acute red eye Flashcards
causes of a painless red eye
conjunctivitis (more itchy/gritty)
episcleritis
subconjunctival haemorrhage
which chemical burns to the eye are worse acid or alkali?
alkali - easier penetration, scars badly
signs of bacterial conjunctivitis
purulent discharge
worse in morning - eyes stuck together
highly contagious - usually spread to other eye
signs of viral conjunctivitis
clear discharge
dry cough, sore throat, blocked nose
tender preauricular lymph nodes (infront of ear)
bacteria to be suspicious of in neonatal conjuntivitis
neisseria gonorrhoea
common causative organism in bacterial conjunctivitis
staph aureus
gonorrhoeae in neonates
treatment of bacterial conjuntivitis
usually topical chloramphenicol
unresponsive in chlamydial
avoid in aplastic anaemia + allergy
commonest cause of conjunctivitis
adenoviral - watery discharge, preauricular lymph nodes
HSV conjunctivitis
purulent vesicles around eye
herpes zoster (shingles) conjunctivitis
V1, if gets in eye then conjunctivitis
chlamydial conjunctivitis
younger, bilateral, recurrent, subtarsal scarring
vaginitis, urethretis
- not responsive to chloramphenical*
- -> oral azithromycin
management of chlamydial conjuntivitis
oral azithromycin
gonococcal conjunctivitis presentation + treatment
really extra, oozing pus
ceftriaxone IM
anterior uveitis presentation
dull painful red eye
ciliary flush (ring of red round iris out)
abnormal shaped pupil
photophobia
pain on movement
hypopyon
which group of conditions is assoc with anterior uveitis
HLA B27
presentation of episcleritis
segmental lateral redness
foreign body sensation
watery eye
conservative + safety net
subconjunctival haemorrhage
often post strenuous activity - constipated, lifting, coughing
patch of red blood under conjunctiva
resolves 2 weeks ish
scleritis vs episcleritis
scleritis = pain on movment, full thickness, more serious
assoc conditions of scleritis
RA SLE IBD sarcoidosis granulomatosis polyangiitis
Mx = treat underlying, NSAIDs
scleritis presentation
pain, pain on eye movment
photophobia
tenderness on palpation
abnormal pupil reaction to light
commonest causative organism in a contact lenses wearer with keratitis
acanthamoeba
treat with antiseptic - not responsive to antibiotics
most common cause of keratitis
herpes keratitis
presentation of herpes keratitis
painful red eye
*dendritic corneal ulcer
vesicles around eye
loss of sensation on cornea
recurrent
treatment of herpes keratitis
topical ganciclovir, acyclovir
Dont give steroids - cornea perforation
fungal keratitis classic presentation
working in garden + shrub brushed their eye
white fluffy region
treatment of contact lens keratitis
polyhexamethylene biguanide
chlorhexadine
scar even once resolved
entropion
inward turning eyelash
diagnosis of corneal abrasion
1st = fluorescein stain
slit lamp
blepharitis
inflammation of eyelid margins
gritty, itchy, dry sensation
dysfunction of meibromian glands - responsible for secreting oil onto eye
hot compress + gentle cleaning
which gland is affected in chalazion?
meibomian - under eyelid, behind muscle
can lead to preseptal celluliti
gland affected in styes?
Zeis or Moll - infront of muscle
Zeis = sebaceous gland at base of eyelashes Moll = sweat gland at base of eyelashes
why might newborns be more prone to orbital infections?
septum in adults is barrier for superfical infections
–> not developed in newborns
how to distinguish preseptal and orbital cellulitis
CT
pain on movement = orbital
complication of orbital cellulitis
potential thrombosis to cavernous brain
causative organism of endophthalmitis
staph epidermis
management of endophthalmitis
intravitreal antibiotics
toxoplasmosis
eating undercooked meat
pregnant can pass it to baby
burnt out macula
toxocara canis (worm)
cats + dogs
larvae can migrate into retina
–> can causee granulomas which cause irreversible visual loss
diagnosis of toxoplasmosis + toxocara
serology
diagnosis of bacterial keratitis
corneal scrapes
Mx of anterior uveitis
urgent review by ophth
cycloplegics -> dilates pupil to relieve photophobia
(cyclopentolate, atropine)
steroids ?drops
