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Ophthalmology Week 2 2017/18 > 7: Red eye > Flashcards

7: Red eye Flashcards

1
Q

What are some causes of red eye?

A

Eye infections

Haemorrhage

Acute angle-closure glaucoma

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2
Q

What is the most common cause of red eye?

A

Conjunctivitis

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3
Q

What helps to defend the eye from infection?

A

Structures

Tear film (lacrimal fluid and mucus via Meibomian glands)

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4
Q

What do tears contain to help defend against infection?

A

Lysozymes

Immunoglobulins

Complement

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5
Q

What are symptoms you should ask about in an ophthalmic history?

A

Pain - grittiness, dryness, headache

Itch

Discharge

Photophobia

Visual loss

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6
Q

Which infection are people with contact lenses particularly prone to?

How is it treated?

A

Acanthaemoba

amoeba which colonises if you sleep, swim with your contact lenses in

Chlorhexidine

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7
Q

How are the eyes examined?

A

Front to back

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8
Q

How can you check IOP in an eye examination?

What piece of equipment can also estimate IOP?

A

Ballot the eyes

like kidneys in GI exam

Tonometer

blows air into the eye

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9
Q

What is blepharitis?

A

Inflamed eyelids

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10
Q

What symptom does blepharitis usually produce?

A

Dry, gritty eyes

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11
Q

What is the usual causal organism of anterior blepharitis?

What signs does it produce?

A

Staph. aureus

Distorted lashes, scaly, inflamed lids

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12
Q

What structure is diseased in posterior blepharitis?

A

Meibomian glands

which produce mucus

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13
Q

What does posterior blepharitis look like?

A

Swollen lump on eyelid

Dried secretions on lashes

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14
Q

What derm problem, common in middle aged women, is posterior blepharitis associated with?

A

Acne rosacea

facial flushing, pustules, rhynophyma

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15
Q

How is blepharitis treated?

A

Proper lid hygiene

Tear drops

Oral antibiotics for Staph e.g doxycycline

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16
Q

What causes conjunctivitis?

A

Bacteria

Viruses

Allergy

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17
Q

What type of conjunctivitis does chlamydia cause?

What else must be screened for?

A

Trachoma

STIs

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18
Q

Does conjunctivitis affect vision?

A

No

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19
Q

What are the symptoms of conjunctivitis?

A

Red eye

Gritty

Discharge (watery for viral, pus in bacterial)

Itch in ALLERGIC conjunctivitis

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20
Q

How is conjunctivitis treated?

A

Antibiotics

Antivirals

Anti-inflammatories

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21
Q

What indicates chlamydial conjunctivitis over viral or other bacterial causes?

A

Follicles on posterior eyelids

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22
Q

What indicates viral conjunctivitis over other types?

A

Pink eye

Watery discharge

Enlarged pre-auricular nodes

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23
Q

What indicates allergic conjunctivitis over other causes?

A

Itchy eye

Papillae on posterior eyelids

Chemosis

History of atopy

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24
Q

What is chemosis?

A

Conjunctival oedema

25
Q

What would you see in a viral conjunctivitis caused by

a) Herpes simplex
b) Herpes zoster?

A

a) Cold sores (papules)

b) Dermatomal rash

26
Q

If a patient has vertical scratches on their cornea, where should you examine?

A

Posterior eyelids for foreign bodies

“ice rink cornea”

27
Q

What are the layers of the cornea?

A

Epithelium (hydrophobic)

Stroma (hydrophilic)

Endothelium (hydrophobic)

28
Q

What stain can be used to identify corneal lesions?

A

Fluorescein

29
Q

What is a sign of significant corneal disease?

A

Vascularisation

30
Q

What microbes can cause corneal ulcers (i.e a keratitis)?

A

Viral (dendritic ulcers)

Fungal (rare)

Bacterial (hypopyon)

Acanthamoeba (contact lenses)

31
Q

Corneal ulcers are an indicator of poor control of which type of disease?

A

Autoimmune disease

e.g RA

32
Q

Are corneal ulcers painful?

A

Yes

33
Q

What are the symptoms of corneal ulcers?

A

Pain

Photophobia

Profuse lacrimation

34
Q

What are some signs of corneal ulcers?

A

Redness

Loss of corneal light reflex

Abnormal fluorescein staining

Hypopion

35
Q

What type of corneal ulcer does proptosis e.g in thyroid eye disease cause?

A

Exposure keratitis

from cornea being too far out into external environment

36
Q

In which autoimmune disease may profuse dryness cause corneal ulcers?

A

Sjogren’s syndrome

37
Q

Which vitamin deficiency can cause corneal ulcers?

A

Vitamin A deficiency

remember retinol in rhodopsin is a Vitamin A derivative

38
Q

How are corneal ulcers investigated?

A

Corneal scrape for culture

39
Q

How often are bacterial corneal ulcers treated with antibacterials?

A

Hourly drops in hospital

40
Q

How is autoimmune keratitis treated?

A

Anti-inflammatories

41
Q

What is given alongside antivirals in viral keratitis?

A

Antibiotics

To prevent superinfection

42
Q

What structures are inflamed in uveitis?

A

Iris

Cilary bodies

Choroid

43
Q

Which type of disease is highly associated with anterior uveitis?

A

Autoimmune disease

e.g Reiter’s syndrome, UC, ANKYLOSING SPONDYLITIS, SARCOIDOSIS

44
Q

What are the symptoms of anterior uveitis?

A

Pain

Reduced vision

Photophobia

Red eye

45
Q

How does the cornea look in anterior uveitis?

A

Clear

46
Q

What is seen in the anterior chamber in uveitis?

A

Flare

cells, protein, inflammatory stuff, debris…

47
Q

Bacterial keratitis and anterior uveitis both cause a hypopyon.

How do you distinguish between them?

A

In anterior uveitis, cornea is clear

48
Q

How is anterior uveitis treated?

A

Topical steroids

49
Q

In glaucoma, drops are used to constrict the pupil.

What type of drops are used in anterior uveitis?

A

Mydriatic drops (dilate)

To relax the eye muscles are reduce pain

50
Q

What is relatively common, self-limiting disease which is associated with gout?

A

Episcleritis

51
Q

What is a painful disease of the deep sclera?

A

Scleritis

associated with RA, vasculitis

52
Q

What does scleritis look like?

A

Deep injection of sclera

“violaceous hue”

53
Q

How is scleritis treated?

A

Oral anti-inflammatories

so steroids, NSAIDs and DMARDs (azathioprine, methotrexate, ciclosporin)

54
Q

Who tends to get acute angle-closure glaucoma?

A

MYOPIC, elderly patients

55
Q

What are the symptoms of acute angle-closure glaucoma?

A

Sudden loss of peripheral vision

Painful, red eye

Headache

Nausea

Vomiting

56
Q

What sign can be felt on balloting of the eye in acute angle closure glaucoma?

A

Stony hard due to raised IOP

57
Q

How does the pupil look in acute angle-closure glaucoma?

A

Mid-dilated

58
Q

How does the cornea look in acute angle-closure glaucoma?

A

Cloudy

Ophthalmology Week 2 2017/18 (8 decks)

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