Acute red eye Flashcards
What are the two types of eye pain and what generally do they indicate?
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
What causes posterior blepharitis?
Blockage of the (Meibomian) glands on the eyelid
What is a chalazion?
Cyst of the Meibomian glands
Why must a child with conjunctivitis within the first 21 days of life be reported?
May be STD from birth
How is HZO treated?
Oral aciclovir
What is chemosis?
conjunctival oedema
What is the big groups of patients involved in keratitis?
Contact lens wearers, herpetic patients
In rare cases, what diseases can lead to peripheral corneal ulcers?
Rheumatoid, Wegeners and other vaculitides
What kinds of diseases can lead to exposure keratitis?
Thyroid disease, facial nerve palsy
How are corneal bacterial corneal ulcers treated?
Swab, culture and treat to sensitivities
What is the classical history of anterior uveitis?
Classic systemic diseases- ankylosing spondylitis Infective causes- TB, herpes, syphilis Achy pain Photophobia Red eye May be referred pain
How is anterior uveitis managed?
Topical steroid
Mydriatics (stop adhesions between iris and lens)
How can scleritis be distinguished from conjunctivitis?
Larger injective vessels
How is acute closed angle glaucoma often precipitated?
Often in long-sighted patients, precipitated by pupil dilatation
How does acute angle glaucoma present?
Severe pain, pink eye, nausea and vomiting, cloudy cornea, stony hard eye, mid-dilated pupil
How is acute glaucoma treated?
Diuretics
Ocular steroids
Constrict the pupil- pilocarpine
How is anterior blepharitis distinguished from posterior?
Anterior- the lid margin is more red and painful looking, rather than deeper part
How is blepharitis treated?
Lid hygiene (warm compresses) Supplementary tear drops Oral doxycycline
How does acute bacterial conjunctivitis present, what usually causes it and how is it treated?
Red, sticky eye.
Usually staph
Self-limiting, will clear up within 2 weeks, faster with antibiotics.
How should the cornea be examined?
Fluorescein dye and blue light under slit lamp
Treatment of herpes corneal ulcers?
Topical aciclovir
Reason for caution in using topical steroids for corneal ulcers?
If viral ulcer, can exacerbate
Differences between scleritis and episcleritis?
Scleritis more painful
Scleritis associated with connective tissue disease, episcleritis not
Episcleritis blanches with topical epinephrine, scleritis doesn’t
Treatment of episcleritis?
Topical lubricants or NSAIDs
Treatment of scleritis?
oral NSAIDs or systemic NSAIDs
Symptoms of anterior uveitis? (4)
Ache
Photophobia
Lacrimation
Blurred vision
Associations of anterior uveitis?
HLA-B27 linked disorders e.g. ank spond, inflammatory bowel disease, psoriatic arthritis
Treatment of anterior uveitis (2)
Hourly topical steroids
Topical mydriatic
Red eye with cloudy cornea, fixed mid-dilated pupil, headache with N&V?
acute angle closure glaucoma
