Acute Red Eye

Question 1

What are the 2 major causes of acute red eye?

Answer 1

Haemorrhage

Congestion

Question 2

How can congestion be further broken down (2)

Answer 2

Localised

Generalised

Question 3

How can generalised congestion be further broken down?

Answer 3

Conjunctival

Ciliary

Question 4

What is blepharitis

Answer 4

Inflammation of eyelid margin

Question 5

If anterior, what does blepharitis affect?

Answer 5

Eyelashes

Question 6

If posterior, what does blepharitis affect?

Answer 6

Melbomian glands

Question 7

PS blepharitis (4)

Answer 7

Sudden onset
Red eye margin
Burning/itching
Eyelids; inflamed, mild discharge, crusting

Question 8

Causes blepharitis (3)

Answer 8

Staph
Sebrrheic dermatitis
Melbomian gland dysfunction

Question 9

Mx blepharitis

Answer 9

Warm compress
Lid clean + massage
Artificial tears

Question 10

Causes red eye; non-pain + norm VA (3)

Answer 10

Conjunctivitis
Subconjunctival haemorrhage
Episcleritis

Question 11

causes red eye; painful + variable VA

Answer 11

Scleritis

Question 12

Causes red eye - painful, decr VA (3)

Answer 12

Keratitis
Uveitis
AACG

Question 13

Features subconjunctival haemorrhage

Answer 13

posterior edge of blood patch visible
Asymp
VA norm

Question 14

Causes of subconjunctival haemorrhage

Answer 14

Post coughing/sneeze

Question 15

Features retobulbar haemorrhage

Answer 15

Posterior edge not visible

Proptosis, restricted eye movements, raised P, pupil reaction

Question 16

IF there is a poor pupil reaction with retrobular haemorrhage, what does this mean

Answer 16

Emergency

Question 17

Causes retrobular haemorrhage

Answer 17

Iatrogrenic

Trauma

Question 18

Causes of episcleritis

Answer 18

Idiopathic (70%)

Autoimmune

Question 19

Sx episcleritis

Answer 19

Discomfort in eye
Acute onset
Eye watering
Gritty

Question 20

Mx episcleritis

Answer 20

Self-limiting

Tx - NSAIDS

Question 21

Scleritis

Answer 21

Inflammation through whole thickness of sclera

Question 22

What is scleritis associated with?

Answer 22

Systemic disease e.g. RA, SLE

Question 23

Sx scleritis

Answer 23

Severe eye pain
Worse on movement
Gradual onset

Question 24

Mx scleritis

Answer 24

Oral/TO NSAIDS

CS

Question 25

Generalised congestion (4)

Answer 25

Conjunctivitis Keratitis Uveitis Acute glaucoma

Question 26

WHere is conjunctival congestion predominantly?

Answer 26

In the conjunctival fornices

Question 27

Features conjunctival fornices (5)

Answer 27

``` Superficial vessels Bright red in colour Blanch w/ TO VC Move w/ conjunctival folds Centripetal blood flow ```

Question 28

Where is ciliary/circumcorneal congestion predominantly?

Answer 28

``` Deep vessels Dusky/dark red in colour Do not blanch w/ TO VC DO not move w/conjunctival folds Centrifugal blood flow ```

Question 29

Viral conjunctivitis features

Answer 29

Gritty eyes Watery discharge Follicles LN

Question 30

Bacterial conjunctivitis features

Answer 30

Gritty eyes Purulent discharge LN

Question 31

Allergic conjunctivitis features

Answer 31

Itchy eyes Stringy discharge Papillae No LN

Question 32

What is a follicle?

Answer 32

A collection of lymphocytes

Question 33

If there is photophobia in conjunctivitis, what does this signify?

Answer 33

Corneal involvement

Question 34

Which 2 conjunctivitis tend to be bilateral?

Answer 34

Viral | Allergic

Question 35

Mx viral/allergic conjunctivitis

Answer 35

Usually self-limiting | Allergic - antiH drops

Question 36

Mx bacterial conjunctivitis

Answer 36

Chloramphenicol Fusidic acid drops Ciprofloxacin drops

Question 37

What are 99% of viral keratitis?

Answer 37

Herpes keratitis

Question 38

Tx herpes keratitis?

Answer 38

Aciclovir

Question 39

Sx viral keratitis

Answer 39

``` Pain Photophobia Redness Superficial dendritic ulcers Decr corneal sensation ```

Question 40

Hutchinson’s sign

Answer 40

Vesicles on the tip of the nose | Precedes herpes keratitis

Question 41

Bacteria causing keratitis (3)

Answer 41

S aureus S pneumonia Pseudomonas

Question 42

Sx bacterial keratitis

Answer 42

``` Diffuse redness Pain Photophobia Discharge Reduced VA ```

Question 43

Tx bacterial keratitis

Answer 43

Cycloplegia | Topical ABX

Question 44

What are keratic preicpitates?

Answer 44

Deposition of keratin on back of cornea

Question 45

What is uveitis?

Answer 45

Inflammation of iris + ciliary body

Question 46

Features of uveitis

Answer 46

``` keratic precipitates Constricted pupil Synechiae (iris adhesions) Pain Photophobia Lacrimation ```

Question 47

Mx uveitis

Answer 47

TO steroids | Cycloplegia

Question 48

Ciliary congestions - AACG Sx+ signs

Answer 48

``` Headache, N+V Reduced vision Red eye Corneal haze/oedema Fixed mid-dilated pupil ```