Acute Red Eye Flashcards
most common causative organism of conjunctivitis
adenovirus
clinical features of conjunctivitis caused by adenovirus
watery discharge
clinical features of conjunctivitis caused by herpes simplex
cutaneous vesicles develop on the eyelids and on the skin around the eyes
clinical features of conjunctivitis caused by herpes zoster
shingles rash
management of conjunctivitis caused by adenovirus
lubrication, cold compress (self-limiting)
management of conjunctivitis caused by herpes simplex or herpes zoster
antivirals, e.g. ganciclovir
complication of herpes simplex conjunctivitis
dendritic ulcer
causative organisms of bacterial conjunctivitis in neonates
staph aureus
neisseria gonnorhoeae
chlamydia trachomatis
causative organisms of bacterial conjunctivitis
staph aureus
strep pneumoniae
haemophilus influenzae (especially in children)
which has a faster onset, bacterial or viral conjunctivitis?
bacterial
spreads to both eyes within 48hrs
clinical features of bacterial conjunctivitis
abrupt onset
morning crusting
mucopurulent yellow discharge
papillae
bacterial conjunctivitis management
- topical broad spectrum antibiotic - usually chloramphenical
- swab and culture if unresponsive
what treats staph aureus conjunctivitis
fusidic acid
what treats most gram negatives including coliforms and pseudomonas aeruginosa conjunctivitis
gentamicin
chlamydial conjunctivitis clinical features
- often chronic history unresponsive to treatments
- suspect in bilateral conjunctivitis in young adults
- may have symptoms of urethritis, vaginitis
- can be passed from mother to newborn
What other symptoms apart from eye may someone with chlamydial conjunctivitis have
urethritis, vaginitis
which type of conjunctivitis can be passed from mother to newborn
chlamydial
what type of conjunctivitis often has a chronic history of being unresponsive to treatments
chlamydial
chlamydial conjunctivitis management
topical oxytetracycline
adults may need oral azithromycin for genital chlamydia infection
need contact tracing
clinical features of allergic conjunctivitis
watery, itchy eyes
bilateral and symmetrical ocular involvement with global injection and chemosis (swelling of conjunctiva)
which is more serious, episcleritis or scleritis
scleritis
give some examples of systemic conditions that scleritis can be associated with
rheumatoid arthritis
SLE
IBD
sarcoidosis
GPA
causes of scleritis
- in half of patients an associated systemic condition
- surgery
- infections
clinical presentation of scleritis
- severe pain that progresses over several days
- pain with eye movement
- photophobia
- eye watering
- reduced visual acuity
- abnormal pupil reaction to light
- tenderness to palpation of the eye
scleritis management
- oral NSAIDs
- oral steroids + steroid sparing agents
what is episclera
the thin vascular sheet which lies between the conjunctiva and sclera
what causes episcleritis
- usually idiopathic
- can be caused by underlying systemic disease
does episcleritis present with severe pain
no
clinical presentation of episcleritis
- typically not painful but can be mild pain
- segmental redness rather than diffuse. there is usually a patch of redness in the lateral sclera
- foreign body sensation
- dilated episcleral vessels
- watering of eye
- no discharge
episcleritis management
self-limiting - lubricants, cold compress, topical NSAIDs, mild steroids
