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Opthamology > Acute Red Eye > Flashcards

Acute Red Eye Flashcards

1
Q

What is the most common cause of red eye?

A

conjunctivits

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2
Q

In who is conjuctivitis more serious?

A

contact lens wearers

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3
Q

Should you give antibiotics to patients with conjunctivitis?

A

No - unless chlamydia

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4
Q

Is a Subconjunctival haemorrhage very serious?

A

No - benign

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5
Q

Is orbital cellulitis a serious cause of red eye?

A

yes

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6
Q

What is anterior blepharitis?

A

inflamed eyelids where lid margin redder than deeper part of lid

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7
Q

What is posterior blepharitis?

A

inflamed eyelids where redness is in deeper part of lid

lid margin often quite normal looking

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8
Q

What causes posterior blepharitis?

A

Meibomian gland dysfunction

M.G.D.

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9
Q

What causes anterior blepharitis?

A

Seborrhoeic (squamous) scales on the lashes

Staphylococcal – infection involving the lash follicle

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10
Q

What are signs of seborrhoeic blepharitis?

A

Lid margin red
Scales ++
Dandruff+
(No ulceration, lashes unaffected)

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11
Q

What are signs of staphylococcal blepharitis?

A

lid margin red
Lashes distorted, loss of lashes, ingrowing lashes - trichiasis
Styes, ulcers of lid margin
corneal staining, marginal ulcers (due to exotoxin)

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12
Q

What is MGD associated with?

A

Acne Rosacea

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13
Q

What are the signs of posterior blepharitis (MGD)?

A

Lid margin skin and lashes unaffected
M.G. openings pouting & swollen
Inspissated (dried) secretion at gland openings
Meibomian Cysts (chalazia)

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14
Q

Describe the treatment for blepharitis.

A

Lid hygiene – daily bathing / warm compresses
Supplementary tear drops
Oral doxycycline for 2-3 months
Very difficult to eradicate

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15
Q

List the main symptoms of conjunctivitis.

A

red eye
foreign body sensation – gritty eye
discharge – sticky eye
Itch = allergy

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16
Q

Is vision affected in conjunctivitis?

A

no

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17
Q

What is the pattern of red eye like in conjunctivitis?

A

diffuses more towards the fornices

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18
Q

Which organisms most commonly cause bacterial conjunctivitis?

A

Staph. aureus, Str. pneumoniae, H. infuenzae

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19
Q

Give examples of drugs which can lead to conjunctivitis.

A

propine, trusopt

20
Q

Which viruses can cause conjunctivitis?

A

adenovirus, herpes simplex, herpes zoster

21
Q

What is chemosis?

A

conjunctival oedema

22
Q

What are the layers of the cornea?

A

Epithelium
Stroma
Endothelium

23
Q

What is keratitis?

A

inflammation of cornea

24
Q

What are the bacterial causes of keratitis?

A

Viral
Fungal
Bacterial
Acanthamoeba

25
Q

What are the autoimmune causes of keratitis?

A

rheumatoid arthritis
hypersensitivity e.g. marginal ulcers

(+ rarely Wegener’s granulomatosis, polyarteritis etc)

26
Q

What are the symptoms of a corneal ulcer?

A 
needle like severe pain
Photophobia
Profuse lacrimation
Vision may be reduced
Red eye - circumcorneal
27
Q

What are the signs of a corneal ulcer?

A 
Redness – circumcorneal
Corneal reflex (reflection abnormal)
Corneal opacity
Staining with fluorescein
hypopyon
28
Q

What is a hypopyon?

A

inflammatory (WBCs) in anterior chamber of eye

29
Q

What is the difference between uveitis and iritis?

A

Nothing - they are the same thing

30
Q

What classic pattern is seen in herpes simplex eye infection?

A

dendritic ulcer (green spidery shape)

31
Q

Who may get corneal ulcers due to Vit A deficiency?

A

autistic patients - refusing to eat groups of food

32
Q

What is the treatment for a corneal ulcer?

A

Identify cause – ‘corneal scrape’
Antimicrobial if bacterial infection (ofloxacin)
Antiviral if herpetic - Aciclovir
Anti-inflammatory if autoimmune (Oral / topical steroids)

33
Q

What are the autoimmune causes of uveitis?

A

Reiter’s, Ulcerative colitis, Ank Spondylitis, Sarcoidosis

34
Q

What are the infective causes of uveitis?

A

T.B. Syphylis, Herpes simplex, Herpes zoster

35
Q

What are the symptoms of uveitis?

A

Pain (+ referred pain)
Vision may be reduced
Photophobia
Red eye (circumcorneal)

36
Q

Give the signs of uveitis.

A 
Ciliary injection (i.e. circum-corneal )
Cells & flare in anterior chamber
Keratic precipitates
Hypopyon
Synechiae
Small/irregular pupils
37
Q

What is the treatment for uveitis?

A

Topical steroids - Pred Forte 1% Hourly tapering over 4-8 weeks
Mydriatics eg Cyclopentolate 1% BD
(Also investigate for systemic associations if recurrent or chronic)

38
Q

What is Episcleritis associated with?

A

gout

39
Q

Does Episcleritis have serious complications?

A

No

40
Q

Is scleritis painful?

A

Yes

41
Q

What may be seen in scleritis?

A

Injection of deep vascular plexus – ‘violaceous hue’

42
Q

What is the treatment for scleritis?

A

Oral NSAIDs
Oral Steroids
Steroid Sparing Agents

43
Q

Who are likely to get an open angle closure glaucoma?

A

Long sighted old people

44
Q

What are signs of glaucoma?

A

Circumcorneal injection
Cornea cloudy (oedematous)
Pupil mid dilated
Eye stony hard

45
Q

Symptoms of glaucoma?

A

severe pain

nausea

Opthamology (22 decks)

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