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acute red eye Flashcards

1
Q

what is the most common cause of a red eye

A

conjunctivitis

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2
Q

what is conjunctivitis

A

inflammation of the conjunctiva

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3
Q

what is the most common type of conjunctivitis

A

viral

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4
Q

name 3 causative organisms of viral conjunctivitis and state the most common

A
  • Adenovirus (most common)
  • Herpes simplex
  • Herpes zoster
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5
Q

clinical presentation of viral conjunctivitis

A

rapidly progressive
typically bilateral
associated with an URTI

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6
Q

feature of an adenoviral conjunctivitis

A

watery discharge

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7
Q

feature of herpes simplex conjunctivitis

A

cutaneous vesicles on the eyelids and skin around the eyes

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8
Q

feature of herpes zoster conjunctivitis

A

shingles rash

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9
Q

management of adenoviral conjunctivitis

A

lubrication (carbomer gel) and cold compress

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10
Q

management of herpes conjunctivitis

A

ganciclovir

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11
Q

complication of herpes simplex conjunctivitis

A

dendritic ulcer

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12
Q

name 3 causative organisms of bacterial conjunctivitis in neonates

A
  • Staph. aureus
  • Neisseria gonnorhoeae
  • Chlamydia trachomatis
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13
Q

name 3 causative organisms of bacterial conjunctivitis in all other age groups

A
  • Staph. aureus
  • Step. pneumoniae
  • Haemophilus influenzae (especially in children)
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14
Q

clinical presentation of bacterial conjunctivitis (3)

A

quick onset- bilateral by 48 hours
morning crusting
mucopurulent yellow discharge

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15
Q

management of bacterial conjunctivitis

A

broad spectrum antibiotics e.g. chloramphenicol

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16
Q

what can treat a staph aureus conjuctivitis

A

fusidic acid

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17
Q

what can treat gram negative conjunctivitis

A

gentamicin

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18
Q

what do we need to suspect in bilateral conjunctivitis in young adults

A

chlamydial conjunctivitis

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19
Q

clinical presentation of chlamydial conjunctivitis

A

chronic history often unresponsive to treatments
may have symptoms of urethritis, vaginitis

