Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ophthalmology > 3. Red Eye > Flashcards

3. Red Eye Flashcards

1
Q

On presentation of a red eye what should be recorded in the Hx?

A
  • Onset (most important, was it chronic/acute)
  • Visual changes
  • Trauma/ contact lens use
  • Photophobia
  • Pain
  • Discharge
  • History of medical illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List Ddx studied for the Red Eye?

A 
Conjunctivitis/ Blepharitis (Most common, viral, bacterial or allergic)
Corneal abrasion/ Foreign body (Very common +/- pain)
Subconjunctival haemorrhage
Keratitis/ corneal ulcer
Uveitis (Important diagnosis to make)
Acute glaucoma (Presents with pain)
Chemical burn
Scleritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common cause of red eye?

A

Conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the signs of acute conjunctivitis?

A
  1. Red eye (conjunctival hyperaemia)
  2. Discharge
  3. Eye lid sticking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which is more common bacterial or viral conjunctivitis?

A

Viral, bacterial less common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which is more contagious, viral or bacterial conjunctivitis?

A

Bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the signs of acute viral conjunctivitis?

A

Inferior palpebral conjunctival follicles
Tender palpable lymph node
Watery discharge/ pseudomembrane (more so with viral, if you lift the formed membrane no blood)
Punctate keratopathy
Infection in the cornea will cause extreme pain.

Recent upper respiratory tract infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Tx for viral conjunctivitis?

A
  • Can try antihistamines first. (Oxford) if not…
  • Treat with steroids (C/I in bacterial CJ)
  • Usually self-limiting within to 2 weeks but if in cornea can take months to years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In whom is bacterial conjunctivitis more common?

A

Children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the hallmarks of bacterial conjunctivitis?

A

Green discharge which can cause corneal infiltration.

Membranous CJ - Bleeds when membrane lifted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the common bacteria that cause conjunctivitis?

A

Staphylococci
Streptococcus Pneumonia
Haemophilis influenza

In sexually active person
Neisseria gonorrhoeae (which is hyperacute)
Chlamydial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Tx for Bacterial Conjunctivitis

A

Supportive:
• Frequent hand washing (Highly contagious)
• Artificial tears, cold compresses, antibiotics sometimes (conservative to super bugs)

Topical antibiotic therapy
If no improvement in 2 weeks time: take a swab to rule out chlamydia or gonococcal infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs and symptoms of allergic conjunctivitis?

A
  • History of allergies (Asthma, Eczema)
  • Itching
  • Water
  • Chemosis (swelling)
  • Red oedematous eye lids
  • Conjunctival papillae (cobblestone, since swelling + attachment at base (>5mm diameter)
  • No lymph nodes enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Tx for allergic conjunctivitis?

A
  • Cool compresses
  • Artificial tears
  • Oral antihistamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Large conjunctival papillae, shield ulcer, history of allergies, seasonal?

A

Vernal Conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is keratitis?

A

Inflammation of the cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the characteristic of bacterial keratitis?

A 
Red Eye
Pain (very)
Decreased vision
Photophobia
Discharge
NB=History of contact lens or trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the signs of bacterial peritonitis on exam?

A

Focal white opacity (fluid level collection over plates)
If there is epithelial defect, stain with fluorescein=ulcer
Discharge
Anterior chamber cells & hypopyon (yellowish exudate in Acham

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the most common bacteria causing keratitis?

A
  • Staphylococcus
  • Streptococcus
  • Pseudomonas (>60yo)
  • Morexella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Tx for Bacterial keratitis?

A
  • Corneal scrapings
  • Contact lens & case culture (must change contact lenses anyway)
  • Topical hourly drops: fluoroquinolone
  • Or Ceftazidime + Vancomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the Ddx for bacterial keratitis?

A
  • Fungal
  • Protozoal (acanthamoeba)
  • Viral: herpes simplex, herpes zoster
  • Sterile ulcer
22
Q

What are the charateristics of fungal keratitis?

A

Same as bacterial but unresponsive to treatment.

Rare, More serious infection

23
Q

What is the common causative agent in fungal keratitis?

A

Protozoal: Acanthamoeba Keratitis

24
Q

In whom is fungal keratitis more common?

