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Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor UCSF Department of Ophthalmology UCSF Family Medicine Board Review March 7, 2017 http://www.timandjeni.com/images/cookiemonster.jpg

Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

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Page 1: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Common Eye Conditions Every Primary Care

Clinician Should Know

Cynthia S. Chiu, MD, FACS Professor

UCSF Department of Ophthalmology

UCSF Family Medicine Board Review March 7, 2017

http://www.timandjeni.com/images/cookiemonster.jpg

Page 2: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Disclosure

I have no financial interest in any of the products mentioned in this presentation

Page 3: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

The Eye Exam

Eye Vital Sign Near Vision Card Held at 14 inches Glasses as needed

http://www.drbanker.com/images/Nearvision.gif

Page 4: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Pupils

Look for afferent pupillary defect

Swinging flashlight test

+APD indicates optic nerve or large retinal lesion

http://img.tfd.com/ElMill/thumb/F0P-24-S2958.jpg

Page 5: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Motility

Six extraocular muscles

Test cardinal fields of gaze

http://www.opsweb.org/OpPhoto/Extern/Motility/muscle.jpg http://www.opsweb.org/OpPhoto/Extern/Motility/9gazedwg.jpg

Page 6: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Confrontational Visual Fields

Cover eyes on same side

Hold fingers midway between

Normal per eye: 60-60-60-90

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A3460&rendertype=figure&id=A3464

Page 7: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Penlight Exam

http://cache.heraldinteractive.com/blogs/sports/rap_sheet/wp-content/uploads/2009/11/bionic-eye.jpg

Lids

Lashes Conjunctiva/Sclera

Cornea

Iris/Pupil

Lens Puncta

Page 8: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Anterior Chamber Depth

Deep chamber: illumination of nasal iris Shallow chamber: shadow on nasal iris Dilation: Phenylephrine 2.5%, Tropicamide 1%

http://www.ophthobook.com/wp-content/uploads/2007/12/video-glaucoma-shallowpenlight.jpg http://iei.ico.edu/images/anatomy.jpg

Page 9: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Fundoscopy

PanOptic or Direct Ophthalmoscope Evaluate optic nerve, retinal vessels, macula

http://www.welchallyn.com/images/corporate/0509_wa_bmurf/011810xx1PanOpticRedHe.jpg http://webvision.med.utah.edu/imageswv/retina.jpeg

Page 10: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Primary Care Ophthalmology

http://www.factzoo.com/sites/all/img/reptiles/chameleon-eyes.jpg

Page 11: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

The Red Eye

http://i.zdnet.com/blogs/lord-of-the-rings-ii-eye-of-sauron-4900244.jpg

Page 12: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Infectious Conjunctivitis

VIRAL: Clear/mucoid discharge Lymphadenopathy Contagious! Treat for comfort

BACTERIAL: Purulent discharge Culture: Staph, Strep, Hflu

– PolyTrim or Vigamox – NOT Tobra or Gent

GC, chlamydia (IM/PO)

Page 13: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Allergic Conjunctivitis

History of atopy Conjunctival edema Itchy!

Topical antihistamines

– Zaditor – Patanol/Pataday/Pazeo

Visine tachyphylaxis

Page 14: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Blepharitis

Redness, itching, “grit”, dry eyes Rosacea, Staph, Demadex Warm compresses, baby shampoo, artificial tears Doxycycline, Azithromycin

http://www.stop-rosacea.com/

Page 15: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Dry Eye Syndrome

Burning, stinging, excess tearing (wind or cold) Blurry vision that improves with blinking Artificial tears, immunologics (Restasis, Xiidra)

http://steptohealth.com/wp-content/uploads/2015/07/dry-eye.png

Page 16: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Herpes Simplex

When to refer: V1, V2 red eye eye pain change in vision Acyclovir

Page 17: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Herpes Zoster

Hutchinson’s sign: nasociliary nerve Treat Post-Herpetic Neuralgia: Lyrica, Neurontin, TCA’s

