Acute red eye

Question 1

most common cause of an acute red eye

Answer 1

conjunctivitis/blepharo-conjunctivitis

Question 2

causes of an acute red eye (5)

Answer 2

conjunctivitis/blepharo-conjunctivitis
keratitis
anterior uveitis
scleritis/episcleritis
AACG

Question 3

the reduction in ocular defenses that parkinsons causes

Answer 3

decreased blink rate

Question 4

procedure for examining IOP digitally =

in glaucoma feels like :

Answer 4

ptnt closes eyes and looks down
ballot eye either side of sup rectus
“stony hard”

Question 5

inflamed eyelids aka

Answer 5

blepharitis

Question 6

blepharitis where lid margin is redder than the deeper part of the lid =
two types and their distinguishing features =

Answer 6

anterior
Seborrhoeic (squamous) - scales on lashes
Staph - infection of lash follicle

Question 7

posterior blepharitis is red in the ___ part of the lid

caused by

Answer 7

deeper

MGD - meibomian gland dysfunction

Question 8

symptoms of blepharitis

Answer 8

gritty eyes
FB sensation
mild discharge - crusting

Question 9

seborrhoeic blepharitis signs

Answer 9

lid margin red
++ scales
+ dandruff
no ulcers and lashes are unaffected

Question 10

staph blepharitis signs

Answer 10

lid margin red
lashes distorted (teepee sign)/lost/ingrowing (trichiasis)
styes
ulcers
corneal staining and marginal ulcers (due to exotoxin)

Question 11

trichiasis =

Answer 11

ingrowing of eyelashes

Question 12

signs of posterior blepharitis

50% associated with

Answer 12

lid margin skin and lashes unaffected
MG openings pouting and swollen
inspissated secretion at gland openings
chalazia
50% Rosacea (may=> corneal ulcers)

Question 13

chalazia =

Rx =

Answer 13

meibomian cysts

LA and curettage

Question 14

treatment to control blepharitis

Answer 14

daily bathing and warm compresses for lids
supplementary tear drops
PO doxycycline for 2-3months

Question 15

causes of conjunctivitis (5)

Answer 15

infective(bac>viral>chlamydial)
allergic
chemical
drugs
skin eg eczema

Question 16

sign of severe conjunctivitis - most commonly allergic –

Answer 16

chemosis

Question 17

conjunctivitis causes a red eye that is ___ +___

Answer 17

more towards the fornicles

diffuse

Question 18

discharge in viral conjunctivitis is __

in bacterial is ___

Answer 18

viral = serous
bac = mucopurulent

Question 19

papillae in conjunctivitis suggest a __ cause

Answer 19

bacterial

Question 20

follicular conjunctivitis suggest a __/___ cause

Answer 20

viral or chlamydial

Question 21

pre-auricular glands are seen in ___ conjunctivitis

Answer 21

viral

Question 22

features of bacterial conjunctivitis

Answer 22

red and sticky eye
papillae
self limiting roughly 14 days
unilateral (then bilateral due to rubbing eye)

Question 23

causes of bacterial conjunctivitis

Answer 23

S. aureus (most common)
Strep pneum
H. influ

Question 24

papillae have ___ blood vessels

follicles look like ____ with ___ blood vessels

Answer 24

papillae = central
follicles = grain of rice - peripheral

Question 25

drugs that can cause a follicular conjunctivitis

Answer 25

propine | trusopt

Question 26

causes of chronic conjunctivitis (6)

Answer 26

``` blepharitis chlamydia keratoconjunctivitis sicca lacrimal disease (chronic dacrocystitis) sensitivity to topical glaucoma Rx subtarsal FB ```

Question 27

2 types of corneal ulcers and their causes

Answer 27

central/infective (viral, bactrerial, acanthamoeba, fungal) | peripheral/AI (RA, hypersensitivity, GPA)

Question 28

s+s of keratitis (9)

Answer 28

``` needle sharp pain photophobia profuse lacrimation circumcorneal red eye maybe decreased vision abnormal corneal reflex corneal opacity stain with fluorescein hypopyon ```

Question 29

exposure keratitis 2 causes

Answer 29

thyroid, CNIII paly cause ectropion

Question 30

neurotrophic keratitis underlying problem = | causes =

Answer 30

tears not stimulated diabetes HZV CNV1

Question 31

___ deficiency can cause keratitis | caused by __/___ possibly

Answer 31

vit A liver disease bariatric Sx

Question 32

Ix for keratitis

Answer 32

cornela reflex? fluorescein opacity/oedema/vascularisation on exam? corneal scrape for gram stain and culture

Question 33

treatment for bacterial keratitis

Answer 33

ofloxacin hrly for at least 48hrs

Question 34

treatment for herpetic keratitis

Answer 34

aciclovir ointment for 5 days /PO

Question 35

AI keratitis Rx

Answer 35

oral / topical steroids

Question 36

causes of anterior uveitis

Answer 36

``` AI (ank spond, Reiters UC, Sarcoid) infective (tb, HS/Z, syphilis) leukaemia idiopathic trauma ```

Question 37

s+s of anterior uveitis (8)

Answer 37

``` dull ache often referred to brow maybe reduced vision photophobia circumcorneal red eye cells and flare in anterior chamber keratic precipitates hypopyon synechiae ```

Question 38

synechiae =

Answer 38

iris adheres to cornea => small/irregular pupil

Question 39

ciliary injection => what sign?

Answer 39

circumcorneal red eye

Question 40

Rx for anterior uveitis

Answer 40

``` topical steroids (Pred Forte 1% hrly - taper over 4-8wks) mydriatics (cyclophentolate 1% bd - breaks synechiae) ```

Question 41

Rx to break synechiae

Answer 41

cyclophentolate 1% bd (mydriatic)

Question 42

phenylephrine test result in episcleritis

Answer 42

vessels blanch

Question 43

Rx for episcleritis

Answer 43

time | or lubricants/topical NSAIDS/mild steroids

Question 44

episcleritis/scleritis is serious?

Answer 44

scleritis

Question 45

scleritis is very ___, associated with __+___, ___ => violaceous hue

Answer 45

painful uveitis and systemic vasculitides (eg. RA, GPA) injection of deep vascular plexus

Question 46

phenylephrine test result in scleritis

Answer 46

vessels are deeper and so dont blanch

Question 47

Rx for scleritis

Answer 47

PO NSAIDs / PO steroids / steroid sparing agents

Question 48

____ precipitates acute closed angle glaucoma and so it is worse at ___

Answer 48

pupil dilatation | night

Question 49

s+s of acute closed angle glaucoma

Answer 49

``` severe pain may lead to nausea circumcorneal injection oedematous/cloudy cornea pupil mid dilated eye stony hard ```

Question 50

at risk groups for AACG (2)

Answer 50

``` elderly hypermetropic (small orbit = less space) ```