Acute red eye Flashcards
A 40-year-old man presents to the emergency department complaining of red eye without purulent discharge. He also has pain, photophobia, blurred vision, and tearing. On slit-lamp examination, the attending ophthalmologist notices a small irregular pupil, conjunctival injection around the corneal limbus, and WBCs in the anterior chamber. What is the most likely diagnosis
anterior uevitis
A 6-year-old girl with no significant past medical history presents 4 days after developing a red, irritated left eye. Her mother states that she has been wiping thick whitish-yellow discharge from her eye, and the eye is matted shut in the morning. She denies any exposure to an infected person, upper respiratory tract symptoms, or contact lens use. She also denies any significant pain or light sensitivity. On examination, the patient’s pupils are equal and reactive. She does not have a tender pre-auricular lymph node. Penlight examination does not reveal any corneal opacity, but thick, whitish discharge is seen. what is the most likely diagnosis
bacterial conjunctivitis
A 14-year-old boy with no significant past medical history presents 3 days after developing a red, irritated right eye that spread to the left eye today. He has watery discharge from both eyes and they are stuck shut in the morning. He reports recent upper respiratory tract symptoms and that several children at his day camp recently had pink eye. He denies significant pain or light sensitivity and does not wear contact lenses. On examination, his pupils are equal and reactive and he has a right-sided, tender pre-auricular lymph node. Penlight examination does not reveal any corneal opacity. What is the most likely diagnosis
viral conjunctivitis
itchy and a watery discharge of the eye is associated with what
allergic conjunctivitis
a white/yellow purulent discharge in someone who is sexually active is typical of
chlamydial conjunctivitis
follicles are usually present in what type of conjunctivitis
chlamydial/fungal
papillae are usually present in which type of conjunctivitis
bacterial
Pre-auricular nodes are usually tender in what type of conjunctivitis
viral/chlamydial
A 65-year-old man presents with bilateral ocular itching, burning, and foreign body sensation, as well as crusting of his eyelids in the morning for the past several months. He also notes that his eyes are often red and feel dry. Physical examination demonstrates facial pustules, facial redness, and telangiectasia. Slit lamp examination shows lid collarettes, telangiectasia, and capped meibomian glands.
What is the most likely diagnosis
posterior blepharitis caused by meibomian gland dysfunction
What are the most likely causative organisms of anterior blepharitis
staph aureus
P. acnes (in rosacea)
corynebacterium
anterior blepharitis caused by seborrheic will present as what
lid margin red
scales
dandruff
lashes unaffected
What is seborrheic anterior blepharitis associated with
seborrheic dermatitis
What will anterior blepharitis caused by staph aureus infection of the lash follicle present as
lid margin red
lashes lost, distorted (collaretes) or ingrown (trichiasis)
styes or ulcers on lid margin
what percentage of posterior blepharitis caused by meibomian gland dysfunction is caused by acne rosacea
50%
what is the presentation of posterior blepharitis caused by meibomian gland dysfunction
redness in deeper part of lid skin and lashes normal lid telangiectasia meibomian glands pouting and swollen - dried secretion at gland opening meibomian cysts (chalazia)
What is the treatment for blepharitis
lid hygiene
supplementary tear drops
if visual impairment secondary to corneal involvement - doxycycline + eyelid hygiene
What is chemosis
oedema of the conjunctiva
What are the layers of the cornea
epithelium
stroma
endothelium
if a corneal ulcer is central, it is most likely to be
infective
if a corneal ulcer is peripheral, it is most likely to be
autoimmune - CTD/RA associated
if a corneal ulcer is central in a person that wears contact lenses, what is the most likely organism involved
acanthamoeba
What does a corneal ulcer present as
needle like pain
photophobia
profuse lacrimation
In a bacterial corneal ulcer, you treat with
ofloxacin
In an autoimmune corneal ulcer, you treat it with
anti-inflammatories - steroids (oral/topical)
