Acute Red Eye Flashcards
What are the 2 major causes of acute red eye?
Haemorrhage
Congestion
How can congestion be further broken down (2)
Localised
Generalised
How can generalised congestion be further broken down?
Conjunctival
Ciliary
What is blepharitis
Inflammation of eyelid margin
If anterior, what does blepharitis affect?
Eyelashes
If posterior, what does blepharitis affect?
Melbomian glands
PS blepharitis (4)
Sudden onset
Red eye margin
Burning/itching
Eyelids; inflamed, mild discharge, crusting
Causes blepharitis (3)
Staph
Sebrrheic dermatitis
Melbomian gland dysfunction
Mx blepharitis
Warm compress
Lid clean + massage
Artificial tears
Causes red eye; non-pain + norm VA (3)
Conjunctivitis
Subconjunctival haemorrhage
Episcleritis
causes red eye; painful + variable VA
Scleritis
Causes red eye - painful, decr VA (3)
Keratitis
Uveitis
AACG
Features subconjunctival haemorrhage
posterior edge of blood patch visible
Asymp
VA norm
Causes of subconjunctival haemorrhage
Post coughing/sneeze
Features retobulbar haemorrhage
Posterior edge not visible
Proptosis, restricted eye movements, raised P, pupil reaction
IF there is a poor pupil reaction with retrobular haemorrhage, what does this mean
Emergency
Causes retrobular haemorrhage
Iatrogrenic
Trauma
Causes of episcleritis
Idiopathic (70%)
Autoimmune
Sx episcleritis
Discomfort in eye
Acute onset
Eye watering
Gritty
Mx episcleritis
Self-limiting
Tx - NSAIDS
Scleritis
Inflammation through whole thickness of sclera
What is scleritis associated with?
Systemic disease e.g. RA, SLE
Sx scleritis
Severe eye pain
Worse on movement
Gradual onset
Mx scleritis
Oral/TO NSAIDS
CS
Generalised congestion (4)
Conjunctivitis
Keratitis
Uveitis
Acute glaucoma
WHere is conjunctival congestion predominantly?
In the conjunctival fornices
Features conjunctival fornices (5)
Superficial vessels Bright red in colour Blanch w/ TO VC Move w/ conjunctival folds Centripetal blood flow
Where is ciliary/circumcorneal congestion predominantly?
Deep vessels Dusky/dark red in colour Do not blanch w/ TO VC DO not move w/conjunctival folds Centrifugal blood flow
Viral conjunctivitis features
Gritty eyes
Watery discharge
Follicles
LN
Bacterial conjunctivitis features
Gritty eyes
Purulent discharge
LN
Allergic conjunctivitis features
Itchy eyes
Stringy discharge
Papillae
No LN
What is a follicle?
A collection of lymphocytes
If there is photophobia in conjunctivitis, what does this signify?
Corneal involvement
Which 2 conjunctivitis tend to be bilateral?
Viral
Allergic
Mx viral/allergic conjunctivitis
Usually self-limiting
Allergic - antiH drops
Mx bacterial conjunctivitis
Chloramphenicol
Fusidic acid drops
Ciprofloxacin drops
What are 99% of viral keratitis?
Herpes keratitis
Tx herpes keratitis?
Aciclovir
Sx viral keratitis
Pain Photophobia Redness Superficial dendritic ulcers Decr corneal sensation
Hutchinson’s sign
Vesicles on the tip of the nose
Precedes herpes keratitis
Bacteria causing keratitis (3)
S aureus
S pneumonia
Pseudomonas
Sx bacterial keratitis
Diffuse redness Pain Photophobia Discharge Reduced VA
Tx bacterial keratitis
Cycloplegia
Topical ABX
What are keratic preicpitates?
Deposition of keratin on back of cornea
What is uveitis?
Inflammation of iris + ciliary body
Features of uveitis
keratic precipitates Constricted pupil Synechiae (iris adhesions) Pain Photophobia Lacrimation
Mx uveitis
TO steroids
Cycloplegia
Ciliary congestions - AACG Sx+ signs
Headache, N+V Reduced vision Red eye Corneal haze/oedema Fixed mid-dilated pupil
