Acute Red Eye Flashcards
What is a subconjuctival haemorrhage and what causes it?
a small bleed behind conjunctiva
due to trauma, coughing, sneezing or spontaneous
What can cause recurrent subconjuctival haemorrhage?
hypertension
diabetes
Management for subconjuctival haemorrhage…
no treatment - self resolves in 10-14 days
Describe the appearance of a subconjuctival haemorrhage…
bright red blood overlying sclera
well-defined borders
what is the commonest cause of a red eye?
conjunctivitis
describe conjunctivitis…
inflammation of membrane overlying globe of eye and eyelids
what are the 2 types of conjunctivitis?
infective
allergic
What bacterial organism is most likely to cause conjunctivitis in children?
H. influenzae
Management for infective conjunctivitis…
self limiting OR
TOPICAL CHLOAMPHENICOL
What are the differences in appearance between viral and bacterial conjunctivitis?
viral - red eye and watery discharge
bacterial - mucopurulent yellow discharge
What is the most common viral cause of conjunctivitis?
adenovirus
What can chlamydia conjunctivitis cause?
subtarsal scarring because of it’s chronic nature
what is the tx for chlamydia conjunctivits?
topical oxytetracycline
Who is most likely to have endophthalmitis?
post-surgical pts
Presentation of endophthalmitis…
extremely painful red eye with decreased visual acuity (sight threatening)
tx for endophthalmitis…
intravitreal antibiotic injection
What is a corneal abrasion?
defect in corneal epithelium due to trauma
painful
What can cause a corneal abrasion?
contact lens
fingernails
foreign bodies
What investigation is used to see the extent of a corneal abrasion?
fluorescein stain
Tx for corneal abrasion…
chloraphemicol ointment
mydriatic (symptomatic relief)
what is the epiclera?
a thin vascular sheet superficial to the sclera
Which is worse, episcleritis or scleritis?
scleritis
treatment for episcleritis…
none
self-limiting
presentation of scleritis…
painful
eye is tender on palpation
red eye
what is scleritis associated with?
systemic disease (RA, WG)
Treatment for scleritis…
systemic immunosuppression
What is anterior uveitis?
infection of iris and ciliary body
presentation and signs of anterior uveitis…
sudden onset red and painful eye
blurry vision
constricted irregular pupil
hypopyon
what can cause anterior uveitis?
idiopathic
trauma
systemic disease (ankylosing spondylitis, IBD)
Tx for anterior uveitis…
depends on cause
consult ophthamologist
what is keratitis?
inflammation of cornea
presentation of keratitis…
photophobia
severe ocular pain
sensation of foreign body
reduced visual acuity
what are the 2 types of keratitis?
infective
non-infective
what can cause non-infective keratitis?
UV exposure
treatment of non-infective keratitis…
analgesia
cool compress
self-limiting
what is the most common cause of viral keratitis?
herpes simplex
what is seen on fluorescein in viral keratitis caused by herpes simplex?
branching dendritic ulcer
what is the most common bacterial organism that causes keratitis and what is it associated with?
pseudomonas aeruginosa
contact lens use
sign of bacterial keratitis…
hypopyon
treatment for bacterial keratitis…
admission - hourly drops
gentamicin
What can cause an acute angle closure glaucoma?
primary - anatomical
secondary - pathological - haemorrhage
what causes an acute angle closure glaucoma?
aqueous fluid accumulation behind the iris leading to a rise in IOP
How does an acute angle closure glaucoma present?
severe monocular eye pain (N&V)
blurred vision
haloes around light
Tx for acute angle closure glaucoma…
timolol eye drops
oral acetazolamide
topical dexamethasone
UNTIL laser or surgical iridectomy
