1. Acute glaucoma (note, generally not observed in chronic glaucoma)
2. Iritis
3. Corneal inflammation
4. Episcleritis
5. Conjunctivitis
6. Stye
7. Blepheritis

1. Conjunctivitis
2. Subjunctival hemorrhage
3. Corneal injury/infection
4. Acute iritis
5. Glaucoma

1. Obstruction of lacrimal duct (neonates)
2. Conjunctivitis (watery, mucoid, or mucopurulent)
3. Corneal injury/inflammation (watery or purulent)
4. Contact lens related infection

1. Glaucoma
2. Cataracts
3. Vascular pathology (GCA, carotid artery plaque, DM, HTN)
4. Macular degeneration
5. Previous medical procedures (e.g. cataract surgery)

Raised, yellowish  plaques. May accompany lipid disorders.

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Harmless yellowish triangular nodule in bulbar conjuntiva. Appears with aging.

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A triangular thickening of bulbar conjunctiva that grows slowly. May interfere with vision as it encroaches on pupil. Wing-like (think pterydactyl)

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Inward turning of lid margin. Presents as "sticky eyelids every morning... hard to open up... crusting on the eyelids."

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Lower lid turned outward, exposes palpebral conjunctiva. Tearing occurs. Common in elderly.

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Conjunctivitis

• No change in vision
• If infection = discharge in the eye
  
  • watery if viral
  • White mucopurulent/mucoid if bacterial
• Allergic conjunctivitis
• Diffusely injected

Subconjunctival hemorrhage

Benign condition, typically. Can be due to lifting, valsalva maneuver, cough, etc. No pain, loss of vision, discharge.

Stye (hordeolum)

Red localized lesion, painful. Due to infection at the margin of eyelid. No change in vision.

Blepharitis

Infection of the lids (commonly due to Staph). Morning crusting foreign bodies. Itchy eyelids. More common in women due to eye makeup.

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Episcleritis

• Superficial inflammation of the outer covering of the eye.
• Considered benign.
•  Presents with tearing, minor discomfort and redness (localized or diffuse).
• Can typically be distinguished from conjunctivitis by its lack of discharge or chemosis, unilateral nature
• Common in patients with allergies.

Iritis

Inflammation of the anterior part of the uveal tract

Presents with redness, small pupil and PHOTOPHOBIA

Also, decreased vision and moderate, aching pain

Cataract

• Opacity in lens of eye
• Leading cause of reversible blindness
• Decreased vision, glare, inability to see with glasses, NO PAIN
• Cloudiness in pupillary area, no red reflex (if severe), no view of fundus at times

Optic neuopathy (disease of optic nerve). Can be due to increased intraocular pressure, although 30% of patients with disease are at normal pressure.

No symptoms in chronic glaucoma. Acute glaucoma presents with severe pain, decreased vision, cloudy cornea.

In closed angle glaucoma (acute), the pupil is fixed mid-dilated, unreactive to light. Typically red-eye, and high pressure (60-70)

Glaucoma

Marked by large "cupping" due to increased pressure and atrophy. The base of cup is pale.

Various diabetic retinopathies

Present with loss of vision. High comorbidity with nephropathy

• Left: nonproliferative retinopathy. Tiny red dots are microaneurysms, white spots are hard exudates, which can affect vision if they extend into macula
• Upper right: proliferative, with neovasculature arising from disc
• Bottom right: proliferative, advanced. Fibrous proliferation, distortion of macula

Hypertensive retinopathy

Punctate exudates are visible (yellow spots). Typically occurs with papilledema (engorged veins)

•           Arteriolar narrowing
•           AV crossing changes
•           Flame hemorrhages
•           Microaneurysms
•           Optic nerve swelling if severe

Papilledema

Venous stasis leads to enrgorgement and swelling. Fundus is pink, hyperemic. Disc vessels are more visible, more numerous. Disc swollen with margins blurred, no physiological cup

Swelling in optic nerve secondary to increase in intracranial pressure. Typically occurs in young patients, female. Present with blurred vision and headache

Central retinal vein occlusion

Sudden painless decrease in vision. Typically seen in diabetics and hypertensives.

"Pizza pie fundus"

In young patients, can be insidious underlying cause (e.g. tumor)

Central retinal artery occlusion

Note pallor of retina and cherry red spot.

Sudden, complete loss of vision and abnormal Marcus-Gunn pupil (afferent pupillary defect)