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Ophthalmology > Acute Red Eye > Flashcards

Acute Red Eye Flashcards

1
Q

What can predispose a patient to a subconjunctival haemorrhage?

A

antiplatelets
trauma
clotting problem
High blood pressure with poor control

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2
Q

How long does a subconjunctival haemorrhage take to disappear?

A

1-2 weeks (stays red for this amount of time)

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3
Q

What is the definition of orbital cellulitis?

A

Infection of soft tissues around the eye and of the orbit

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4
Q

What consequences can orbital cellulitis have?

A
  • Infection can track to brain and cause abscess

- Can cause visual loss if severe

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5
Q

`What are the most common causes of orbital cellulitis?

A
  • Insect bites
  • eyelid trauma
    PAEDs = Sinus infection through the nasal orbital wall
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6
Q

What components of tears make them important in immune defence?

A
  • Tear flow/drainage
  • Mucous trapping
  • Lysozyme
  • IgA and IgG
  • Complement
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7
Q

What should be asked about in a specific eye history?

A
  • Pain
  • Foreign body sensation (grittiness, dryness)
  • Itch
  • Discharge / Tearing
  • Photophobia
  • Visual loss?
  • Past ocular disorders
  • Contact lenses?
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8
Q

Eye pain radiating to the brow suggests what?

A

Intra-ocular inflammation

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9
Q

A report of itch in an eye history indicates what?

A

The cause of inflammation is likely to be an allergy

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10
Q

What severe infection can result from contact lens wear?

A

Acanthomoeba

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11
Q

What facial signs should be looked for in an eye examination?

A

muscle wasting due to a CN VII palsy which could affect functions of the eyes

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12
Q

What other structures should be observed on the face during an eye examination?

A
  • Lids (lid margins, lashes)
  • Conjunctivae – (tarsal and bulbar)
  • Cornea
  • Anterior chamber
  • Iris / pupil
  • Intra-ocular pressure
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13
Q

What is blepharitis and what are the two subtypes?

A

Inflamed eyelid

ANTERIOR vs POSTERIOR

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14
Q

What are the two causes of anterior blepharitis?

A 
Seborrhoeic cause (scales on lashes)
Staph. (lash follicle involved)
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15
Q

What causes posterior blepharitis?

A
  • Meibomian gland dysfunction

redness is in deeper part of lid

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16
Q

How does staph blepharitis usually present?

A
  • Lashes distorted/loss of lashes/ingrowing lashes
  • Styes (ulcers of lid margin)
  • corneal staining
  • marginal ulcers (due to exotoxin)
17
Q

What sign is distinctive of seborrhoeic blepharitis?

A

Teepee Sign

lashes are stuck together in groups which look like Teepee’s

18
Q

What signs are present in Meibomian Gland disease?

A
  • Dried secretion at gland openings

- Meibomian Cysts due to gland blockage

19
Q

Meibomian gland disease is related to what dermatological condition?

A

Acne rosacea

20
Q

How is blepharitis treated?

A
  • Lid hygiene – daily bathing / warm compresses
  • Supplementary tear drops
  • Oral doxycycline for 2-3 months
21
Q

Papillae are present in bacterial conjunctivitis, whereas follicles can be seen viral and chlamydial conjunctivitis. TRUE/FALSE?

A

TRUE

22
Q

Vision can be affected in conjunctivitis. TRUE/FALSE?

A

FALSE

vision is unaffected

23
Q

What lymph nodes become enlarged in viral and chlamydial conjunctivitis?

A

pre-auricular

24
Q

If Herpes Zoster ophthalmica extends to the tip of the nose, what does this normally indicate?

A

Nasociliary nerve involvement

25
Q

What is chemosis?

A

Conjunctival oedema

26
Q

Give an example of a drug which can cause chronic conjunctivitis?

A

Alphagan (used in glaucoma)

25% of patients have a drug reaction after using for 12 months

27
Q

What causes corneal ulcers in the centre?

A

Viral
Fungal (rare in UK)
Bacterial
Acanthamoeba

28
Q

What causes peripheral corneal ulcers?

A

rheumatoid arthritis

hypersensitivity e.g. marginal ulcers

29
Q

Why is a local anaesthetic required to do a corneal exam?

A

Highest density of sensory nerves

30
Q

What symptoms and signs indicate a corneal ulcer?

A 
Pain
Photophobia
Profuse lacrimation
Red
Corneal opacity
Staining 
hypopyon
31
Q

Why are patients with thyroid eye disease or a CN VII palsy at increased risk of eye infection?

A

Increased exposure due to eyelid not closing properly

32
Q

How are corneal ulcers treated?

A 
Bacterial = ofloxacin hourly
Herpetic = Antiviral = Aciclovir ointment 5 x day
Autoimmune = Anti-inflammatory = Oral / topical steroids
33
Q

What malignancy can cause anterior uveitis?

A

leukaemia

34
Q

What autoimmune conditions can cause anterior uveitis?

A

Ulcerative colitis
Ankylosing Spondylitis
Sarcoidosis

35
Q

What is synechiae?

A

Irregular shaped pupil as iris is stuck to crystalline lens

36
Q

How is anterior uveitis treated?

A 
Steroids suppress inflammation
Pupil dilatation (Mydriatics) => prevent it from being stuck down
37
Q

How do we differentiate between episcleritis and scleritis?

A

Scleritis = painful!

Also phenylephrine test

  • episcleritis blanches
  • scleritis does not as inflammation is deeper
38
Q

What is the treatment for episcleritis?

A

Lubricants / topical NSAIDs / mild steroids

the condition is self limiting

39
Q

How is scleritis treated?

A
  • Oral NSAIDs
  • Oral Steroids
  • Steroid Sparing Agents

Ophthalmology (13 decks)

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