Red Eye

Question 1

List the main conditions that cause a red eye

Answer 1

Conjunctivitis
Keratitis
Anterior uveitis
Scleritis
Acute closed-angle glaucoma
Haemorrhage
Orbital cellulitis

Question 2

What is blepharitis?

Answer 2

Inflamed eyelids

Question 3

List the two main causes of anterior blepharitis

Answer 3

Seborrheic scales on lashes

Staphylococcal infection involving lash follicle

Question 4

List the main cause of posterior blepharitis

Answer 4

Meibomian (tarsal) gland dysfunction

Question 5

How do the appearances of anterior + posterior blepharitis differ?

Answer 5

Anterior: red lid margin
Posterior: red in deep part of lid

Question 6

List signs of seborrheic anterior blepharitis

Answer 6

Red lid margin
Scales
Dandruff
Seborrheic dermatitis

Question 7

List signs of Staphyloccoal anterior blepharitis

Answer 7

Red lid margin
Distorted/loss of lashes
Styes, ulcers
Corneal staining

Question 8

List signs of posterior blepharitis (Meibomian gland dysfunction)

Answer 8

Normal lid margin + skin
Swelling
Dried secretions
Chalazia (Meibomian cyst)
Acne rosacea

Question 9

Meibomian cysts can induce astigmatism. True/False?

Answer 9

True

Question 10

Outline treatment of blepharitis

Answer 10

Lid hygiene (bathing, warm massage)
Supplementary teardrops
Oral doxycycline for 2-3 months

Question 11

List clinical features of conjunctivitis

Answer 11

Red, gritty eye
Discharge
Itch
Papillae or follicles
Chemosis (oedema)

Question 12

What are papillae and which type of conjunctivitis are they seen in?

Answer 12

Tiny bubble-wrap-like lumps with central red dot

Bacterial conjunctivitis

Question 13

What are follicles and which type of conjunctivitis are they seen in?

Answer 13

Diffuse redness with grainy rice-like aggregations

Viral/chlamydial conjunctivitis

Question 14

Vision is usually unaffected in conjunctivitis. True/False?

Answer 14

True

Question 15

Watery discharge is associated with bacterial/viral conjunctivitis and sticky discharge is associated with bacterial/viral discharge

Answer 15

Watery discharge is associated with viral conjunctivitis and sticky discharge is associated with bacterial conjunctivitis

Question 16

Acute bacterial conjunctivitis does not require treatment. True/False?

Answer 16

True

Usually self-limiting and resolves within 14 days, but can use antibiotic to speed up recovery

Question 17

Describe the pattern of disease symptoms in bacterial conjunctivitis

Answer 17

Symptoms begin in one eye but spread to both

Question 18

What is the 1st line antibiotic treatment for bacterial conjunctivitis?

Answer 18

Chloramphenicol eye drops

Question 19

What are Acanthamoeba corneal ulcers associated with?

Answer 19

Contact lenses

Question 20

List clinical features of corneal ulcers

Answer 20

Severe needle-like pain
Photophobia
Profuse watering
Circumcorneal redness
Hypopyon

Question 21

How does exposure keratitis arise?

Answer 21

Dryness of cornea e.g. thyroid, VII palsy

Question 22

Which disease is keratoconjunctivitis sicca associated with?

Answer 22

Sjogren’s disease

Question 23

Deficiency in which vitamin can lead to dry eyes?

Answer 23

Vitamin A

Question 24

How are corneal ulcers treated?

Answer 24

Identify cause with corneal scrape + Gram stain
Antimicrobial if bacterial (ofloxacin)
Antiviral if herpetic (acyclovir)
Anti-inflammatory if autoimmune

Question 25

Anterior uveitis is synonymous with the term iritis. True/False?

Answer 25

True | Essentially inflammation of anterior chamber of the eye

Question 26

List clinical features of anterior uveitis

Answer 26

``` Pain Vision may be reduced Photophobia Circumcorneal red eye Ciliary injections Hypopyon ```

Question 27

Outline management of anterior uveitis

Answer 27

Topical steroids Mydriatics Antimicrobial if infection

Question 28

Which conditions are associated with episcleritis?

Answer 28

Gout | IBD

Question 29

Where does inflammation occur in episcleritis?

Answer 29

Between conjunctiva and sclera

Question 30

Scleritis is much more serious than episcleritis - list clinical features

Answer 30

Severe eye pain with radiation Violaceous hue - injection of deep vascular plexus Tender globe Assoc. uveitis

Question 31

What is a diagnostic test for scleritis?

Answer 31

Phenylephrine drops - constricts blood vessels

Question 32

Outline treatment of episcleritis

Answer 32

Usually self-limiting Lubricants Topical NSAID Mild steroid

Question 33

Outline treatment of scleritis

Answer 33

Oral NSAID | Oral steroid

Question 34

``` Hyperaemia is present in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 34

``` Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Question 35

``` Discharge is present in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 35

Conjunctivitis | Uveitis (minimal)

Question 36

``` The pupil is affected in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 36

Uveitis (constricted) | Glaucoma (moderate dilation)

Question 37

``` Vision is affected in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 37

Keratosis Uveitis Glaucoma Scleritis (maybe)

Question 38

``` There is pain in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 38

Keratosis Uveitis Glaucoma Scleritis

Question 39

``` The cornea is hazy in (select all that apply): Conjunctivitis Subconjunctival haemorrhage Keratosis Uveitis Glaucoma Scleritis ```

Answer 39

Keratosis Uveitis (maybe) Glaucoma Scleritis