Acute red eye

Question 1

What are the two types of eye pain and what generally do they indicate?

Answer 1

1 “Gritty/scratchy” discomfort- external or surface problem e.g. foreign body, conjunctivitis
2. “Acheing/deep” pain more likelt to be intra-ocular e.g. iritis, scleritis, glaucoma

Question 2

What causes posterior blepharitis?

Answer 2

Blockage of the (Meibomian) glands on the eyelid

Question 3

What is a chalazion?

Answer 3

Cyst of the Meibomian glands

Question 4

Why must a child with conjunctivitis within the first 21 days of life be reported?

Answer 4

May be STD from birth

Question 5

How is HZO treated?

Answer 5

Oral aciclovir

Question 6

What is chemosis?

Answer 6

conjunctival oedema

Question 7

What is the big groups of patients involved in keratitis?

Answer 7

Contact lens wearers, herpetic patients

Question 8

In rare cases, what diseases can lead to peripheral corneal ulcers?

Answer 8

Rheumatoid, Wegeners and other vaculitides

Question 9

What kinds of diseases can lead to exposure keratitis?

Answer 9

Thyroid disease, facial nerve palsy

Question 10

How are corneal bacterial corneal ulcers treated?

Answer 10

Swab, culture and treat to sensitivities

Question 11

What is the classical history of anterior uveitis?

Answer 11

Classic systemic diseases- ankylosing spondylitis
Infective causes- TB, herpes, syphilis
Achy pain
Photophobia
Red eye
May be referred pain

Question 12

How is anterior uveitis managed?

Answer 12

Topical steroid

Mydriatics (stop adhesions between iris and lens)

Question 13

How can scleritis be distinguished from conjunctivitis?

Answer 13

Larger injective vessels

Question 14

How is acute closed angle glaucoma often precipitated?

Answer 14

Often in long-sighted patients, precipitated by pupil dilatation

Question 15

How does acute angle glaucoma present?

Answer 15

Severe pain, pink eye, nausea and vomiting, cloudy cornea, stony hard eye, mid-dilated pupil

Question 16

How is acute glaucoma treated?

Answer 16

Diuretics
Ocular steroids
Constrict the pupil- pilocarpine

Question 17

How is anterior blepharitis distinguished from posterior?

Answer 17

Anterior- the lid margin is more red and painful looking, rather than deeper part

Question 18

How is blepharitis treated?

Answer 18

Lid hygiene (warm compresses)
Supplementary tear drops
Oral doxycycline

Question 19

How does acute bacterial conjunctivitis present, what usually causes it and how is it treated?

Answer 19

Red, sticky eye.
Usually staph
Self-limiting, will clear up within 2 weeks, faster with antibiotics.

Question 20

How should the cornea be examined?

Answer 20

Fluorescein dye and blue light under slit lamp

Question 21

Treatment of herpes corneal ulcers?

Answer 21

Topical aciclovir

Question 22

Reason for caution in using topical steroids for corneal ulcers?

Answer 22

If viral ulcer, can exacerbate

Question 23

Differences between scleritis and episcleritis?

Answer 23

Scleritis more painful
Scleritis associated with connective tissue disease, episcleritis not
Episcleritis blanches with topical epinephrine, scleritis doesn’t

Question 24

Treatment of episcleritis?

Answer 24

Topical lubricants or NSAIDs

Question 25

Treatment of scleritis?

Answer 25

oral NSAIDs or systemic NSAIDs

Question 26

Symptoms of anterior uveitis? (4)

Answer 26

Ache
Photophobia
Lacrimation
Blurred vision

Question 27

Associations of anterior uveitis?

Answer 27

HLA-B27 linked disorders e.g. ank spond, inflammatory bowel disease, psoriatic arthritis

Question 28

Treatment of anterior uveitis (2)

Answer 28

Hourly topical steroids

Topical mydriatic

Question 29

Red eye with cloudy cornea, fixed mid-dilated pupil, headache with N&V?

Answer 29

acute angle closure glaucoma