• Acute angle closure glaucoma
• Para-trigeminal neuralgia
• Referred headache pain
• Sinusitis
• Uveitis
• Viral myalagia

Allergies

Type I Anaphylactic

• Mastcells release vasoreactive substance in response to antigen
• Hayfever

Type II Cytotoxic

• (Ig)G or (Ig)E antibodies combine with exogenous antigen and attach to cell causing destruction
• Transplant rejection

Type III Immune complex

• Antigen-antibody complexes produce inflammatory response
• Rheumatoid arthritis
• System lupus erythematosis

Type IV Delayed cell-mediated

• Antigen-T lymphocyte complex
• Contact lens solution allergy

Amaurosis

• Acute angle closure glaucoma
• Pain
• Halos
• Steamy cornea

Papillitis

• If disc swollen and visual acuity O.K. Papilledema
• If disc swollen and visual acuity poor Papillitis
• If disc normal and visual acuity poor Retrobulbar neuritis

Anterior ischemic optic neuropathy (AION )

• Disk edema
• Central retinal artery occlusion (CRAO)
• White retina and "cherry macula"

Cerebral vascular accident (CVA)

• Involves speech or muscle control

Migraine

• Scotoma
• Headache
• Nausea

Transient ischemic accident (TIA)

• Confusion
• Vertigo
• Blindness for minutes to hours

Ptosis

• Central
• Lesion of III nerve to levator muscle
• Lesion of sympathetic pathway of IV nerve
• Acetylcholine transmission defect
• Myasthenia gravis (MG)
• Lid edema
• Trauma

New diplopia

• Diabetes
• Stroke
• Trauma
• Extraocular muscle palsy
• Facial fracture
• Orbital emphysema
• Orbital hemorrhage
• Orbital herniation

Red Eye

Allergic keratoconjunctivitis

• Itching
• Papilla

Bacterial keratoconjunctivitis

• Discharge

Viral keratoconjunctivitis

• Infiltrates

• Follicles

Episcleritis

• Injection

Glaucoma

• Edema

Iritis

• Pain

Trauma

• History

Sector injection

• Contact lenses
• Episcleritis
• Graves disease
• Phlyctenular conjunctivitis
• Ptyrgium
• Inflamed pinguecula
• Subconjunctival hemorrhage
• Sentinel vessel with malignancy

Slowly progressive proptosis

• Carotid - cavernous fistula

• Cavernous hemangioma

• Craniofacial dystosis

• Orbital pseudotumor

• Thyroid

• Tumors

• Von Ricklinghausens

Sudden onset unilateral pain

• Abrasion
• Foreign body
• Iritis
• Recurrent corneal erosion (RCE)
• Retrobulbar neuritis
• Ulcer or infiltrate

Leukocoria

• Cataract
• Coats disease
• Endophthalmitis
• Medullated nerve fibers
• Panophthalmitis
• Retinoblastoma
• Toxoplasmosis
• Tuberculosis

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Last modified: May 1, 2006