The acute red eye Flashcards Preview

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Flashcards in The acute red eye Deck (22)
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1
Q

What part of the eye is most likely to be affected if the patient describes a scratchy/gritty discomfort?

A

External or surface problem such as conjuntivitis or a foreign body (examine the lids, conjuntiva and cornea)

2
Q

What part of the eye is likely to be affected if the patient describes a severe deep aching pain?

A

Intra ocular or orbital problem such as irits, scleritis or angle closure glaucoma

3
Q

If there is circumcorneal injection what does this mean?

A

Redness is greatest around the cornea indicating the problem is most likely to be intra ocular

4
Q

If the redness is greater in the fornices then what is this likely to indicate?

A

Surface infection or lid disease

5
Q

What does fluorescein dye and blue light show up?

A

Epithelial defect wil fluoresce

6
Q

List 8 potential causes of a red eye

A
Infection
1. Conjunctivitis 
2. Corneal Ulcers
Trauma
3. Corneal Foreign body 
4. Chemical injury 
Inflammatory 
5. Episcleritis
6. Scleritis
7. Iritis
Pressure
8. Acute angle closure glaucoma
7
Q

What do you use to treat bacterial conjunctivitis?

A

Chloramphenicol

8
Q

What do you do to treat viral conjunctivitis?

A

Supportive treatment: Cool compresses/lubricants

9
Q

What is the treatment for a bacterial corneal ulcer?

A

Topical ofloxacin hourly

10
Q

How do you treat a dendritic ulcer?

A

Topical aciclovir for 7 - 10 days

11
Q

What virus causes a dendritic ulcer?

A

Herpes simplex

12
Q

Is episcleritis or scleritis more likely to be associated with connective tissue disease?

A

Scleritis

13
Q

What is the treatment for scleritis?

A

NSAIDS
Systemic steroids
Immunosupression may be needed if there is necrosis

14
Q

How can you tell the diffeence between episcleritis and scleritis?

A
  1. Pain is worse with scleritis

2. Scleritis does not blanch with topical phenylephrine but episcleritis does.

15
Q

What kind of conditions is anterior uveitis associated with?

A

HLA B27 linked conditions such as ankylosing spondylitis/IBD/Psoriatic arthtisis

16
Q

What are the symptoms of anterior uveitis?

A

Ache
Photophobia
Lacrimation
Blurred vision

17
Q

What are the signs you see in a patient with anterior uveitis?

A

Circumcorneal redness
Cells in anterior chamber
Hypopyon
Posterior synechiae

18
Q

What is the treatment for anterior uveitis?

A

Topical steroids hourly with tapering down

Pupil dilating agent (mydratic) such as cyclopentolate

19
Q

Give three topical mydratics and the difference between them?

A
  1. Tropicomide (quick half life)
  2. Cyclopentolate (Medium half life)
  3. Atropine (long half life)
20
Q

Unilateral painful red eye with severe loss of vision, a hazy cornea and a fixed, mid dilated pupil.

A

Acute angle closure glaucoma

21
Q

What is the immediate treatment for acute closed angle glaucoma?

A

IV Diamox (Acetazolamide)
Topical beta blockers
Topical steroids
Pilocarpine (Once IOP is less than 50mmHg)

22
Q

Give a surgical option for acute angle closure glaucoma?

A

YAG laser peripheral iridotomy which creates a alternative flow pathway for aqueous and reduces risk of recurrence