Acute Red Eye

Question 1

What types of haemorrhage cause acute red eye

Answer 1

subconjunctival

retrobulbar

Question 2

What are features of subconjunctival haemorrhage

Answer 2

ptosis 
sharp eye pain
decreased eye movement 
increased IOP 
pupil reactions
posterior border of the bleed CAN be seen

Question 3

What are the features of retrobulbar haemorrhage

Answer 3

similar to sunconjunctival but posterior border of bleed CANNOT be seen

Question 4

what are the most common reasons for subconjunctival haemorrhage

Answer 4

post-surgery
trauma
warfarin
increased pressure (URTI, breathing disorders)

Question 5

what is a complication of ocular haemorrhages

Answer 5

cranial nerve compression and blindness

Question 6

what are some features of episcleritis

Answer 6

localised epithelial inflammation of episcleral tissue, usually autoimmune

mild pain
non sight threatening

Question 7

what is the treatment of episcleritis

Answer 7

watch/wait + cold compress

NSAID eye drops

Question 8

what has a similar presentation to episcleritis but tends to be more severe

Answer 8

Scleritis

Question 9

what are the 2 types of congestion

Answer 9

conjunctival

ciliary/circumcorneal

Question 10

what are some features of conjunctival congestion

Answer 10

bright red ‘bloodshot’ eye
blanches with topical vasocontrictors
periphery has cornea flow

Question 11

what are some features of ciliary/cicumcorneal congestion

Answer 11

predominately around cornea
dusky in colour
does not lanch with vasoconstrictors  or move with conjunctival folds
centrifugal flow (cornea to periphery)

Question 12

how do you differentiate between viral/bacteria/allergic red eye

Answer 12

BACTERIA
gritty eye with purulent discharge and lymph involvement

VIRUS
gritty eye wth watery discharge and follicles on lower fornix. Lymph involvemen

ALLERGIC
itchy eye 
stringy discharge 
papillae in upper fornix (inside upper eyelid) 
no lymph involvement

Question 13

what commonly causes neonatal conjunctivitis

Answer 13

gonococcal and chlamydia organisms

Question 14

how serious is neonatal conjunctivitis

Answer 14

very - its sight-threatening

Question 15

what are some common causes of corneal trauma

Answer 15

pH
everted lids
conjunctiva laceraction 
corneal abrasion 
traumatic myadriasis 
vitreous haemorrhage

Question 16

what are features of herpes simplex keratitis

Answer 16

most common corneal infection

causes a painful cornea

Question 17

what is diagnostic of herpes simplex keratitis (99%)

Answer 17

squiggly branching ulcer seen on blue light

Question 18

how do you treat herpes simplex keratitis

Answer 18

aciclovir eye drops/ointment + steroids

Question 19

what causes herpes simplex keratitis most commonly

Answer 19

poor contact lens hygiene

Question 20

whats a consequence of chronic herpes simplex keratitis

Answer 20

necrosis in epithelium/stroma

Question 21

what is a hypopyon

Answer 21

pus released from the iris due to toxins released from ulcer after it builds in the anterior chamber

Question 22

what is uveitis

Answer 22

inflammation of the iris and ciliary body producing keratitis precipitates

Question 23

what are signs of uveitis

Answer 23

constricted pupil

irregular pupils due to attachment of the iris from inflammation

Question 24

what normally causes uveitis

Answer 24

usually unknown

Question 25

how do you treat uveitis

Answer 25

pupil dilator and steroids

Question 26

what are features of acute angle closure glacucoma

Answer 26

headache 
nausea
vomiting
decreased viison
'halos' 
red eye 
corneal haze
fixed mid-dilated pupil

Question 27

what happens if you treat herpetic corneal infections with only steroids + what should you add

Answer 27

increase chance of reinfection (immune suppression), aciclovir