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Ophthalmology > 2: Keratitis > Flashcards

2: Keratitis Flashcards

1
Q

What is keratitis also known as

A

Corneal ulcer

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2
Q

What is keratitis

A

Inflammation of the cornea

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3
Q

What is the cornea

A

Transparent structure covers iris and pupil

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4
Q

What is trauma (scratch) to the cornea called

A

Corneal abrasion (Not a corneal ulcer)

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5
Q

What is the most common cause of keratitis

A

Bacterial (80%)

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6
Q

What bacterial organisms cause keratitis

A

More commonly gram negative

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7
Q

What viral organisms cause keratitis

A

HSV1

VZV

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8
Q

What are 3 risk factors for bacterial keratitis

A

Contact lenses
Recent eye surgery
Immunodeficiency

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9
Q

What are 5 symptoms of bacterial keratitis

A 
Red-eye
Purulent discharge 
Hypophyon 
Severe eye pain 
Photophobia 
Vision can be affected
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10
Q

What is a hypophyon

A

Collection of pus behind the cornea

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11
Q

Is viral conjunctivitis unilateral or bilateral

A

bilateral

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12
Q

How does viral keratitis present

A 
Unilateral 
Red-eye 
Severe eye pain 
Photophobia 
Blurry vision
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13
Q

What is first-line investigation for keratitis

A

Slit lamp with fluroscein

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14
Q

In bacterial keratitis what will be seen on slit lamp with fluroscein

A

Round corneal ulcers

Hypophyon

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15
Q

How will HSV keratitis present on slit lamp with fluroroscein

A

Dendritic ulcers (superficial corneal ulcers)

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16
Q

What do dendritic ulcers indicate

A

Virus is replicating

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17
Q

What is performed on dendritic ulcers

A

Direct fluorescien antibody test or PCR

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18
Q

How soon should individuals with keratitis be referred to opthalmology

A

Same-day

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19
Q

What cranial nerve should be tested in keratitis

A

CN5

20
Q

What is first line for herpes simplex or varicella zoster virus keratitis

A

Topical acyclovir

21
Q

What is first Line for bacterial keratitis

A

Ciprofloxacin hourly for 48h. Then QDS for 5d

22
Q

Explain regimen for giving ciprofloxacin

A

Hourly for 48h and then QDS for 5 days

23
Q

What is a complication of HSV1 keratitis

A

Corneal scarring and subsequent blindness

24
Q

What increases risk of scarring and blindness in HSV1 keratitis

A

Glucocorticoid drops are used without anti-viral cover

25
Q

What is a complication of bacterial keratitis

A

Loss of vision

26
Q

What are 4 main Ddx for red eye

A
  • Acute glaucoma
  • Keratitis
  • Conjunctivitis
  • Uveitis
27
Q

What is subconjunctival haemorrhage

A

Pool of blood under conjunctiva

28
Q

What are 3 causes of subconjunctival haemorrhage

A

High BP
Anticoagulant use
Leptospira in sewage

29
Q

In which individuals does subconjunctival haemorrhage occur more often

A

Elderly frail females

30
Q

What is scleritis

A

Inflammation of the sclera with oedema of the conjunctiva

31
Q

What are the two types of scleritis

A

Anterior scleritis

Posterior scleritis

32
Q

What is the most common type of scleritis

A

Anterior (90%)

33
Q

What is 50% of scleritis associated with

A

Systemic disease such as RA

34
Q

How does scleritis present clinically

A

Painful eye movements
Dull ache
Photophobia
Headache

35
Q

Why does scleritis present with pain on eye-movements

A

As extra-ocular muscles attach onto the sclera

36
Q

In what time frame should someone with scleritis be referred to opthalmology

A

Urgently

37
Q

What is episcleritis

A

Inflammation of episclera, located just below the sclera

38
Q

How will episcleritis present

A

Blue discolouration below a focal cone-shaped wedge of engorged vessels

39
Q

In which gender is episcleritis more common

A

Females

40
Q

How does episcleritis present

A

Acute onset

Dull ache

41
Q

What is a corneal abrasion

A

Trauma to the eye

42
Q

What may cause corneal abrasion

A

Contact lenses

Chemical injury

43
Q

How do corneal abrasions present clinically

A

Pain
Photophobia
Decreased vision

44
Q

What is used to investigate corneal abrasions

A

Blue slit lamp with fluoroscein

45
Q

How will corneal abrasions appear on blue light slit lamp and fluoroscein

A

Green

Ophthalmology (12 decks)

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