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AY Ophthalmology > Acute red eye > Flashcards

Acute red eye Flashcards

1
Q

hat coniditons can cause a red eye?

A 
Conjunctivitis 
Keratits 
Anterior uveitis 
Acleritis/Episcleritis 
Acute close angle glaucoma 
Subconjunctival haemorrhage 
Orbital disease (e.g. cellulitis)
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2
Q

What is the most common cause of a red eye?

A

Conjunctivitis

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3
Q

What is secreted from the lids in defence?

A

Mebomian

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4
Q

What is blepharitis?

A

Inflamed eyelids

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5
Q

What is a sty?

A

Staph infection involving the lash follicle

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6
Q

How do differentiate between anterior & posterior blepharitis?

A

Anterior - seborrhoeic scales on the lashed, lid margin redder than deeper part of lid

Posterior - redness is in deeper part of lid, lid margin often quite normal looking

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7
Q

What causes posterior blepharitis?

A

Meibomian gland dysfunction

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8
Q

Symptoms of blepharitis

A

Similar to conjunctivitis
Gritty eyes
Foreign body sensation
Mild discharge

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9
Q

What other causes of red eye is blepharitis associated with?

A

Conjunctivitis
Keratitis
Episcleritis

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10
Q

Signs of seborrhoeic anterior blepharitis

A

Lid margin red
Scales ++
Dandruff +
(No ulceration, lashes unaffected)

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11
Q

Sign of staphylococcal anterior blepharitis

A 
Lid margin red 
Lashes distorted, loss of lashes, ingrowing lashes 
Styes ulcer of lid margin 
Corneal staining 
Marginal ulcers (due to axotoxin)
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12
Q

Signs of posterior blepharitis

A

Lid margin skin and lashes unaffected
MG openingspouting & swollen
Inspissated (dried) secretion at gland openings
Meibomian cysts (chalazia)

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13
Q

What is posterior blepharitis associated with?

A

Acne Rosacea (50%) `

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14
Q

Management of Blepharitis

A

Lid hygiene - daily bathing/warm compresses
Supplementary tear drops
Oral doxycyine for 2-3 mnths

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15
Q

Infective causes of conjunctivitis

A

Viral
Bacterial
Chylamydial

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16
Q

Non-infective causes of conjunctivitis

A

Allergic
Chemical/drugs
Skin diseases - eczema

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17
Q

Symptoms of conjunctivitis

A 
Red eye 
Foreign body sensation (gritty eye) 
Discharge - sticky eye 
Itch = allergy
VISION UNAFFECTED
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18
Q

Signs of conjunctivitis

A 
Red eye 
Discharge
Papillae or follicles 
Sub conjunctival haemorrhage 
Chemosis
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19
Q

Which glands may be enlarged in viral conjunctivitis?

A

Pre-auricular glands

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20
Q

How long does acute bacterial conjunctivitis take to clear up without treatment?

A

14 days

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21
Q

What are the most common causative organism of acute bacterial conjunctivitis?

A

Staph. aureus
Strep. pneumoniae
H. influenzae

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22
Q

What causes follicular conjunctivitis?

A

Viral (adeno, HS, HZ)
Chlamydial
Drugs (e.g. propine, trusopt)

23
Q

Causes of chronic conjunctivitis

A

Blepharitis
Chlamydial infection
Keratoconjunctivitis sicca
Lacrimal disease (chronic dacryocysitis)
Sensitivity to topical glaucoma medication
Sub-tarsal foreign body

24
Q

How long does conjunctivitis have to last for to be termed chronic?

A

4 weeks

25
Q

What are the 3 layers of the cornea?

A

Epithelium
Stroma
Endothelium

26
Q

Causes of central cornea ulcers?

A

Viral
Fungal
Bacterial
Acanthamoeba

27
Q

Causes of peripheral corneal ulcers

A

RA

Hypersensitivity e.g. marginal ulcers)

28
Q

Symptoms of corneal ulcer

A 
Pain +
Photophobia 
Profuse lacrimation 
Vision may be reduced 
Circumcorneal red eye
29
Q

Signs of corneal ulcer?

A 
Redness
Corneal reflex (reflection abnormal) 
Corneal opacity 
Staining with luroscein 
Hypopyon
30
Q

Causes of exposure keratitis

A

Thyroid

VII palsy

31
Q

In what condition does keratoconjunctivitis sicca occur?

A

Sjogren’s

32
Q

What can cause neutrophic keratitis?

A

Herpes zoster V1

33
Q

Deficiency of which vitamin can causes corneal ulcers?

A

Vitamin A

34
Q

Investigation for corneal ulcers?

A

‘Corneal scrape’[ for gram stain & culture

35
Q

Treatment of bacterial infected corneal ulcer?

A

Antimicrobial (e.g.ofloxacin hourly)

36
Q

Treatment of herpetic corneal ulcer

A

Aciclovir ointment 5 x day

37
Q

Autoimmune causes of anterior uveitis

A

Reiter’s
UC
Ankylosing spondylitis
Sarcoidosis

38
Q

Infective causes of anterior uveitis

A

TB
Syphylis
Herpes Simplex
Herpes Zoster

39
Q

Malignant cause of anterior uveitis

A

Leukemia

40
Q

Symptoms of anterior uveitis

A

Achy pain (+ referred pain)
Vision may be reduced
Photophobia
Red eye (circumcorneal)

41
Q

Signs of anterior uveitis

A 
Ciliary injection 
Cells & flare in anterior chamber 
Keratic precipitates 
Hypopyn 
Synechia (small or irregular pupil)
42
Q

Management of anterior uveitis

A

Topical steroids (pred forte 1% hourly tapering over 4-8 weeks)
Mydriatics
Investigate for systemic associations

43
Q

What is episcleritis associated with?

A

Gout

44
Q

Management of episcleritis

A

Self limiting

Lubricants/topical NSAIDs/ mild steroids

45
Q

Which is more serious scleritis or episcleritis?

A

Scleritis

46
Q

What is scleritis associated with?

A

Serious systemic vasculitides (e.g. RA, Wegners)

47
Q

Presentation of scleritis

A

PAINFUL +

Injection of deep vascular plexus - violaceous hue

48
Q

What other eye condition is scleritis commonly associated with?

A

Uveitis

49
Q

What test can be used to confirm scleritis?

A

Phenylephrine test

50
Q

Treatment of scleritis

A

Oral NSAIDs
Oral Steroids
Steroid sparing agents

51
Q

WHat is acute closed angle galucoma?

A

IOP rises acutely due to drainage angle being closed

52
Q

Features of glaucoma

A 
Circumcorneal injection 
Cornea cloudy 
Pupil middilated 
Eye stony hard 
Severe pain + nausea
53
Q

Which individuals are particularly predisposed to acute closed angle galucoma?

A

Elderly

Hypermetropic

54
Q

What wrrants an urgent referral in a red eye?

A

Vision affected

Marked photophobia

AY Ophthalmology (10 decks)

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