Infection/Inflammation

Question 1

What is conjunctivitis?

Answer 1

Inflammation of conjunctiva (layer covering sclera and inner eyelids)

Question 2

How does conjunctivitis present?

Answer 2

Red eye
Discharge
Foreign body sensation

Question 3

What does a red eye with a sticky discharge suggest?

Answer 3

Bacterial conjunctivitis

Question 4

What does a red eye with a watery discharge suggest?

Answer 4

Viral conjunctivitis

if itch present, allergic conjunctivitis

Question 5

What does a red eye with watery, itchy discharge suggest?

Answer 5

Allergic conjunctivitis

Question 6

What is papillary conjunctivitis and what does it suggest?

Answer 6

Conjunctivitis forming small red dots on inner surface of eye lids

Bacterial conjuncitivits

Question 7

What is follicular conjunctivitis and what does it suggest?

Answer 7

Conjunctivitis forming avascular white nodules on eyelid

Viral/chlamydial conjuncitvitis

Question 8

What organisms commonly cause bacterial conjunctivitis?

Answer 8

Staph. aureus
Strep. pneumoniae
H. influenzae

Question 9

What is the treatment of bacterial conjunctivitis?

Answer 9

Chloramphenicol

Gentamicin if pseudomonas

Question 10

What does follicular conjunctivitis with scarring suggest?

Answer 10

Chlamydial conjuncitvitis

Question 11

What would make you consider chlamydial conjunctivitis?

Answer 11

Persistent conjunctivitis unresponsive to treatment

Question 12

What is the management of chlamydial conjunctivitis?

Answer 12

Topical oxytetracycline

Full STI work up

Oral azithromycin if genital chlamydia infection

Question 13

What is keratitis?

Answer 13

Inflammation of the cornea (transparant layer covering the anterior chamber)

Question 14

How does keratitis present?

Answer 14

Sharp pain
Photophobia
Red, watery eye
Hypopyon (bacterial)
Dendritic ulcer (herpes)

Question 15

What can cause keratitis?

Answer 15

Infection (bacterial, viral, fungal, parasitic)

Systemic disease (RA, Graves disease, Sjogren’s syndrome)

Question 16

How is bacterial keratitis managed?

Answer 16

Hospital admission

Hourly antibiotic drops (olfaxacin and gentamicin-cefuroxime)

Question 17

What treatment should not be used if a dendritic ulcer is present and why?

Answer 17

Steroids

Risks corneal melt and perforation

Question 18

How is herpetic keratitis managed?

Answer 18

Aciclovir ointment (5 times daily)

Question 19

Patient presents with a sharp pain in his eye with is red a week after suffering a URTI.

What is the diagnosis?

Answer 19

Adenoviral keratitis

Question 20

Who is predisposed to developing fungal keratitis?

Answer 20

Africans

Immunocompromised

Question 21

What parasite can cause keratitis with inappropriate contact lens wear?

Answer 21

Acanthamoeba keratitis

Question 22

What treatment will show corneal abrasion?

Answer 22

Fluorescein stain

Question 23

What inflammatory eye condition is associated with systemic conditions?

Name 3

Answer 23

Anterior uveitis

Ankylosing spondylitis (HLA-B27)
Inflammatory bowel disease
Sarcoidosis

Question 24

What is anterior uveitis?

Answer 24

Inflammation of the iris and anterior chamber

Question 25

How does anterior uveitis present?

Answer 25

Eye pain Red eye (circumcorneal and injection) Photophobia Cells/flare in anterior chamber Hypopyon

Question 26

How is anterior uveitis managed?

Answer 26

Hourly topical steroids Twice daily mydriatic

Question 27

What is anterior blepharitis?

Answer 27

Inflammation of eyelid causing a red lid margin

Question 28

What is posterior blepharitis?

Answer 28

Inflammation of meibonian gland causing chalazia (cyst) formation under eyelids

Question 29

What are the two classes of anterior blepharitis and how do they differ?

Answer 29

Seborrhoeic - basically seborrhoeic dermatitis of eyelids (causes red lid margin with scaling but no eyelash dysfunction) Staphylococcal - staph infection of eyelash follicle (causes red lid margin with styes and dysfunctional eyelash growth)

Question 30

What condition is posterior blepharitis strongly associated with?

Answer 30

Rosacea

Question 31

What is chorioretinitis?

Answer 31

Inflammation of choroid and retina

Question 32

What can cause chorioretinitis?

Answer 32

Toxoplasma Toxocariasis Cytomegalovirus

Question 33

What is cytomegalovirus chorioretinitis associated with?

Answer 33

AIDS

Question 34

What is endopthalmitis?

Answer 34

Sight threatening and potentially devastating infection of the inner eye

Question 35

How does endopthalmitis present?

Answer 35

Severe pain Very red eye Decreasing vision

Question 36

How is endopthalmitis managed?

Answer 36

Intravitreal antibiotics (amikacin, cefatazidime, vancomycin)

Question 37

What is episcleritis?

Answer 37

Non-serious inflammation of the episclera (layer between sclera and conjunctiva)

Question 38

What is the management of episcleritis?

Answer 38

Nothing | self-limiting condition

Question 39

What is scleritis?

Answer 39

Inflammation of the sclera

Question 40

How does scleritis present?

Answer 40

Severe eye pain | Violaceous vessel injection

Question 41

How is scleritis managed?

Answer 41

Oral NSAIDs and steroids

Question 42

What is orbital cellulitis?

Answer 42

Infection of tissues around the orbital septum (membranous sheet preventing spread of infection into orbit)

Question 43

How does orbital cellulitis present?

Answer 43

Erythema and oedema around the orbit Pain on eye movements

Question 44

How is orbital cellulitis managed?

Answer 44

1. MRI to assess whether pre/post septal cellulitis and source of infection (e.g. ethmoid sinus or chalazion) 2. Broad spectrum antibiotics 3. Drain any abscesses

Question 45

What are the two classifications of orbital cellulitis? Which of these is more serious?

Answer 45

Pre-septal (infection anterior to orbital septum) Post-septal (infection posterior to orbital septum) Post-septal is much more serious as it is sight threatening

Question 46

What eye condition is often assosiated with rheumatoid arthritis and granulomatosis with polyangiitis (GPA)?

Answer 46

Scleritis