Ophthalmology - Red Eye Flashcards
features of allergic conjunctivitis?
mucous
itchy
features of viral conjunctivitis?
watery
follicles on underside of lid
features of bacterial conjunctivitis?
purulent
gritty eyes
stuck together
papillae on underside lid
common causes of bacterial conjunctivitis?
staph
streo
chlamydia
viral causes of conjunctivitis?
adenovirus (after URTI)
HZV
HSV
Tx for bacterial conjunctivitis?
clean eyelids
chloramphenicol 4xday
what is keratitis?
microbial invasion of the cornea
EMERGENCY
commonest cause of keratitis?
corneal ulcer (HS)
bacterial
fungal
viral
features of a corneal ulcer?
severe pain photophobia lacrimation reduced vision red eye ± hypophyn
features of viral keratitis?
bilateral
after URTI
Ix for corneal ulcer?
corneal scraping
+ microscopy/culture/PCR
Tx for viral corneal ulcer?
acyclovir if HS
steroids if adenovirus
features of orbital cellulitis?
painful decreased eye movements colour vision goes decreased visual acuity fever
how to differentiate orbital and peri orbital cellulitis?
orbital function remains
stye often causes
risks factors for orbital cellulitis?
sinusitis
post op
kids
Ix for orbital cellulitis?
CT
inflam markers
Tx for orbital cellulitis?
ceftriaxone + fluclox + met
what is endopthalmitis?
infection of the intraocular eye fluids
when does endopthalmitis often occur?
post op
causes of endopthalmitis?
staph epi
Tx for endopthalmitis? how is it prophylactically avoided?
intravitreal Abx
given during surgery
features of episcleritis?
blanching eye redness
not painful
what are features of scleritis?
painful deep red lacrimation photophobia vessels do not blanch systemic disease
Tx for scleritis?
NSAIDs
steroids
what is anterior uveitis?
inflam of the iris + ciliary body (made up the anterior uvea)
features of anterior uveitis?
pain dull ache reduced vision photophobia curcumcorneal redness hypopyn cells in anterior chamber synechiae
causes of anterior uveitis?
UC
ank spon
sarcoid
TB
Tx for anterior uveitis?
steroids
mydriatics
investigate for systemic disease
what is the normal IOP?
10-21mmHg
what causes acute closed angle glaucoma?
closure of the anterior angle chamber
fluid builds up as usually drains through this angle
causes raised IOP
risk factors for acute closed angle glaucoma?
elderly
hypermetropia (long sighted)
coming from dark to bright lights
features of acute closed angle glaucoma?
pain N+V headache blurred vision cloudy cornea pupil non reactive and mid dilated circumcorneal redness
Ix for acute closed angle glaucoma?
gonioscopy
avoid dark rooms
Tx for acute closed angle glaucoma? example of drug from each class?
carbonic anhydrase inhibitors (acetazolamide)
B blockers (timolol)
cholinergic agonist (pilocarpine - pupils CONSTRICT)
topical steroids
laser peripheral iridectomy once IOP controlled
what bacterial causes keratitis? what do contact lens wearers often get?
staph aureus
pseudomonas aerguinosa in contact lens wearers
what is the preferred conjunctivitis treatment in pregnancy? why?
topical fusidic acid
risk of aplastic anaemia
features of a corneal abrasion?
gritty photophobia painful blurred vision pain
Ix for corneal abrasion?
fluorescin dye (yellow glow in epithelial surface breaks)
Tx for corneal abrasion?
chloramphenicol
dilate (cyclopentolate)
analgesia
who gets fungal corneal ulcers?
contact lens wearers
acamthamoeba
what can cause peripheral eye ulcers?
RA
HS
vasculitis
Ix for corneal ulcer?
corneal scrape
gram stain and culture
PCR
common cause of bacterial ulcers?
staph
strep
