2: Keratitis

Question 1

What is keratitis also known as

Answer 1

Corneal ulcer

Question 2

What is keratitis

Answer 2

Inflammation of the cornea

Question 3

What is the cornea

Answer 3

Transparent structure covers iris and pupil

Question 4

What is trauma (scratch) to the cornea called

Answer 4

Corneal abrasion (Not a corneal ulcer)

Question 5

What is the most common cause of keratitis

Answer 5

Bacterial (80%)

Question 6

What bacterial organisms cause keratitis

Answer 6

More commonly gram negative

Question 7

What viral organisms cause keratitis

Answer 7

HSV1

VZV

Question 8

What are 3 risk factors for bacterial keratitis

Answer 8

Contact lenses
Recent eye surgery
Immunodeficiency

Question 9

What are 5 symptoms of bacterial keratitis

Answer 9

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

Question 10

What is a hypophyon

Answer 10

Collection of pus behind the cornea

Question 11

Is viral conjunctivitis unilateral or bilateral

Answer 11

bilateral

Question 12

How does viral keratitis present

Answer 12

Unilateral 
Red-eye 
Severe eye pain 
Photophobia 
Blurry vision

Question 13

What is first-line investigation for keratitis

Answer 13

Slit lamp with fluroscein

Question 14

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

Answer 14

Round corneal ulcers

Hypophyon

Question 15

How will HSV keratitis present on slit lamp with fluroroscein

Answer 15

Dendritic ulcers (superficial corneal ulcers)

Question 16

What do dendritic ulcers indicate

Answer 16

Virus is replicating

Question 17

What is performed on dendritic ulcers

Answer 17

Direct fluorescien antibody test or PCR

Question 18

How soon should individuals with keratitis be referred to opthalmology

Answer 18

Same-day

Question 19

What cranial nerve should be tested in keratitis

Answer 19

CN5

Question 20

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

Answer 20

Topical acyclovir

Question 21

What is first Line for bacterial keratitis

Answer 21

Ciprofloxacin hourly for 48h. Then QDS for 5d

Question 22

Explain regimen for giving ciprofloxacin

Answer 22

Hourly for 48h and then QDS for 5 days

Question 23

What is a complication of HSV1 keratitis

Answer 23

Corneal scarring and subsequent blindness

Question 24

What increases risk of scarring and blindness in HSV1 keratitis

Answer 24

Glucocorticoid drops are used without anti-viral cover

Question 25

What is a complication of bacterial keratitis

Answer 25

Loss of vision

Question 26

What are 4 main Ddx for red eye

Answer 26

- Acute glaucoma - Keratitis - Conjunctivitis - Uveitis

Question 27

What is subconjunctival haemorrhage

Answer 27

Pool of blood under conjunctiva

Question 28

What are 3 causes of subconjunctival haemorrhage

Answer 28

High BP Anticoagulant use Leptospira in sewage

Question 29

In which individuals does subconjunctival haemorrhage occur more often

Answer 29

Elderly frail females

Question 30

What is scleritis

Answer 30

Inflammation of the sclera with oedema of the conjunctiva

Question 31

What are the two types of scleritis

Answer 31

Anterior scleritis | Posterior scleritis

Question 32

What is the most common type of scleritis

Answer 32

Anterior (90%)

Question 33

What is 50% of scleritis associated with

Answer 33

Systemic disease such as RA

Question 34

How does scleritis present clinically

Answer 34

Painful eye movements Dull ache Photophobia Headache

Question 35

Why does scleritis present with pain on eye-movements

Answer 35

As extra-ocular muscles attach onto the sclera

Question 36

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

Answer 36

Urgently

Question 37

What is episcleritis

Answer 37

Inflammation of episclera, located just below the sclera

Question 38

How will episcleritis present

Answer 38

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

Question 39

In which gender is episcleritis more common

Answer 39

Females

Question 40

How does episcleritis present

Answer 40

Acute onset | Dull ache

Question 41

What is a corneal abrasion

Answer 41

Trauma to the eye

Question 42

What may cause corneal abrasion

Answer 42

Contact lenses | Chemical injury

Question 43

How do corneal abrasions present clinically

Answer 43

Pain Photophobia Decreased vision

Question 44

What is used to investigate corneal abrasions

Answer 44

Blue slit lamp with fluoroscein

Question 45

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

Answer 45

Green