Page 18: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Uveitis

Inflammation of vascular tissue

Auto-immune Infectious Toxic Masquerade

May require

immunosuppression

Page 19: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Angle Closure Glaucoma

Headache Loss of vision Firm eye

IV Diamox, Mannitol Glaucoma gtt’s Surgical treatment

Page 20: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Subconjunctival Hemorrhage

Coughing/sneezing, HTN, anti-coagulation, eye rubbing, spontaneous

Not dangerous unless vision has changed In the setting of trauma: refer

http://sixfishes.com/_cache/assets/img/441-r-w320-q75-m1445457194.jpg

Page 21: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Corneal Abrasion

Pain! Loss of epithelium Not infected

Erythromycin ung PolyTrim gtt Artificial Tears Patching

Page 22: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Corneal Foreign Body

Iron is toxic Surgical treatment

Page 23: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Hyphema

Severe eye trauma Risk of rebleed Risk of glaucoma

Page 24: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Ruptured Globe

Peaked pupil Brown tissue

outside the eye CT scan NOT MRI Fox shield, NPO

Page 25: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Common Diseases of Aging

http://www.jaredyellin.com/wp-content/uploads/2009/12/old-man-winking1.jpg

Page 26: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Cataract

Painless progressive loss of vision with age Also caused by DM, XRT, trauma, medications Difficulty reading, driving, glare Outpatient surgery

Page 27: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Glaucoma

Chronic progressive optic neuropathy Loss of visual field Risk factors: age, tobacco, race, family hx Medications may have systemic interactions

http://img.medscape.com/fullsize/migrated/569/545/569545.fig2.gif http://cdn.shopmedvet.com/images/uploads/2640_7780_thumb.jpg

Page 28: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Macular Degeneration

Risk factors: age, UV, tobacco, Family Hx Loss of central vision Dry form: AREDS vitamins, stop smoking Wet form: anti-VEGF injections

Page 29: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Disorders of the Eyelid and Orbit

http://greatpiercingshop.com/blog/wp-content/uploads/2009/12/eyelid-piercing-method-and-aftercare_49.jpg

Page 30: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Ptosis

Loosening of eyelid muscle, extra skin Surgical repair

http://www.drduerksen.com/public/images/gallery/1366466717-1366466717-111052-(Small).jpg

Page 31: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Trichiasis

Eyelash growing inward toward the eye

Epilation Electrolysis

http://healthfixit.com/wp-content/uploads/2016/01/Trichiasis-or-Ingrown-Eyelash-1.jpg

Page 32: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Ectropion/Entropion

Ectropion: rotation of eyelid outward Entropion: rotation of eyelid inward Irritation of the ocular surface Surgical repair

http://www.shropshireeyecare.co.uk/sites/default/files/Bilateral%20LL%20ectropion_2_0.jpeg http://www.lancashireeyeclinic.co.uk/wp-content/uploads/2014/09/lower-lid-entropion-6.jpg

Page 33: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Chalazion

Blocked oil gland Inflammation

Warm compresses Incision/curettage

Page 34: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Cellulitis

Preseptal vs Orbital

Preseptal: full EOM, no proptosis, quiet eye Treat PO Abx

Orbital: proptosis,

strabismus, inflamed eye Treat IV ABx

Page 35: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Thyroid Orbitopathy

Proptosis Strabismus/Diplopia Corneal exposure Optic nerve

compression

131-I may aggravate Surgical treatment

Page 36: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Disorders of the Retina

http://webphysics.davidson.edu/faculty/dmb/EdibleOpticalMaterials/index_files/cyclops.jpg

Page 37: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Posterior Vitreous Detachment

Separation of vitreous from optic nerve and retina Sudden appearance of floaters (ring/lines) Small risk of retinal tear when first occurs,

otherwise benign

http://www.retinacarecenternj.com/images/p-pvd_diagram_100.jpg http://theretinagroup.com/wp-content/uploads/2015/06/Screen-Shot-2015-06-14-at-8.08.41-PM.png

