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Yr5 Ophthalmology > Infection & inflammation of eye & surrounding > Flashcards

Infection & inflammation of eye & surrounding Flashcards

1
Q

What is an entropion?

A

Inversion of eyelid margin

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2
Q

What are the Sx of an entropion?

A

Ocular irritation
Blepharospasm
Tearing
Redness & FB sensation

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3
Q

What are the causes of an entropion?

A

Involution
Cicatricial
Secondary to ocular irritation: infectious, inflammatory, traumatic

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4
Q

How is an entropion treated?

A

Lubricating drops
Botox injections
Surgical correction
Taping can provide temporary relief

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5
Q

What is an ectropion?

A

Eversion of eyelid margin

Conjunctival & corneal exposure lead to irritation

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6
Q

What are the causes of an ectropion?

A

Involuted: Age-related
Paralytic: CN VII palsy
Mechanical: Tumour
Congenital

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7
Q

How does an ectropion appear?

A 
Asymptomatic
Itchy
Irritated 
Red & watery
May complain of dry eye
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8
Q

How is an ectropion treated?

A

Lubricating drops- artificial tears

Surgery: Only corrective measure

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9
Q

What is the most common cause of a watery eye in infants?

A

Nasolacrimal duct obstruction

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10
Q

How is nasolacrimal duct obstruction treated?

A

Lacrimal duct massage

Sx tend to resolve in 1yr

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11
Q

What is a chalazion?

A

AKA Meibomian cyst
Blocked meibomian gland
Normally secretes sebum to hydrate eye
Leads to granulomatous inflammation in eyelid

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12
Q

How common are meibomian cysts?

A

Most common lid lump

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13
Q

What is a hordeolum?

A

AKA Stye
OR
Infective abscess

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14
Q

What are the types of stye?

A

Internal: Meibomian gland infected leads to abscess
External: Acute infection of lash follicle

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15
Q

What are the risk factors for a stye?

A 
Chronic blepharitis
Rosacea
Seborrhoeic dermatitis
Pregnancy
DM
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16
Q

How does a chalazion present?

A 
Gradually enlarging round firm lesion
UPPER eyelid
2-8mm diameter
Multiple or single
Painful initially- MOSTLY non-tender
YELLOW
IMMOBILE when lid inverted
17
Q

How long does a chalazion take to reabsorb?

A

2-8w

Absorbs through inner eyelid

18
Q

How does a stye present?

A 
Yellow, Tender swelling
Gradually enlarging
Tender on palpation
At base of eyelashes
Discharges anteriorly
May develop: Fevers/rigors
19
Q

When should a lump be referred to an ophthalmologist?

A

Visual disturbances

Associated w/cellulitis

20
Q

How is a meibomian cyst be treated?

A

1) Warm compress: BD massage lids
2) Resection under LA if refractory
3) Triamicinolone injection
Persistent: Doxycycline 50mg OD

21
Q

How is a stye treated?

A

1) Warm compress
2) TOP Choramphenicol
3) Curetting
Cellulitis: Flucloxacillin

22
Q

What is conjunctivitis?

A

Inflammation of the conjunctivitis

23
Q

What are the causes of conjunctivitis?

A

Infectious: Adenovirus 80%, staph

Non-infectious: Allergic, mechanical, immune-mediated, neoplastic, irritative

24
Q

How does conjunctivitis present?

A 
Red eye
Irritation
Grittiness
Discomfort
Discharge
Sticky eye lids
25
Q

What can the consistency of eye discharge tell you about the type of conjunctivitis?

A

Viral: Watery/serous
Allergic: Mucoid/string
Bacterial: Sticky/purulent

26
Q

When does conjunctivitis warrant a referral to ophthalmology?

A

Severe purulent discharge
Follicular
Neonatal (Safe-guarding)
Refractory to conventional Tx

27
Q

How is viral conjunctivitis treated?

A

Self-limiting: 1-2w
Symptomatic relief
TOP artificial tears + antihistamines

28
Q

How is bacterial conjunctivitis treated?

A

TOP Chloramphenicol 0.5% 4-6hrs
OR
Fusidic acid drops 1w

29
Q

How is allergic conjunctivitis treated?

A

Cold press

TOP antihistamines

30
Q

How does episcleritis present?

A

Red eye associated with tearing & photophobia

Engorged episcleral vessels extending radially

31
Q

How is episcleritis treated?

A

Spont resolves
Usually lasts 7-10days
NSAIDs
Artificial tears

32
Q

What is episcleritis & what are the types?

A

Episcleritis involves inflammation of the episclera.
SIMPLE: Vascular congestion on even surface
NODULAR: Discrete elevated area of inflamed episclera.

33
Q

What conditions can episcleritis be associated with?

A

UC & Crohn’s

CT disorders

34
Q

What is scleritis?

A

Severe inflammation that occurs throughout the entire thickness of the sclera.

35
Q

How is scleritis categorised?

A

98% ANTERIOR: Diffuse, Nodular, Necrotising (Sklerokeratitis)
POSTERIOR: See lid oedema & proptosis

36
Q

What conditions is scleritis usually associated with?

A

RA
Granulomatosis
CT disease- may be 1st Sx
Other: Gout, Churg-Strauss, Syphilis

37
Q

How does scleritis present?

A 
Sudden
Boring eye pain can radiate to forehead, worse at night & w/eye movements
Watering
Local or diffuse redness
Photophobia
Gradual ↓vision
38
Q

Should scleritis be investigated?

A

YES- assume underlying cause until proven otherwise

RULE OUT: Systemic vasculitis (can be life-threatening)

39
Q

How is scleritis managed?

A

URGENT REFERAL
NSAIDS
Prednisolone 80mg OD: NSAIDs ineffective
Immunosuppression: Methotrexate/ Ciclosporin

Yr5 Ophthalmology (5 decks)

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