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ophthalmology > acute red eye > Flashcards

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
Q

give an example of a mast cell stabiliser

A

sodium cromoglycate

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26
Q

what is keratitis

A

inflammation of the cornea

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27
Q

clinical presentation of keratitis (3)

A

photophobia
severe ocular pain and feeling of a foreign body
hypopyon

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28
Q

what is hypopyon

A

aggregation of inflammatory cells within the anterior chamber resulting in visible ‘sediment’ in front of the eye inferiorly

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29
Q

what is bacterial keratitis associated with

A

wearing contact lenses

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30
Q

management of gram negative bacterial keratitis

A

ofloxacin eye drops

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31
Q

what is another name for herpetic keratitis

A

dendritic ulcer

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32
Q

what causes dendritic ulcers

A

herpes simplex virus

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33
Q

management of dendritic ulcer

A

ganciclovir

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34
Q

what should we AVOID when managing dendritic ulcers and why

A

steroids as they cause corneal melt

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35
Q

clinical features of adenoviral keratitis

A

bilateral subepithelial infiltrates
usually follows URTI/conjunctivitis

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36
Q

who usually presents with fungal keratitis

A

people who work outside or have ocular surface disease

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37
Q

clinical presentation of fungal keratitis

A

chronic history
corneal lesions more defined than in bacterial
hypopyon

38
Q

management of fungal keratitis

A

natamycin

39
Q

who usually gets acanthamoeba keratitis

A

contact lens wearers

40
Q

what is cellulitis

A

bacterial infection of the lower dermis and subcutaneous tissue

41
Q

what is preseptal cellulitis

A

infection of the eyelid and surrounding skin anterior to the orbital septum

42
Q

what usually causes preseptal cellulitis

A

contiguous spread of infection from local trauma e.g. insect bites

43
Q

clinical features of preseptal cellulitis

A

tenderness, warmth, swelling and redness of the eyelid

44
Q

what is orbital cellulitis

A

infection of the orbital tissues posterior to the orbital septum

45
Q

3 main causes of orbital cellulitis

A
  • Direct extension from sinus
  • Extension from focal orbital infection
  • Post-operative
46
Q

clinical presentation of orbital cellulitis

A

painful, especially on eye movements
proptosis
pyrexial

47
Q

what is orbital cellulitis associated with

A

paranasal sinusitis

48
Q

investigations of orbital cellulitis

A

CT scan to identify orbital abscesses and asses optic nerve function

49
Q

management of orbital cellulitis

A

broad spectrum antibiotics
some abscesses will need draining

50
Q

what is the most common causative organism of endophthalmitis

A

staph epi

51
Q

clinical presentation of endophthalmitis

A

very painful, V V red eye
decreasing vision

52
Q

management of endophthalmitis

A

intravitreal amikacin/ceftazidime/vancomycin and topical antibiotics

53
Q

what is scleritis

A

full thickness inflammation of the sclera

54
Q

conditions associated with scleritis

A

rheumatoid arthritis, SLE, IBD, sarcoidosis, GPA

55
Q

clinical presentation of scleritis

A

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
Q

management of scleritis

A

oral NSAIDs, steroids + steroid sparing agents

57
Q

main complication of scleritis

A

potentially blinding

58
Q

what is episcleritis

A

inflammation of the episclera

59
Q

what is the episclera

A

thin vascular sheet which lies between the conjunctiva and the sclera

60
Q

clinical presentation of episcleritis

A

segmented redness, usually in the lateral sclera
foreign body sensation
watery eye

61
Q

management of episcleritis

A

self limiting so lubricants, cold compresses, topical NSAIDs

62
Q

name some autoimmune causes of anterior uveitis (4)

A
  • Reiter’s
  • Ulcerative colitis
  • Ankylosing spondylitis
  • Sarcoidosis
63
Q

name 3 infective causes of anterior uveitis

A
  • TB
  • Syphilis
  • Herpes simplex, herpes zoster
64
Q

name a malignancy that can cause anterior uveitis

A

leukaemia

65
Q

symptoms of anterior uveitis

A

unilateral symptoms start spontaneously
may occur with the flare of a disease
dull, aching, painful red eye
vision reduced, photophobia

66
Q

clinical signs of anterior uveitis

A
  • Circumcorneal red eye
  • Ciliary injection
  • Keratic precipitates
  • Hypopyon
  • Synechiae
  • Cells and flare in the anterior chamber
67
Q

what is synechiae

A

small or irregular pupil due to adhesions pulling the iris into abnormal shapes

68
Q

management of anterior uveitis

A

topical steroids and mydriatics

69
Q

when does acute angle-closure glaucoma occur

A

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
Q

clinical presentation of acute angle-closure glaucoma (3)

A

severe pain and nausea
cloudy cornea
stony hard eye

71
Q

when does blepharitis usually develop

A

middle-age

72
Q

what is anterior blephitis

A

inflammation of the base of the eyelids

73
Q

name the 2 most common types of anterior blepharitis

A

staphylococcal and seborrhoeic

74
Q

what is posterior blepharitis

A

inflammation of the meibomian glands

75
Q

symptoms of blepharitis

A

burning, itching and crusting of the eyelids
worse in the mornings
recurrent hordeolum

76
Q

another name for a hordeolum

A

a stye

77
Q

clinical sign of anterior blepharitis

A

lid margin redder than deeper part of the lid

78
Q

clinical sign of posterior blepharitis

A

redness in the deeper part of the lid

79
Q

management of unresolving anterior blepharitis

A

chloramphenicol

80
Q

management of unresolving posterior blepharitis

A

oral doxycycline

81
Q

name 2 complications of blepharitis

A

stye
chalazion

82
Q

another name for chalazion

A

meibomian cyst

83
Q

name 3 risk factors of chalaizon

A

pregnancy
blepharitis
seborrhoeic dermatitis

84
Q

what causes chalazion

A

a foreign body reaction to sebum within a meibomian gland

85
Q

clinical presentation of chalazion

A

firm, painless, localised eyelid swelling that has slowly developed

86
Q

management of chalazion

A

warm compresses for several weeks

87
Q

what is a stye

A

acute localised infection or inflammation of the eyelid margin

88
Q

name 2 risk factors for a stye

A

rosacea
chronic blepharitis

89
Q

clinical presentation of a stye

A

acute, painful localised swelling near the eyelid margin

90
Q

management of stye

A

warm compresses to encourage it to drain
usually resolves within 5-7 days

ophthalmology (10 decks)

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