Page 38: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Retinal Detachment

Flashes/Floaters Loss of vision/field Sudden, painless

Surgical treatment

http://www.rameshshahmd.com/pictures/retinal%20detach.%201.jpg?nxg_versionuid=published

Page 39: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Diabetic Retinopathy Microvascular disease Bleeding Macular edema Neovascularization

Glucose/BP control Laser ablation Anti-VEGF

Page 40: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Hypertensive Retinopathy

Mild: arteriolar narrowing Mod: cotton wool spots,

hemorrhages Severe: disc edema,

vessel leakage, infarcts

Page 41: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

HIV/CMV Retinopathy

Microvascular disease

Annual exam if CD4>200

CMV retinitis

http://depts.washington.edu/hivaids/images/oit/oit_c7_d06.jpg

Page 42: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Retinal Artery Occlusion

Embolic: cardiac echo, carotid doppler

Vasculitic (GCA)

Page 43: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Retinal Vein Occlusion

HTN/hyperlipidemia Glaucoma Young patients:

hypercoagulable

Page 44: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Neuro-Ophthalmology

http://www.capitalgainsmedia.com/images/Development%20News%20Photos/Dev-Ino-Issues%2002/Dev-Ino%20Issue%200244/DSC01869.jpg

Page 45: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Stroke

Homonymous field defect

Location of lesion is contralateral + upside-down

Page 46: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Pituitary Adenoma

Compression of nasal fibers at optic chiasm

Bitemporal hemianopia

http://www.lfhk.cuni.cz/patfyz/intranet/Figures/58/18.13.jpg

Page 47: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Temporal Arteritis

Acute vision loss

Headache, jaw claudication, scalp tenderness, proximal myalgias, constitutional symptoms

ESR and CRP Prednisone 100mg QD Temporal artery biopsy

Page 48: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Optic Neuritis

Loss of vision Pain with EOM +/- disc edema

Multiple Sclerosis Steroids

http://www.djo.harvard.edu/files/2982_355.jpg

Page 49: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Pseudotumor Cerebri

Headache, tinnitus Papilledema Vision loss

Female, overweight Medication-induced

LP: opening pressure

http://www.caleyes.com/images/papilledema-image.jpg

Page 50: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Horner Syndrome

Anisocoria in the dark Mild ptosis Acute and painful: R/O carotid dissection

http://www.mrcophth.com/oculoplasticgallery/traumatichorner/horner.jpg

Page 51: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Third Nerve Palsy

Aniscoria in the light

Severe Ptosis EOM paresis Microvascular PCA/PCom aneurysm

http://www.nature.com/eye/journal/v18/n3/images/6700625f1.jpg http://www.revophth.com/Images//2008/10/083_RPJ8_F6.gif

Page 52: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

Thank You!

http://blog.omy.sg/dingan/files/2009/05/bob.jpg

Page 53: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

References http://www.drgreene.com/21_1254.html http://www.bobzyeruncle.com/archives/images/conjunctivitis-GC.html http://www.ueseyecare.com/images/photos/allergic_conjunctivitis_l.jpg http://www.ueseyecare.com/images/photos/viral_conjunctivitis_l.jpg http://www.vigamox.com/images/packaging.jpg http://dro.hs.columbia.edu/ced3/conjhemb.jpg http://www.aafp.org/afp/20030401/1481_f3.jpg http://eyemicrobiology.upmc.com/Images/Sub/PhotoEyeDendrite.jpg http://www.hkmj.org.hk/skin/images/108-1.jpg http://www.medicalskincare.be/images/content/herpes03.jpg http://www.tusalud.com.mx/images/herpes_zoster.jpg http://eyelearn.med.utoronto.ca/Lectures04-05/RedEye/images/11Kera2.jpg http://www.nova.edu/~albert/ScleritisWeb.jpg http://www.mrcophth.com/externaleyediseases/sp.JPG http://e-learning.studmed.unibe.ch/augenheilkunde/systematik/aderhaut/images/iritis2.jpg http://www.emedicine.com/oph/images/456cmv7.jpg http://www.revoptom.com/handbook/images/62a.jpg http://images.google.com/imgres?imgurl=http://www.asoprs.org/Graphics/gravesct.jpg&imgrefurl=http://www.asoprs.org/Pages/thyroid.html&h=250&w=

