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Ophthalmology RIA > Acute red eye + AACG > Flashcards

Acute red eye + AACG Flashcards

1
Q

list the causes of an acute red eye (6)

A
  • Scleritis
  • Episcleritis
  • Anterior uveitis
  • Infectious keratitis
  • Conjunctivitis
  • Acute angle closure glaucoma
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2
Q

what is the importance in asking about sexual history?

A

Chlamydia can be spread to the eye causing conjunctivitis

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3
Q

what is the importance of asking about a recent URTI?

A

-

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4
Q

conditions that present with both red eye + photophobia

A
  • Scleritis
  • Anterior uveitis
  • Infectious keratitis
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5
Q

pathophysiology of AACG

A

blockage of flow of aqueous humour from the posterior to anterior chamber resulting in a build up of pressure behind the irs, produces a hard eye

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6
Q

risk factors for AACG? (4)

A
  • hypermetropia
  • pupillary dilatation
  • lens growth associated with ageing
  • female
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7
Q

appearance of eye and cause of this in AACG

A
  • red: inflammation

- painful: raised IOP

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8
Q

associated symptoms in AACG?

A
  • progressive headache, and may give a history of intermittent headaches that usually are in the evening
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9
Q

visual changes in AACG

A

blurry vision

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10
Q

visual symptoms and the cause of this in AACG?

A
  • visual halos around lights/ “looking at a light through frosted glass”
  • due to dispersion of light through waterlogged cornea
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11
Q

examination signs in AACG?

A
  • hazy cornea
  • fix and mid dilated pupil
  • red + tender eye
  • pupil non reactive to light
  • impaired visual acuity
  • eye is hard on gentle palpation
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12
Q

1st line investigations in AACG?

A

gonioscopy + slit lamp examination

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13
Q

finding on Gonioscopy?

A

closed angle

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14
Q

finding on slit lamp examination?

A

shallow anterior chamber + large optic disc

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15
Q

Management of AACG?

A
  • urgent referral to ophthalmology
  • IOP reduction with Acetozolamide 500 mg oral
  • topical pilocarpine: to induce pupil constriction
  • steroid eye drops
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16
Q

what is the definitive management of AACG?

A

laser iridotomy

17
Q

what is laser iridotomy?

A

creating a hole in the iris, allowing aqueous humor to flow into the anterior chamber; reducing the pressure difference between the anterior and posterior chambers, allowing the angle to open up and decrease the IOP

18
Q

medications that lower the intraocular pressure by reducing the production of aqueous humor?

A

Beta adrenergic receptor antagonists

Acetozolamide (CAI)

19
Q

medications that increase the outflow of aqueous humor?

A

Iatanoprost (prostaglandin analogue)

20
Q

medication that both decreases the production and increases the outflow

A

Bimonidine (alpha adrenergic agonist)

21
Q

when must patients with AACG inform the DVLA about their diagnosis?

A

as soon as they are diagnosed with AACG they must stop driving and inform the DVLA whom will then assess whether the individual meets the current driving standards

22
Q

equiptment that measures intraocular pressure

A

Goldmann visual field machine

23
Q

what are the 3 stages for the drainage of fluid out of the eye/

A

1) flows forwards over the anterior surface
2) through the pupil
3) through the trabecular meshwork into schlemms canal

24
Q

4 risk factors for ACAG

A
  • elderly
  • chinese race
  • cataracts
  • hypermetropia
25
Q

immediate treatment for ACAG?

A

IV acetozolamide

26
Q

what is the action of acetozolamide?

A

suppresses aqueous production

27
Q

what is the maintenance treatment for ACAG?

A

oral acetozolamide

28
Q

what is used as topical aqueous suppressors in ACAG?

A

beta blockers + alpha agonists

29
Q

what is used to open the drainage angle in ACAG?

A

Pilocarpine drops, by constricting the pupil

30
Q

2 surgical preventative measures in ACAG?

A
  • Laser peripheral cridotomy

- surgical iridectomy

31
Q

Prophylatic topical drops for ACAG?

A

Phenylphrine

Tropicamide

Ophthalmology RIA (13 decks)

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