Acute Red Eyes Flashcards
Describe what would be seen in the eye in someone with a third nerve palsy.
Eye moves down and out as SO and LR unaffected.
Drooping of eyelid.
Eye unable to look towards nose.
Describe what would be seen in the eye in someone with a sixth nerve palsy.
LR affected.
Unable to move eyes laterally.
Describe what would be seen in the eye in someone with a fourth nerve palsy.
Unable to move eye downwards
When does increased IOP occur?
When there is an imbalance between production of aqueous humor and the drainage
RECAP- in those with myopia, where does the light focus?
In front of the retina
RECAP- in those with hyperopia, where does the light focus?
Behind the retina
RECAP- in those with emmetropia, where does the light focus?
On the retina
->normal vision
Give an example of a common lesion affecting the optic chiasm.
Pituitary adenoma
What is the most common cause of homonymous hemianopia?
Stroke
List symptoms to ask about in the presenting complaint of an eye related issue.
Changes in vision
Redness
Pain
Any double vision
Any discharge
Change in eye appearance
What is important to ask in terms of past ocular history?
Contact lens wear?
Amblyopia/lazy eye?
Previous surgery etc.
Give some examples of medications which can affect the eye.
Ethambutol, chloroquine (both can have toxic affects on optic nerve and retina in the long term)
Anticoagulants
Tamsulosin
What can Tamsulosin cause?
Floppy iris syndrome
Which ocular issue can occur in alcoholic patients?
Nutritional optic neuropathies
Which chart is sued to assess vision?
Snellen Chart
How is vision assessed in babies?
Preferential looking test
How is vision assessed in toddlers?
Matching Kay pictures
How is vision assessed in older children?
Naming Kay pictures or Snellen Chart
How is vision assessed in adults?
Snellen chart
What is usually used for examination of the eye?
Slit lamp
Which dye can be used to outline epithelial defects?
Fluorescein
What may occur if a patient has walked into a branch?
Corneal abrasion
What may the issue be if a patient complains of their eye feeling gritty?
Dendritic ulcer of eye
What are the symptoms and signs of infective conjunctivitis?
Eyes are gritty and red
Watery discharge
What is the treatment for infective conjunctivitis?
Topical antibiotics
What are the symptoms and signs of a subconjunctival haemorrhage?
Red bleed into sclera, painless
What is the treatment for a subconjunctival haemorrhage?
Reassurance
What are the symptoms and signs of allergic conjunctivitis?
Itchy, red eyes
Watery discharge
Lid swelling
Conjunctiva swelling (chemosis)
What is the treatment for allergic conjunctivits?
Avoid allergen
Topical antihistamine e.g. olopatadine
Mast cell stabiliser e.g. sodium chromoglycate
What are the symptoms and signs of a corneal ulcer?
Painful, red eyes
Watery discharge
History of contact lens use
Sometimes cells/pus in anterior chamber
Photophobia
What is photophobia?
Sensitivity to light
What is the treatment for corneal ulcers?
Corneal scrape
Topical antibiotics
What is a risk factor for corneal ulcers?
Contact lens use
What are the signs and symptoms of corneal abrasion?
History of trauma
Painful, red, watering eyes
Blurred vision
What is the treatment for corneal abrasion?
Topical antibiotics
Analgesia - used to relieve pain
What is acute anterior uveitis?
Inflammation of iris and ciliary body
What are the signs/symptoms of anterior uveitis?
Painful watery eyes
Photophobia
+/- blurred vision/floaters
May be blurred vision
May have had previous episodes
Hypopyon
Small irregular pupil
Cells in anterior chamber
What is the treatment for acute anterior uveitis?
Topical steroids- prednisolone
Dilating drops- cyclopentolate
What are the signs/symptoms of scleritis?
Severe pain
Deep scleral redness
Nodule (doesn’t move over sclera)
Very tender
What is the treatment for scleritis?
Systemic steroids
When does acute angle closure glaucoma occur?
Aqueous humor cannot flow through pupil
What are the signs and symptoms of acute angle closure glaucoma?
Severe pain
Redness
Blurred vision
Nausea and vomiting
Hazy cornea
Fixed mid dilatory pupil
Hard eyeball
What is the treatment for acute angle closure glaucoma?
Lower IOP-
Constrict pupil
Laser iridotomy
Which drugs can be used to lower IOP?
Carbonic anhydrase inhibitors
Beta blockers
Prostaglandins
Which drug can constrict the pupil?
Pilocarpine
What is orbital cellulitis?
Infection of orbital tissues
Orbital cellulitis can be in front or behind the septum. Which one is sight threatening?
If the infection is behind the septum
What are the signs and symptoms of orbital cellulitis?
Very sore
Redness
Blurred vision
Double vision - diplopia
Generally unwell
Pyrexia- fever
Proptosis- protrusion of eyeball
Reduced eye movement
What is the treatment for orbtial cellulitis?
Admit
IV antibiotics
CT scan
Drainage of pus
What is endophthalmitis?
Inflammation of inner coating of the eye- a medical emergency
What are the signs and symptoms of endophthalmitis?
Redness
Blurred vision
Pain
History or recent surgery/trauma
What is the treatment for endophthalmitis?
Admit
Topical antibiotics
Vitreous tap
Intravitreal antibiotics
How can thyroid eye disease present?
Bilateral red eyes
What are the signs and symptoms of thyroid eye disease?
Redness
Blurred vision
Pain
Diplopia
History of thyroid dysfunction
Proptosis
Lid retraction
Reduced eye movement
What is the treatment for thyroid eye disease?
Topical lubrication
Systemic steroids
Orbital radiotherapy
Orbital decompression
