Common Ophthalmic Symptoms

Two Common Ophthalmic Symptoms

1. Loss of Vision (Most Common)

   • Sudden/gradual
   • Painful/painless {Transient/permanent}
   • Both eyes/single eye/part of field

2. Red Eye

   • Watery/sticky
   • Painful {With visual loss}
   • Duration

Red Eye

Appendix I: Red Eye

• Deep Red

  • Sclera obscured: Sub-conjunctival haemorrhage

• Diffuse Bulbar and Tarsal Injection

  • Infective conjunctivitis
  • Allergic conjunctivitis
  • Angle closure glaucoma

• Diffuse/Focal Bulbar Injection

  • Episcleritis
  • Scleritis

• Perilimbal Injection

  • Uveitis
  • Abrasion
  • Keratitis
  • Corneal abrasion
  • Corneal foreign body

Painful Eye

Appendix 4: Painful Eye

• Discomfort

  • Blepharitis
  • Dry eye
  • Conjunctivitis
  • Allergy
  • Dysthyroid eye disease

• Pain on Eye Movements

  • Optic neuritis

• Pain Around Eye

  • Giant cell arteritis
  • Migraine
  • Orbital cellulitis
  • Causes of ‘headache’

• Severe Pain

  • Corneal abrasion/foreign body
  • Keratitis
  • Angle closure glaucoma
  • Endophthalmitis
  • Uveitis
  • Scleritis
  • Myositis

Acute Visual Loss

Appendix 3: Acute Loss of Vision

• Painful

  • Prolonged
    • Acute angle closure glaucoma
    • Optic neuritis
    • Giant cell arteritis
    • Orbital cellulitis
    • Endophthalmitis

• Painless

  • Fleeting
    • Embolic
    • Migraine
    • Raised intracranial pressure (papilloedema with other symptoms of raised intracranial pressure)
  • Prolonged
    • Ischaemic optic neuropathy
    • Retinal artery occlusion
    • Retinal vein occlusion
    • Vitreous haemorrhage
    • Retinal detachment

Gradual Visual Loss

Appendix 2: Gradual Loss of Vision

• Media Cloudy

  • Corneal opacity
  • Cataract
  • Vitreous haemorrhage

• Media Clear

  • Retinal Disorder
    • Age-related macular degeneration
    • Macular/retinal dystrophy
  • Optic Nerve/Pathway Disorder
    • Optic neuropathy
    • Cranial disease affecting visual pathway

This refers to the presence of opacities in the cornea, lens, or vitreous which will appear black against the red reflex