Acute Red Eyes

Question 1

Describe what would be seen in the eye in someone with a third nerve palsy.

Answer 1

Eye moves down and out as SO and LR unaffected.
Drooping of eyelid.
Eye unable to look towards nose.

Question 2

Describe what would be seen in the eye in someone with a sixth nerve palsy.

Answer 2

LR affected.
Unable to move eyes laterally.

Question 3

Describe what would be seen in the eye in someone with a fourth nerve palsy.

Answer 3

Unable to move eye downwards

Question 4

When does increased IOP occur?

Answer 4

When there is an imbalance between production of aqueous humor and the drainage

Question 5

RECAP- in those with myopia, where does the light focus?

Answer 5

In front of the retina

Question 6

RECAP- in those with hyperopia, where does the light focus?

Answer 6

Behind the retina

Question 7

RECAP- in those with emmetropia, where does the light focus?

Answer 7

On the retina

->normal vision

Question 8

Give an example of a common lesion affecting the optic chiasm.

Answer 8

Pituitary adenoma

Question 9

What is the most common cause of homonymous hemianopia?

Answer 9

Stroke

Question 10

List symptoms to ask about in the presenting complaint of an eye related issue.

Answer 10

Changes in vision
Redness
Pain
Any double vision
Any discharge
Change in eye appearance

Question 11

What is important to ask in terms of past ocular history?

Answer 11

Contact lens wear?
Amblyopia/lazy eye?
Previous surgery etc.

Question 12

Give some examples of medications which can affect the eye.

Answer 12

Ethambutol, chloroquine (both can have toxic affects on optic nerve and retina in the long term)
Anticoagulants
Tamsulosin

Question 13

What can Tamsulosin cause?

Answer 13

Floppy iris syndrome

Question 14

Which ocular issue can occur in alcoholic patients?

Answer 14

Nutritional optic neuropathies

Question 15

Which chart is sued to assess vision?

Answer 15

Snellen Chart

Question 16

How is vision assessed in babies?

Answer 16

Preferential looking test

Question 17

How is vision assessed in toddlers?

Answer 17

Matching Kay pictures

Question 18

How is vision assessed in older children?

Answer 18

Naming Kay pictures or Snellen Chart

Question 19

How is vision assessed in adults?

Answer 19

Snellen chart

Question 20

What is usually used for examination of the eye?

Answer 20

Slit lamp

Question 21

Which dye can be used to outline epithelial defects?

Answer 21

Fluorescein

Question 22

What may occur if a patient has walked into a branch?

Answer 22

Corneal abrasion

Question 23

What may the issue be if a patient complains of their eye feeling gritty?

Answer 23

Dendritic ulcer of eye

Question 24

What are the symptoms and signs of infective conjunctivitis?

Answer 24

Eyes are gritty and red
Watery discharge

Question 25

What is the treatment for infective conjunctivitis?

Answer 25

Topical antibiotics

Question 26

What are the symptoms and signs of a subconjunctival haemorrhage?

Answer 26

Red bleed into sclera, painless

Question 27

What is the treatment for a subconjunctival haemorrhage?

Answer 27

Reassurance

Question 28

What are the symptoms and signs of allergic conjunctivitis?

Answer 28

Itchy, red eyes Watery discharge Lid swelling Conjunctiva swelling (chemosis)

Question 29

What is the treatment for allergic conjunctivits?

Answer 29

Avoid allergen Topical antihistamine e.g. olopatadine Mast cell stabiliser e.g. sodium chromoglycate

Question 30

What are the symptoms and signs of a corneal ulcer?

Answer 30

Painful, red eyes Watery discharge History of contact lens use Sometimes cells/pus in anterior chamber Photophobia

Question 31

What is photophobia?

Answer 31

Sensitivity to light

Question 32

What is the treatment for corneal ulcers?

Answer 32

Corneal scrape Topical antibiotics

Question 33

What is a risk factor for corneal ulcers?

Answer 33

Contact lens use

Question 34

What are the signs and symptoms of corneal abrasion?

Answer 34

History of trauma Painful, red, watering eyes Blurred vision

Question 35

What is the treatment for corneal abrasion?

Answer 35

Topical antibiotics Analgesia - used to relieve pain

Question 36

What is acute anterior uveitis?

Answer 36

Inflammation of iris and ciliary body

Question 37

What are the signs/symptoms of anterior uveitis?

Answer 37

Painful watery eyes Photophobia +/- blurred vision/floaters May be blurred vision May have had previous episodes Hypopyon Small irregular pupil Cells in anterior chamber

Question 38

What is the treatment for acute anterior uveitis?

Answer 38

Topical steroids- prednisolone Dilating drops- cyclopentolate

Question 39

What are the signs/symptoms of scleritis?

Answer 39

Severe pain Deep scleral redness Nodule (doesn't move over sclera) Very tender

Question 40

What is the treatment for scleritis?

Answer 40

Systemic steroids

Question 41

When does acute angle closure glaucoma occur?

Answer 41

Aqueous humor cannot flow through pupil

Question 42

What are the signs and symptoms of acute angle closure glaucoma?

Answer 42

Severe pain Redness Blurred vision Nausea and vomiting Hazy cornea Fixed mid dilatory pupil Hard eyeball

Question 43

What is the treatment for acute angle closure glaucoma?

Answer 43

Lower IOP- Constrict pupil Laser iridotomy

Question 44

Which drugs can be used to lower IOP?

Answer 44

Carbonic anhydrase inhibitors Beta blockers Prostaglandins

Question 45

Which drug can constrict the pupil?

Answer 45

Pilocarpine

Question 46

What is orbital cellulitis?

Answer 46

Infection of orbital tissues

Question 47

Orbital cellulitis can be in front or behind the septum. Which one is sight threatening?

Answer 47

If the infection is behind the septum

Question 48

What are the signs and symptoms of orbital cellulitis?

Answer 48

Very sore Redness Blurred vision Double vision - diplopia Generally unwell Pyrexia- fever Proptosis- protrusion of eyeball Reduced eye movement

Question 49

What is the treatment for orbtial cellulitis?

Answer 49

Admit IV antibiotics CT scan Drainage of pus

Question 50

What is endophthalmitis?

Answer 50

Inflammation of inner coating of the eye- a medical emergency

Question 51

What are the signs and symptoms of endophthalmitis?

Answer 51

Redness Blurred vision Pain History or recent surgery/trauma

Question 52

What is the treatment for endophthalmitis?

Answer 52

Admit Topical antibiotics Vitreous tap Intravitreal antibiotics

Question 53

How can thyroid eye disease present?

Answer 53

Bilateral red eyes

Question 54

What are the signs and symptoms of thyroid eye disease?

Answer 54

Redness Blurred vision Pain Diplopia History of thyroid dysfunction Proptosis Lid retraction Reduced eye movement

Question 55

What is the treatment for thyroid eye disease?

Answer 55

Topical lubrication Systemic steroids Orbital radiotherapy Orbital decompression