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Neuro > Ophthalmology - Acute Red Eye > Flashcards

Ophthalmology - Acute Red Eye Flashcards

1
Q

What can be involved in presenting complaint?

A

Change in vision, redness, pain, discharge, double vision and change in appearance of eye

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2
Q

What can be included in past ocular history?

A

Previous similar episode
Previous surgery
Contact lens wear
Amblyopia - lazy eye

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3
Q

What can be included in past medical history?

A

CV risks - ischaemic optic neuropathies, retinal vein occlusion and CN palsies
Eczema/asthma/hay fever
Joints - uveitis, scleritis and episcleritis
Bowels - IBS - uveitis
Infection - uveitis

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4
Q

What is included in drug history?

A

Ethambutol and chloroquine
Tamsulosin - intraoperative floppy iris syndrome
Anticoagulants

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5
Q

What can be included in the social history?

A

Driver
Smoking - CV risk, age related macular degeneration , thyroid eye disease
Alcohol - nutritional optic neuropathies
Drug abuse

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6
Q

How is vision assessed in adults?

A

Snellen chard - best corrected acuity measured at 6m
Recorded as 6/60 - 6/6
Numerator is distance form chart and denominator is distance that is normal

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7
Q

What is used to assess vision in babies and toddlers?

A

Babies - preferential looking
Toddlers - matching Kay pictures
Older children - naming Kay pictures or Snellen chart

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8
Q

What is included in inspection of eye?

A

Facial asymmetry, rashes, lip position (ptosis, entropion, ectropion)
Globe position - proptosis and enophthalmos
Pupil symmetry
Lumps, bumps, redness and discharge

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9
Q

What is used for examination?

A

Slit lamp
Fundoscopy
Visual field exam
Eye movement and pupil exam

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10
Q

What are commonly encountered ophthalmic conditions?

A

Acute red eye - anterior segment
Loss of vision - posterior segment
Trauma

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11
Q

How is acute red eye examined?

A

Staining with fluorescein - outlines epithelial defects

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12
Q

What is the symptoms of infective conjunctivitis?

A

Gritty, red and discharge (purulent and watery)

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13
Q

What is the treatment for infective conjunctivitis?

A

Topical antibiotics - chloramphenicol/ fucidic acid

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14
Q

What are the symptoms of subconjunctival haemorrhage?

A

Red and painless
Treatment is reassurance - if BP high then do again after presentation

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15
Q

What are the symptoms and signs of allergic conjunctivitis?

A

Itchy, red, discharge, acute, lid swelling and conjunctival swelling (chemosis)

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16
Q

What is the treatment of allergic conjunctivitis?

A

Topical antihistamine
Avoid allergen
Mast cell stabilisers - sodium chromoglycate

17
Q

What are the signs of symptoms of corneal ulcer?

A

Pain, red, photophobia, discharge, history of contacts, corneal defects with surrounding infiltrate and pus or cells in anterior chamber

18
Q

What is the treatment of corneal ulcer?

A

Corneal scrape - MCS culture
Topical antibiotics

19
Q

What are the symptoms and signs of corneal abrasion?

A

History of trauma, pain, red, watering, blurred vision and epithelial defect

20
Q

What is the treatment for corneal abrasion?

A

Topical antibiotics
Analgesia

21
Q

What are the symptoms and signs of acute anterior uveitis?

A

Pain, watering, photophobia, blurred vision/ floaters, red, keratic precipitates, cells in AC, hypopyon (white fluid in AC) and small irregular pupil

22
Q

What is the treatment of acute anterior uveitis?

A

Topical steroids - prednisolone
Dilating drops - cyclopentolate

23
Q

What are the signs and symptoms of scleritis?

A

Intense pain, redness, nodule which does not move over sclera and very tender

24
Q

What is the treatment for scleritis?

A

Systemic steroids

25
Q

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

A

Very painful, redness, blurred vision, nausea and vomiting, hazy cornea, fixed mid dilated pupil and hard eyeball

26
Q

What is the treatment for acute angle closure glaucoma?

A

Lower IOP - carbonic anhydrase inhibitors, BB and prostaglandins
Constrict pupil - pilocarpine
Laser iridotomy

27
Q

Describe orbital cellulitis

A

Infection of orbital tissues
Symptoms - very painful, red, blurred vision, diplopia, generally unwell, pyrexia proptosis and reduced eye movements

28
Q

What is the treatment for orbital cellulitis?

A

Admit and IV antibiotics
CT scan
Drainage of pus

29
Q

What are the signs and symptoms of endophthalmitis?

A

Is inflammation of internal eye tissues
Redness, blurred vision, pain and history or recent surgery

30
Q

What is the treatment for endophthalmitis?

A

Admit and topical antibiotics
Vitreous tap
Intravitreal antibiotics

31
Q

What is thyroid eye disease?

A

Inflammation of orbital fat and muscles
Can compress nerve

32
Q

What are the signs and symptoms of thyroid eye disease?

A

Red, blurred vision, pain, diplopia, history of thyroid dysfunction, proptosis, lid retraction and reduced eye movement

33
Q

What is the treatment for thyroid eye disease?

A

Topical lubrication
Systemic steroids
Orbital radiotherapy
Orbital decompression

Neuro (40 decks)

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