429&sz=9&tbnid=ul6zL-4JdFYJ:&tbnh=71&tbnw=122&start=1&prev=/images%3Fq%3Dthyroid%2Beye%2Bmuscles%26hl%3Den%26lr%3D http://www.medscape.com/content/2002/00/44/63/446304/art-mop446304.coat.fig3.jpg http://www.jeremydiamond.co.uk/graphics/cataract_eye.jpg http://technology.kingston.ac.uk/dirc/medical/images/catara2.jpg http://www.drloden.com/Pages/Pics/cataract.gif http://www.eri.harvard.edu/faculty/peli/Opthalm_Mngt_0803_files/xNat.beauty.jpg http://www.avclinic.com/images/tonometry.jpg http://www.avclinic.com/Glaucoma.htm http://www.lasikinstitute.org/Glaucoma_whatis.html http://www.neec.com/images/photos/mitrev5.jpg http://www.rvscny.com/images/Diabetic%20retinopathy.jpg http://www.tedmontgomery.com/the_eye/eyephotos/pics/DiabeticRetinopathyProliferative.jpg http://www.neec.com/images/photos/diabetic%20retinopathy%20figure%203.jpg

http://www.drgreene.com/21_1254.html
http://www.bobzyeruncle.com/archives/images/conjunctivitis-GC.html
http://www.ueseyecare.com/images/photos/allergic_conjunctivitis_l.jpg
http://www.ueseyecare.com/images/photos/viral_conjunctivitis_l.jpg
http://www.vigamox.com/images/packaging.jpg
http://dro.hs.columbia.edu/ced3/conjhemb.jpg
http://www.aafp.org/afp/20030401/1481_f3.jpg
http://eyemicrobiology.upmc.com/Images/Sub/PhotoEyeDendrite.jpg
http://www.hkmj.org.hk/skin/images/108-1.jpg
http://www.medicalskincare.be/images/content/herpes03.jpg
http://www.tusalud.com.mx/images/herpes_zoster.jpg
http://eyelearn.med.utoronto.ca/Lectures04-05/RedEye/images/11Kera2.jpg
http://www.nova.edu/%7Ealbert/ScleritisWeb.jpg
http://www.mrcophth.com/externaleyediseases/sp.JPG
http://e-learning.studmed.unibe.ch/augenheilkunde/systematik/aderhaut/images/iritis2.jpg
http://www.emedicine.com/oph/images/456cmv7.jpg
http://www.revoptom.com/handbook/images/62a.jpg
http://www.medscape.com/content/2002/00/44/63/446304/art-mop446304.coat.fig3.jpg
http://www.jeremydiamond.co.uk/graphics/cataract_eye.jpg
http://technology.kingston.ac.uk/dirc/medical/images/catara2.jpg
http://www.drloden.com/Pages/Pics/cataract.gif
http://www.eri.harvard.edu/faculty/peli/Opthalm_Mngt_0803_files/xNat.beauty.jpg
http://www.avclinic.com/images/tonometry.jpg
http://www.avclinic.com/Glaucoma.htm
http://www.lasikinstitute.org/Glaucoma_whatis.html
http://www.neec.com/images/photos/mitrev5.jpg
http://www.rvscny.com/images/Diabetic%20retinopathy.jpg
http://www.tedmontgomery.com/the_eye/eyephotos/pics/DiabeticRetinopathyProliferative.jpg
http://www.neec.com/images/photos/diabetic%20retinopathy%20figure%203.jpg
Page 54: Common Eye Conditions Every Primary Care Clinician Should Kno€¦ · Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor . UCSF Department

