Ophthalmology - condition presentations Flashcards
Sudden onset severe painful eye
Red eye
Blurred vision
Halos around lights
Associated headache, nausea and vomiting
Photophobia
On examination - red eye, teary, hazy cornea, decreased visual acuity, dilatation of pupil, fixed pupil size, firm eyeball on palpation
Acute angle closure glaucoma
Asymptomatic to start with
Loss of peripheral vision first and then tunnel vision
Gradual onset of fluctuating pain, headaches, blurred vision and halos around lights
Open angle glaucoma
Gradually worsening central visual field loss (central scotoma)
Reduced visual acuity
Crooked or wavy appearance to straight lines
Age related macular degeneration
Very slow reduction in vision
Increasing progressive blurring of vision
Change of colour of vision - colours becoming more brown/yellow
Starbursts around lights (especially at night time)
Loss of red reflex - on examination
Cataracts
Causes of painless red eye
Conjunctivitis
Episcleritis
Subconjunctival haemorrhage
Causes of painful red eye
Glaucoma Anterior uveitis Scleritis Corneal abrasions/ulceration Keratitis Foreign body Traumatic or chemical injury
Unilateral or bilateral red eye
Itchy and gritty
Discharge from the eye
No pain, reduced visual acuity or photophobia
Conjuncitivitis
Painful red eye - typically unilateral
Ciliary flush
Reduced visual acuity
Painful eye movements
Small or abnormally shaped pupil
Lacrimation
Photophobia
Hypopyon
Anterior uveitis
Acute onset unilateral symptoms
Red eye - segmental redness (rather than diffuse - typically in lateral sclera)
Foreign body sensation
No pain or mild pain
No discharge
Episcleritis
Severe pain
Pain on eye movement
Photophobia
Eye watering
Reduced visual acuity
Abnormal pupil reaction to light
Tenderness to palpation of the eye
Scleritis
History of contact lenses or foreign body
Painful red eye
Foreign body sensation
Watering eye
Blurred vision
Photophobia
Corneal abrasions
Differential could be herpes keratitis (very similar presentation but without obvious trauma to eye??)
Painless
Spots of vision loss
Flashes and floaters
Posterior vitreous detachment
Peripheral vision loss - often sudden
Blurred or distorted vision
Flashes and floaters
Retinal detachment
Sudden painless loss of vision with cardio risk factors
RAPD
Central retinal vein occlusion/ central retinal artery occlusion
RAPD is a feature of central retinal artery occlusion
Night blindness - first symptom
Peripheral vision lost before central vision
Retinitis pigmentosa
Differential for pain worse on eye movement
Scleritis
Anterior uveitis
Differential for photophobia in ophthalmology conditions
Acute angle glaucoma
Anterior uveitis
Scleritis
Corneal abrasions
Age Related Macular Degeneration presentations
Gradual worsening vision - central visual field loss (central scotoma)
Reduced visual acuity
Crooked/wavy appearance to straight lines
Wet vs Dry - wet age-related macular degeneration presents more acutely - loss of vision over days (full loss in 2-3y), also often progresses to bilateral disease
Retinal detachment presentation
Painless vision loss (peripheral vision loss)
Blurred distorted vision
Flashes and floaters
Cataracts presentations
Very gradual loss of vision
Progressive blurring of vision
Change of colour of vision with colours becoming more brown or yellow
“Starbursts” can appear around lights, particularly at night time
Loss of red reflex
Open angle glaucoma presentation
Asymptomatic to start with
Loss of peripheral vision first and then tunnel vision
Gradual onset of fluctuating pain, headaches, blurred vision and halos around lights
Conjunctivitis presentation
Unilateral or bilateral red eye
Itchy and gritty
Discharge from the eye
No pain, reduced visual acuity or photophobia
Anterior uveitis presentation
Painful red eye - typically unilateral
Ciliary flush
Reduced visual acuity
Painful eye movements
Small or abnormally shaped pupil
Lacrimation
Photophobia
Hypopyon
Corneal abrasions presentation
History of contact lenses or foreign body
Painful red eye
Foreign body sensation
Watering eye
Blurred vision
Photophobia
Herpes Keratitis is a differential with a very similar presentation but often without history of trauma
Scleritis presentation
Severe pain
Pain on eye movement
Photophobia
Eye watering
Reduced visual acuity
Abnormal pupil reaction to light
Tenderness to palpation of the eye
Central retinal vein/artery occlusion presentation
Sudden painless loss of vision with cardio risk factors
RAPD - central retinal artery occlusion
Acute angle closure glaucoma presentation
Sudden onset severe painful eye
Red eye
Blurred vision
Halos around lights
Associated headache, nausea and vomiting
Photophobia
On examination - red eye, teary, hazy cornea, decreased visual acuity, dilatation of pupil, fixed pupil size, firm eyeball on palpation
Episcleritis presentation
Acute onset unilateral symptoms
Red eye - segmental redness (rather than diffuse - typically in lateral sclera)
Foreign body sensation
No pain or mild pain
No discharge
Posterior vitreous detachment presentation
Painless
Spots of vision loss
Flashes and floaters
Retinitis pigmentosa presentation
Night blindness - first symptom
Peripheral vision lost before central vision
