What are the causes of acute red eye?
Uveitis Conjunctivitis Scleritis Acute glaucoma Keratitis Corneal ulcer Orbital cellulitis
What is uveitis?
Inflammation of the eye
What ae the causes of uveitis?
Idiopathic
Systemic disease
Infection
Cancer
What systemic diseases are associated with uveitis?
Ankylosing spondylitis Behcet's disease Sarcoidosis egener's Lupus
What infections are associated with uveitis?
TB Syphilis Toxoplasma Hepres simples Lyme's
What is the treatment for uveitis?
Treat infection
Topical antiinflammatories
Systemic steroids
Systemic immunosuppressants
What are the symptoms of acute angle glaucoma?
Severe pain
Vomiting
Fixed dilated pupil
What are the symptoms of orbital cellulitis?
Pain, redness, lid swelling, systemically unwell
Double, blurred vision
Exophthalamus
What are the causes of orbital cellulitis?
Sinusitis
Dental infections
Haematological spread
What systemic diseases can have ophthalmic presentations?
Diabetes Hypertension Rheumatoid arthritis Grave's Sarcoidosis Crohn's Infection Haematological Albinism Marfan's Thyroid eye disease
What are the types of adnexal tumours?
Eyelid
Lacrimal drainage
Orbital
What are the types of benign eyelid tumours?
Squamous cell papilloma Basal cell papilloma Melanocytic naevus Actinic keratosis Pyogenic granuloma Keratoacanthoma Capillary haemangioma Cavernous haemangioma
What is the appearance and cause of a squamous cell papilloma?
Pedunculated, raspberry texture
Viral
How is a squamous cell papilloma treated?
Excision or laser ablation
What is the appearance of a basal cell papilloma?
Greasy, brown, flat
Oval or round
How is a basal cell papilloma treated?
Excision
What must be watched for with melanocytes naves?
Malignant transformation
What is the appearance and cause of actinic keratosis?
Flat hyperkeratosed skin
Sun exposure
What is the treatment of actinic keratosis?
Excision
Medical treatment
What is a pyogenic granuloma?
Fast growing, highly vascularised granuloma
How is a pyrogenous granuloma treated?
Excision
What is a keratoacanthoma and what is the appearance?
Squamous cell carcinoma in situ
Pink papule, hyperkeratotic crater
How is a keratoacanthoma treated?
Excision
Where do capillary haemangiomas normally occur?
Upper eyelid, with to without orbital extension
What is the treatment of a capillary haemangioma?
Beta blockers
Intralesion steroid
Surgery
What is a cavernous haemangioma?
Well demarcated pink patch that darken with age
How is a cavernous haemangioma treated?
Laser
What are the types of malignant adnexal tumours?
Basal cell carcinoma Squamous cell carcinoma Sebaceous gland carcinoma Melanoma Kaposi sarcoma Marcela cell carcinoma
What is a basal cell carcinoma?
Slow, inexorable growth over months
Usually non pigmented, but elevated and ulcerated with a pearly rolled irregular border
What are the subtypes of basal cell carcinoma?
Nodular
Ulcerative
Morphaeform/ilfiltrative
What is a modular basal cell carcinoma?
Common classic firm pearly nodule
What is an ulcerative basal cell carcinoma?
Common
Cyles of crusting and bleeding
May progress from nodular basal cell carcinoma
What is a morphaaeform/ilfiltrative basal cell carcinoma?
Less common
Indurated plaques
What is the management of a basal cell carcinoma?
Excision with 3mm margin
Chemo, cryotherapy, radiotherapy, photodynamic therapy
What increases the likelihood of squamous cell carcinoma?
Sun damaged skin
Existing actinic keratosis
What is a squamous cell carcinoma?
Scaly surface over thick plaque
Develops over weeks
What is the management of a squamous cell carcinoma?
Excision with 4mm margin
What is a sebaceous gland carcinoma?
Nodular indurated lid margin with yellowish discolouration
What is the management of sebaceous gland carcinoma?
Excision with 5-10mm margin
What are the 3 types of melanoma?
Letting maligna
Superficial spread
Nodular
What is a letting maligna?
Flat variably pigmented macule
What is superficial spread of melanoma?
Slightly raised pigmented plaque
How is a melanoma managed?
Excision with 10-30mm margin
What are the types of benign orbital tumour?
Capillary haemangioma
Cavernous haemangioma
Pleimorphic adenoma
Optic nerve glioma
What are the types of malignancy orbital tumour?
Lymphoma Metastasis Phabdomyosarcoma Lacrimal gland sarcoma Osterosarcoma Primary melanoma