References http://www.gaileyeyeclinic.com/images/dr3.gif http://www.foxeyecare.com/canon/large/diabetic_retinopathy.jpg http://hubnet.buffalo.edu/ophthalmology/site/Home/Eye_Disorders/Hypertensive_retinopathy.jpg http://www.mrcophth.com/retinacases/CMV.gif http://www.opt.indiana.edu/ce/antseg/graphics/cwsaids.jpg http://www.ohiovalleyeye.com/images/macdegen_K45_dry.jpg http://www.opt.pacificu.edu/ce/catalog/10701-PS/4hemorr.jpg http://www.ttuhsc.edu/eye/Faculty%20Presentations/Visual%20Field%20Testing%20Tech%20Seminar_files/slide0036_image002.jpg http://webeye.ophth.uiowa.edu/dept/GCA/images/GCAfig1b_.jpg http://www.ophthalmic.hyperguides.com/tutorials/oculoplastics/temporal_arteritis/slides/Slide1.jpg http://www.mrcophth.com/pathology/gca2.jpg http://content.lib.utah.edu/EHSL-WFH/image/icon124.jpg http://www.atlasophthalmology.com/atlasimg/1396_6_low_thumb.jpg http://www.tedmontgomery.com/the_eye/eyephotos/pics/CentralRetinalArteryOcclusion.jpg http://www.omnieyespecialists.com/images/eye_brao.jpg http://dro.hs.columbia.edu/vr3/crvob.jpg http://www.scielo.br/img/revistas/abo/v66n6/18991f1.jpg http://www.drugdigest.org/images/pillimages/A0315100.JPG http://ec1.images-amazon.com/images/I/31ITYXvQYpL._AA200_.jpg http://www.aafa.org/images/eye.jpg http://www.aclens.com/accessoryphotos/visine-advanced-relief-eye-drops-15-6683-v3b.jpg http://content.answers.com/main/content/wp/en-commons/thumb/6/69/420px-Gray784.png http://eyelearn.med.utoronto.ca/Lectures02-03/RedEye/images/RedEye_033.jpg http://www.varga.org/corneal_foreign_body_2.jpg http://www.permanente.net/homepage/kaiser/pictures/7945.gif http://www.medscape.com/pi/editorial/conferences/2001/747/art-aad-02.fig1.jpg http://www.opt.pacificu.edu/ce/catalog/10310-SD/Trauma%20Pictures/Hyphema.jpg http://www.revoptom.com/handbook/images/25aa.jpg http://www.tedmontgomery.com/the_eye/eyephotos/pics/Chalazion.jpg http://medicine.ucsd.edu/clinicalimg/eye-periorbital-cellulitis1.jpg http://eyelearn.med.utoronto.ca/Lectures05-06/RedEye/images/RedEye_010.jpg

http://www.gaileyeyeclinic.com/images/dr3.gif
http://www.foxeyecare.com/canon/large/diabetic_retinopathy.jpg
http://hubnet.buffalo.edu/ophthalmology/site/Home/Eye_Disorders/Hypertensive_retinopathy.jpg
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http://www.opt.indiana.edu/ce/antseg/graphics/cwsaids.jpg
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http://www.mrcophth.com/pathology/gca2.jpg
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http://www.atlasophthalmology.com/atlasimg/1396_6_low_thumb.jpg
http://www.tedmontgomery.com/the_eye/eyephotos/pics/CentralRetinalArteryOcclusion.jpg
http://www.omnieyespecialists.com/images/eye_brao.jpg
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http://www.scielo.br/img/revistas/abo/v66n6/18991f1.jpg
http://www.drugdigest.org/images/pillimages/A0315100.JPG
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