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20
Q

complication of untreated chlamydial conjunctivitis

A

subtarsal scarring

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21
Q

management of chlamydial conjunctivitis

A

topical oxytetracycline

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22
Q

what additional treatment may adults with chlamydial conjunctivitis need

A

oral azithromycin to treat genital infection

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23
Q

clinical features of allergic conjunctivitis

A

watery, ITCHY eyes
bilateral and symmetrical involvement
vision is usually fine

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24
Q

management of allergic conjunctivitis when under control

A

mast cell stabiliser

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25
give an example of a mast cell stabiliser
sodium cromoglycate
26
what is keratitis
inflammation of the cornea
27
clinical presentation of keratitis (3)
photophobia severe ocular pain and feeling of a foreign body hypopyon
28
what is hypopyon
aggregation of inflammatory cells within the anterior chamber resulting in visible 'sediment' in front of the eye inferiorly
29
what is bacterial keratitis associated with
wearing contact lenses
30
management of gram negative bacterial keratitis
ofloxacin eye drops
31
what is another name for herpetic keratitis
dendritic ulcer
32
what causes dendritic ulcers
herpes simplex virus
33
management of dendritic ulcer
ganciclovir
34
what should we AVOID when managing dendritic ulcers and why
steroids as they cause corneal melt
35
clinical features of adenoviral keratitis
bilateral subepithelial infiltrates usually follows URTI/conjunctivitis
36
who usually presents with fungal keratitis
people who work outside or have ocular surface disease
37
clinical presentation of fungal keratitis
chronic history corneal lesions more defined than in bacterial hypopyon
38
management of fungal keratitis
natamycin
39
who usually gets acanthamoeba keratitis
contact lens wearers
40
what is cellulitis
bacterial infection of the lower dermis and subcutaneous tissue
41
what is preseptal cellulitis
infection of the eyelid and surrounding skin anterior to the orbital septum
42
what usually causes preseptal cellulitis
contiguous spread of infection from local trauma e.g. insect bites
43
clinical features of preseptal cellulitis
tenderness, warmth, swelling and redness of the eyelid
44
what is orbital cellulitis
infection of the orbital tissues posterior to the orbital septum
45
3 main causes of orbital cellulitis
- Direct extension from sinus - Extension from focal orbital infection - Post-operative
46
clinical presentation of orbital cellulitis
painful, especially on eye movements proptosis pyrexial
47
what is orbital cellulitis associated with
paranasal sinusitis
48
investigations of orbital cellulitis
CT scan to identify orbital abscesses and asses optic nerve function
49
management of orbital cellulitis
broad spectrum antibiotics some abscesses will need draining
50
what is the most common causative organism of endophthalmitis
staph epi
51
clinical presentation of endophthalmitis
very painful, V V red eye decreasing vision
52
management of endophthalmitis
intravitreal amikacin/ceftazidime/vancomycin and topical antibiotics
53
what is scleritis
full thickness inflammation of the sclera
54
conditions associated with scleritis
rheumatoid arthritis, SLE, IBD, sarcoidosis, GPA
55
clinical presentation of scleritis
severe pain that progresses - enough to wake someone up, pain with eye movement photophobia watering eye reduced visual acuity abnormal pupillary response to light
56
management of scleritis
oral NSAIDs, steroids + steroid sparing agents
57
main complication of scleritis
potentially blinding
58
what is episcleritis
inflammation of the episclera
59
what is the episclera
thin vascular sheet which lies between the conjunctiva and the sclera
60
clinical presentation of episcleritis
segmented redness, usually in the lateral sclera foreign body sensation watery eye
61
management of episcleritis
self limiting so lubricants, cold compresses, topical NSAIDs
62
name some autoimmune causes of anterior uveitis (4)
- Reiter's - Ulcerative colitis - Ankylosing spondylitis - Sarcoidosis
63
name 3 infective causes of anterior uveitis
- TB - Syphilis - Herpes simplex, herpes zoster
64
name a malignancy that can cause anterior uveitis
leukaemia
65
symptoms of anterior uveitis
unilateral symptoms start spontaneously may occur with the flare of a disease dull, aching, painful red eye vision reduced, photophobia
66
clinical signs of anterior uveitis
- Circumcorneal red eye - Ciliary injection - Keratic precipitates - Hypopyon - Synechiae - Cells and flare in the anterior chamber
67
what is synechiae
small or irregular pupil due to adhesions pulling the iris into abnormal shapes
68
management of anterior uveitis
topical steroids and mydriatics
69
when does acute angle-closure glaucoma occur
iris bulges forward and seals off the trabecular meshwork from the anterior chamber preventing aqueous humour from being able to drain away, leading to a continual build up of IOP
70
clinical presentation of acute angle-closure glaucoma (3)
severe pain and nausea cloudy cornea stony hard eye
71
when does blepharitis usually develop
middle-age
72
what is anterior blephitis
inflammation of the base of the eyelids
73
name the 2 most common types of anterior blepharitis
staphylococcal and seborrhoeic
74
what is posterior blepharitis
inflammation of the meibomian glands
75
symptoms of blepharitis
burning, itching and crusting of the eyelids worse in the mornings recurrent hordeolum
76
another name for a hordeolum
a stye
77
clinical sign of anterior blepharitis
lid margin redder than deeper part of the lid
78
clinical sign of posterior blepharitis
redness in the deeper part of the lid
79
management of unresolving anterior blepharitis
chloramphenicol
80
management of unresolving posterior blepharitis
oral doxycycline
81
name 2 complications of blepharitis
stye chalazion
82
another name for chalazion
meibomian cyst
83
name 3 risk factors of chalaizon
pregnancy blepharitis seborrhoeic dermatitis
84
what causes chalazion
a foreign body reaction to sebum within a meibomian gland
85
clinical presentation of chalazion
firm, painless, localised eyelid swelling that has slowly developed
86
management of chalazion
warm compresses for several weeks
87
what is a stye
acute localised infection or inflammation of the eyelid margin
88
name 2 risk factors for a stye
rosacea chronic blepharitis
89
clinical presentation of a stye
acute, painful localised swelling near the eyelid margin
90
management of stye
warm compresses to encourage it to drain usually resolves within 5-7 days

ophthalmology (10 decks)

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