A
  • Common if history of Trauma from natural object
  • People using own saliva to clean lens
  • Swimming, using hot tub while wearing lenses is a risk factor
25
What are the symptoms of Herpes Simplex Corneal Ulcer
``` Usually dormant originates from dormant infection, first episode in childhood • Red eye • Pain • Photophobia • Decrease vision • Tearing • Recurrent ```
26
What are the signs of HSV corneal ulceration?
* Dendritic ulcer * Usually just one eye infected * Recurrence
27
What is the treatment for HSV corneal ulceration?
``` Fluorescence Highlighting to dx Topical acyclovir ointment Avoid steroid (can lead to giant corneal ulcer) ```
28
What type of drugs are C/I in HSV Corneal Ulceration?
Steroids
29
Vesicular skin rash in the first division of trigeminal nerve?
Herpes Zoster Ophthalmicus
30
What are the symptoms of Herpes Zoster Ophthalmicus?
* Dermatomal skin rash (not crossing dermatomal line, i.e. following a nerve) * Discomfort * Headache & general malaise
31
What are the signs of Herpes Zoster Ophthalmicus?
* Vesicular skin rash in the first division of trigeminal nerve * Hutchinson sign suggest corneal involvement (crust and inflammation over tip and dorsum of the nose suggests corneal involvement) * Corneal pseudodendrites * Very painful since infection of the nerve fibre itself
32
What is the Tx for Herpes Zoster Ophthalmicus?
* Oral acyclovir (within 72 hours) 800mmg Oral 5x Daily | * Warm compresses & erythromycin skin ointment
33
What are the signs of corneal abrasion by foreign body?
* Corneal epithelial defect stains with fluorescein | * Foreign body can be seen & removed
34
What is the Tx for corneal abrasion by FB?
1. AB Ointment. 2. Nerve endings expose once epithelial tissue of cornea and severe pian therefore cover the eye for 24 hours to allow reepithelialisation of the eye. 3. Cyclopentolate to counter spasm
35
What are the common causes of subconjunctival haemorrhage?
Valsalva (coughing), traumatic, hypertension, idiopathic
36
What is the Tx for subconjunctival haemorrhage?
No treatment required. Painless Should resolve in 2 weeks. Blood reabsorbed.
37
What are the symptoms of Uveitis?
``` Pain Redness Photophobia Tearing Decrease vision ```
38
What are the symptoms of Uveitis?
* Cells & flare in the anterior chamber (due to iris barrier break-up) * Ciliary flush * Keratic preciptates KP (cells suspended in the, attempt to dilate the tissue results in the irregular iris margin due to cell deposits) * In severe cases: posterior synechiae (adherence of iris to the lens) & hypopyon
39
What is the aetiology of Uveitis?
* Idiopathic (sometimes med Hx e.g. spondylitis, facial disease, toxoplasmosis etc) * If recurrent must look for underlying cause * HLA-B27 associated uveitis: ankylosing spondylitis * Behcet disease * Sarcoidosis * Toxoplasmosis
40
What is the Tx for Uveitis?
Cycloplegic to ease spasming in the mussle Topical steroid mainstay, given hourly Treat ideology
41
In whom is Acute Angular Closure Glaucoma most common?
Usually >60yo, presenting during the evening
42
When does AACG commonly present?
In the evening (Hx of pain during the evening)
43
What are the symptoms of AACG?
``` Coloured halos around lights Blurred vision Frontal headache Pain Nausea & vomiting May present as an acute abdomen Usually Hx of pain during the evening ```
44
What are the signs for AACG?
Closed angle in the involved eye (check both eyes) Increase intra ocular pressure Corneal oedema Narrow occludable angle in the fellow eye Conjunctival injection Fixed mid dilated pupil
45
Describe the pathophysiology of AACG?
* Pupillary block (prevents drainage of aquas causing pressure that pushes on the iris) * Normal IO pressure 10-20, can reach 40-60mmhg in AACG * Angle crowding: high peripheral iris
46
What is the treatment for AACG?
Topical drops: Beta-blocker/ alpha agonist IV Carbonic anhydrase inhibitor (acetazolamide) (inhibits the formation of aqueous huour, takes 30-40 mins to work) YAG laser peripheral iridotomy, when the is quiet 20% Manntiol IV, High osmolality, wont cross eye? Barrier, therefoe draws fluid out. Give steroid to make eye more?
47
What is the Tx for a chemical burn?
* Treatment IMMEDIATELY before checking the vision: | * Copious irrigation for 30 minutes
48
What is episcleritis?
``` Inflammation of the episclera • Patients tend to be younger • Red eye • Mild pain • No discharge • No change in vision • Self limiting ```
49
What is the Tx for Episcleritis?
Artificial Tears
50
What is scleritis?
Inflammation of the sclera & episclera resulting in a severe and boaring eye pain.
51
Describe the aetiology of scleritis?
50% of the cases have associated systemic (usually autoimmune) disease Connective tissue disease (RA, Wegener granulomatosis, SLE, polyarteritis nodosa, rheumatoid arthritis) Herpes zoster ophthalmicus Syphilis Postocular surgery
52
What is the treatment for scleritis?
NSAIDs Systemic steroid (since usually autoimmune in nature) Immunosuppressive therapy

Ophthalmology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions