pain, swollen glands. This condition will usually go away by itself in a couple of weeks and does not require treatment. Often patients demand antibiotic treatment which is unnecessary and can lead to bacterial resistance to the antibiotics used. Allergic conjunctivitis, Characterized by a sticky ropey discharge, itching and swelling. Tends to be seasonal but may exist all year round in contact lens wears or as the result of environmental allergies. Treatment is with anti-histamine or corticosteroid drops. Inclusion conjunctivitis is associated with the sexually transmitted organism called chlamydia. The clinical appearance is similar to viral conjunctivitis except this condition tends to hang around, lasting longer than viral disease and may become chronic. It is often associated with other symptoms of sexually transmitted disease such as painful urination in males. Viral disease confers lasting immunity to the particular virus. Chlamydia can be caught over and over. It is important to treat all parties that might have this condition so it is not passed back and forth. Treatment is with antibiotics specifically tetracycline and erythromycin.

Cornea:

Keratitis, also referred to as corneal ulcer is a serious and potentially blinding condition. Bacterial keratitis is characterized by intense pain, a visible spot on the cornea often filled with pus. Generally requires a pre-existing injury and needs to be treated with powerful antibiotics. Corneal pain is most often felt (refers) in the corners of the eyes. Pain involving the eye surface is not usually specifically felt at the source of the pain. This process is called referred pain. Viral keratitis is most often associated with the various human herpes viruses. It is not usual painful but feels like something is in the eye. The patient may have had a recent outbreak of a cold sore. Shingles can affect the cornea and iris. Protozoan keratitis (acanthemeba) is a serious very painful infection of the cornea. It is most often seen in soft contact lens wearers. The source of contamination is the use of tap water to wet the lenses for insertion.

Iris;

Iritis, the iris is inside the eye so no discharge is evident. Pus may be released inside the eye (floating white blood cells and protein) but generally needs a diagnostic microscope (biomicroscope, slit-lamp) to be seen. Iris pain is felt in the eyebrow (referred) and the condition is associated with pain, and light sensitivity called photophobia. The iris changes shape to limit the amount of light that is allowed to reach the retina which is the film in the camera known as the eye. This shape change is accomplished by muscles in the iris. The nerves in the iris are pressed by fluid caused by the swelling of inflammation. Light causing the iris to change shape causes movement and pulling on these nerves causing pain or photophobia. The iris and the cornea share the same nerves (nasociliary branch of the ophthalmic division of the trigeminal nerve.) so conditions affecting either may result in inflammation of the other.

Episclera and Sclera:

Episceritis/scleritis is most often associated with autoimmune conditions like Rheumatoid arthritis and Crohn’s disease. It may be associated with no known cause (idiopathic episodic episcleritis) When painful it tends to be a boring pain. There is usually no discharge like we see in conjunctivitis. Treatment is with non-steroidal anti-inflammatory medication and sometimes corticosteroids.

Glaucoma:

Acute Angle closure glaucoma, this condition is extremely painful, associated with headache, nausea and vomiting. The eye is described as “beefy red”, with a “ground glass” cloudiness to the cornea. The pupil is often fixed and dilated. The treatment is surgical. Attempts to control the pressure are made medically. A hole is then made in the iris usually with a laser to equalize the pressure that has built up due to the closed drain. A full drainage surgery may be necessary.

We have examined the basic anatomy of the front of the eye. We have looked at some of the physiologic and pathophysiologic principles governing the red eye. We have looked at the microbiological and non-microbiological conditions causing the red eye. We have explored some of the basic treatment methods for the red eye.

The red eye is an often annoying condition that may in certain instances lead to serious visual loss.

what is the best medicine or cure for re eye?

Is a reference to orbital cellulitis appropriate or needed? --Mdscottis (talk) 00:54, 21 January 2013 (UTC)Reply

I'm reasonably familiar with medical terminology but this article is so brief and technical that I had trouble figuring out what everything means. "Corneal abnormalities including edema or opacities." What does this mean?? The mention of Ophthalmology in the first paragraph would also be a good idea. Risssa (talk) 02:08, 7 April 2013 (UTC)Reply

... on the clinical assessment: doi:10.1016/j.amjmed.2015.06.026 JFW | T@lk 22:55, 24 October 2015 (UTC)Reply

It would have been nice to read this article without the horrific jump-scare image at the top... are there any guidelines about this on wikipedia? -- SocioCogLing (talk) 06:37, 27 December 2020 (UTC)Reply

Yes, the images guideline MOS:IMAGES says that images should meet "conventional expectations of readers". —Jade Ten (talk) 20:55, 5 August 2021 (UTC)Reply