Acute Red Eye

Question 1

most common causative organism of conjunctivitis

Answer 1

adenovirus

Question 2

clinical features of conjunctivitis caused by adenovirus

Answer 2

watery discharge

Question 3

clinical features of conjunctivitis caused by herpes simplex

Answer 3

cutaneous vesicles develop on the eyelids and on the skin around the eyes

Question 4

clinical features of conjunctivitis caused by herpes zoster

Answer 4

shingles rash

Question 5

management of conjunctivitis caused by adenovirus

Answer 5

lubrication, cold compress (self-limiting)

Question 6

management of conjunctivitis caused by herpes simplex or herpes zoster

Answer 6

antivirals, e.g. ganciclovir

Question 7

complication of herpes simplex conjunctivitis

Answer 7

dendritic ulcer

Question 8

causative organisms of bacterial conjunctivitis in neonates

Answer 8

staph aureus
neisseria gonnorhoeae
chlamydia trachomatis

Question 9

causative organisms of bacterial conjunctivitis

Answer 9

staph aureus
strep pneumoniae
haemophilus influenzae (especially in children)

Question 10

which has a faster onset, bacterial or viral conjunctivitis?

Answer 10

bacterial
spreads to both eyes within 48hrs

Question 11

clinical features of bacterial conjunctivitis

Answer 11

abrupt onset
morning crusting
mucopurulent yellow discharge
papillae

Question 12

bacterial conjunctivitis management

Answer 12

1. topical broad spectrum antibiotic - usually chloramphenical
2. swab and culture if unresponsive

Question 13

what treats staph aureus conjunctivitis

Answer 13

fusidic acid

Question 14

what treats most gram negatives including coliforms and pseudomonas aeruginosa conjunctivitis

Answer 14

gentamicin

Question 15

chlamydial conjunctivitis clinical features

Answer 15

• 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

Question 16

What other symptoms apart from eye may someone with chlamydial conjunctivitis have

Answer 16

urethritis, vaginitis

Question 17

which type of conjunctivitis can be passed from mother to newborn

Answer 17

chlamydial

Question 18

what type of conjunctivitis often has a chronic history of being unresponsive to treatments

Answer 18

chlamydial

Question 19

chlamydial conjunctivitis management

Answer 19

topical oxytetracycline
adults may need oral azithromycin for genital chlamydia infection
need contact tracing

Question 20

clinical features of allergic conjunctivitis

Answer 20

watery, itchy eyes
bilateral and symmetrical ocular involvement with global injection and chemosis (swelling of conjunctiva)

Question 21

which is more serious, episcleritis or scleritis

Answer 21

scleritis

Question 22

give some examples of systemic conditions that scleritis can be associated with

Answer 22

rheumatoid arthritis
SLE
IBD
sarcoidosis
GPA

Question 23

causes of scleritis

Answer 23

• in half of patients an associated systemic condition
• surgery
• infections

Question 24

clinical presentation of scleritis

Answer 24

• 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

Question 25

scleritis management

Answer 25

• oral NSAIDs
• oral steroids + steroid sparing agents

Question 26

what is episclera

Answer 26

the thin vascular sheet which lies between the conjunctiva and sclera

Question 27

what causes episcleritis

Answer 27

• usually idiopathic
• can be caused by underlying systemic disease

Question 28

does episcleritis present with severe pain

Answer 28

no

Question 29

clinical presentation of episcleritis

Answer 29

• 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

Question 30

episcleritis management

Answer 30

self-limiting - lubricants, cold compress, topical NSAIDs, mild steroids