Acute red eye Flashcards
What would you find on taking a history from a patient with Acute Red Eye? (6)
Redness of the eye – distribution, degree?
Pain – gritty, itchy, stabbing, throbbing
Discharge – purulent, mucoid, watery?
Photophobia - discomfort or pain due to light exposure
Flashing lights and floaters
Blurred vision – always ask
How would you examine acute red eye?
Determine best corrected visual acuity (degree of visual impairment) By using a Snellen chart - determine the smallest letters you can read on a standardised chart
Fundoscopy - direct ophthalmoscope, slit lamp & volk lens
Inspection of the lids and brows
Staining with fluroscene - outlines epithelial defects, foreign bodies, corneal abrasions, and corneal ulcers.
What is acute red eye? differential diagnoses?
the acute red eye refers to a patient with conjunctival and/or scleral redness
There’s a range of differential diagonses:
Acute Glaucoma
Anterior uveitis
Conjunctivitis
Subconjunctival haemorrhage
Infective Conjunctivitis:
Symptoms and signs? (3)
Treatment? (1)
Symptoms & Signs:
- Gritty
- Red
- Discharge (purulent/watery)
Treatment:
- Topical antibiotics
Allergic Conjunctivitis:
Symptoms and signs? (6)
Treatment? (3)
Symptoms & Signs: - Itchy - Red - Discharge (mucoid/watery) - Acute - Lid swelling - Conjunctival swelling (chemosis)
Treatment:
- Topical antihistamine
- Avoid allergen
- Mast cell stabilisers
Corneal Abrasion
Symptoms and signs? (4)
Treatment? (2)
Symptoms & Signs:
- Pain
- Watering
- Blurred vision
- Epithelial defect
Treatment:
- Topical antibiotics
- Analgesia
What is Acute Anterior Uveitis?
inflammation of iris and ciliary body
Symptoms and signs of Acute Anterior uveitis? (9)
- Pain
- Watering
- Photophobia
- +/- Blurred vision
- +/- floaters
- Red
- Hypopyon (inflammatory cells in the anterior chamber of the eye - leukocyte exudate)
- Small irregular pupil
- May have previous history
Treatment for Acute anterior uveitis?
Topical steroids
dilating drops
Scleritis
Symptoms + signs? (4)
Treatment? (1)
- Pain++
- Redness (deep scleral vessels)
- Nodule (does not move over sclera)
- Tender++
Treatment:
Systematic steroids
What is Acute Angle Closure Glaucoma?
occurs when the flow of aqueous humour out of the eye is blocked and pressure inside the eye becomes too high very quickly.
It is an emergency because if it is not treated quickly, it can lead to permanent loss of vision
Acute Angle closure Glaucoma
Symptoms and signs? (7)
Pain++
Redness
Blurred vision
Nausea & vomiting
Hazy cornea
Fixed mid dilated pupil
Hard eyeball
Treatment for acute angle closure glaucoma (2)
Lower intraocular pressure (eyedrops etc)
Constrict pupil
What is orbital cellulitis?
infection of orbital tissues
Symptoms and signs of orbital cellulitis? (8)
Pain+ Redness Blurred vision Diplopia (double vision) Malaise (unwell) Pyrexia Proptosis Reduced eye movement
