Acute Red Eye Flashcards
What can predispose a patient to a subconjunctival haemorrhage?
antiplatelets
trauma
clotting problem
High blood pressure with poor control
How long does a subconjunctival haemorrhage take to disappear?
1-2 weeks (stays red for this amount of time)
What is the definition of orbital cellulitis?
Infection of soft tissues around the eye and of the orbit
What consequences can orbital cellulitis have?
- Infection can track to brain and cause abscess
- Can cause visual loss if severe
`What are the most common causes of orbital cellulitis?
- Insect bites
- eyelid trauma
PAEDs = Sinus infection through the nasal orbital wall
What components of tears make them important in immune defence?
- Tear flow/drainage
- Mucous trapping
- Lysozyme
- IgA and IgG
- Complement
What should be asked about in a specific eye history?
- Pain
- Foreign body sensation (grittiness, dryness)
- Itch
- Discharge / Tearing
- Photophobia
- Visual loss?
- Past ocular disorders
- Contact lenses?
Eye pain radiating to the brow suggests what?
Intra-ocular inflammation
A report of itch in an eye history indicates what?
The cause of inflammation is likely to be an allergy
What severe infection can result from contact lens wear?
Acanthomoeba
What facial signs should be looked for in an eye examination?
muscle wasting due to a CN VII palsy which could affect functions of the eyes
What other structures should be observed on the face during an eye examination?
- Lids (lid margins, lashes)
- Conjunctivae – (tarsal and bulbar)
- Cornea
- Anterior chamber
- Iris / pupil
- Intra-ocular pressure
What is blepharitis and what are the two subtypes?
Inflamed eyelid
ANTERIOR vs POSTERIOR
What are the two causes of anterior blepharitis?
Seborrhoeic cause (scales on lashes) Staph. (lash follicle involved)
What causes posterior blepharitis?
- Meibomian gland dysfunction
redness is in deeper part of lid
How does staph blepharitis usually present?
- Lashes distorted/loss of lashes/ingrowing lashes
- Styes (ulcers of lid margin)
- corneal staining
- marginal ulcers (due to exotoxin)
What sign is distinctive of seborrhoeic blepharitis?
Teepee Sign
lashes are stuck together in groups which look like Teepee’s
What signs are present in Meibomian Gland disease?
- Dried secretion at gland openings
- Meibomian Cysts due to gland blockage
Meibomian gland disease is related to what dermatological condition?
Acne rosacea
How is blepharitis treated?
- Lid hygiene – daily bathing / warm compresses
- Supplementary tear drops
- Oral doxycycline for 2-3 months
Papillae are present in bacterial conjunctivitis, whereas follicles can be seen viral and chlamydial conjunctivitis. TRUE/FALSE?
TRUE
Vision can be affected in conjunctivitis. TRUE/FALSE?
FALSE
vision is unaffected
What lymph nodes become enlarged in viral and chlamydial conjunctivitis?
pre-auricular
If Herpes Zoster ophthalmica extends to the tip of the nose, what does this normally indicate?
Nasociliary nerve involvement
