Acute red eye Flashcards
what is blepharitis
inflammation of the eyelid margins
what is anterior vs posterior blepharitis
anterior is lid margin and not deeper lid whereas posterior is further back n eyelid
what are symptoms of blepharitis
gritty eyes / dry / mild discharge (can feel like conjunctivitis)
what can blepharitis be associated with
conjunctivitis, keratitis and episcleritis
what types of anterior blepharitis are there
seborrheic (scale on lashes) vs staph (infection of lash follicle)
what are symptoms of anterior seborrheic blepharitis
red lid margin, scale and dandruff (no ulceration and unaffected lashes)
what are symptoms of anterior staph blepharitis
red lid margin, distorted lashes, stys and ulcers, corneal staining
what causes posterior blepharitis
meibomian gland dysfunction (MGD)
what are symptoms of MGD
lid margin and lashes unaffected / swelling in upper eyelids / dried secretion at gland opening / meibomian cysts
what is MGD associated with
acne rosacea (50%)
how do you manage blepharitis
lipid hygiene / tear drops / oral doxycycline for 2-3 months
what infective causes of conjunctivitis are there
viral, bacterial, chlamydial
what are common non-infective causes of conjunctivitis
ALLERGIC, chemical, eczema
what are symptoms of viral conjunctivitis
red eye / gritty sensation / discharge (sticky vs watery) / itch / oedema / UNaffected vision
what are symptoms of bacterial conjunctivitis
red sticky eye / papillae (chlamydia) / start in one eye and spread to the other
what causes bacterial conjunctivitis
staph A, strep pneumonia, H influenza, chlamydia
how do you treat bacterial conjunctivitis
chloramphenicol (not pseudomonas)
wha causes viral conjunctivitis
adenovirus, H simplex, H zoster (secondary to mollucusm contagiosium - pox virus)
what are the layers of the cornea from anterior to posterior
epithelium - stroma - endothelium
what are infective causes of corneal ulcers
viral, fingal, bacterial, acanthamoeba (contact lenses)
what are systemic causes of corneal ulcers
RA, hypersensitivity, rarely small vessel vasculitis
what are symptoms of corneal ulcers (5)
pain (needle like and severe) / photophobia / profuse lacrimation / red eye/ reduced vision
what are signs of corneal ulcers (5)
circumcorneal redness / corneal reflex / corneal opacity / hypopyon / dendritic ulcers (HSV)
what vitamin deficiency can cause corneal ulcers
Vit A
how would you treat corneal ulcer depending on the cause
corneal scrape for culture –> bacterial: ofloxacin / herpetic: acyclovir / autoimmune: steroids and anti-inflamm
what is anterior uveitis
inflammation of anterior uvea which consists of ciliary body, iris and choroid (in-between retina and sclera all around the eyeball) - aka iritis
what are common causes of anterior uveitis
usually autoimmune but can be infective, traumatic, ischaemic or malignant
what autoimmune causes can cause anterior uveitis
HLA B27 conditions: annk spondy, IBD, RA, sarcoidosis
what infective and malignant causes can cause anterior uveitis
SYPHILLIS, TB, H simplex/ zoster, leukaemia
what are symptoms of anterior uveitis (4)
dull, achy pain / photophobia / affected vision / excessive tears
what are signs of anterior uveitis (5)
ciliary injective vessels around cornea / cells and flares in ant chamber / hypopyon / keratic precipitates (spots in front of pupil in cornea) / synechia (irregular pupil shape)
how do you manage anterior uveitis
steroids (pred 4-6 weeks) / mydiatrics (cyclopentolate) / immunosuppression (DMARDS)
what is episleritis
inflammation of the epislera - outermost layer of sclera just below conjunctiva
what are symptoms of episleritis (5)
unilateral / normally patch of redness in one part of lateral eye/ mild pain, watering of eye / dilated episclera vessels
how do you manage episcleritis
self-limiting and superficial - lubricants/ topical NSAIDs / mild steroids
what is scleritis
serious inflammation of whole sclera
what is scleritis associated with
RA, SLE sarcoidosis and GPA
what are symptoms of uveitis
VV painful, pain on movement, injected deep vessels, photophobia
how do you identify and treat scleritis
phenylephrine test - oral NSAIDs, topical steroids
