Ophthamology: Red Eye Flashcards
What does the term injection mean in the field of ophthamology?
Increased blood flow (hyperemia) to the eye. Usually results in a “red eye”.
What is one emergent situation that can cause Red Eye?
Acute Angle Closure Glaucoma
-sudden complete occlusion of the anterior chamber angle by the iris tissue.
What do characteristic dendrites in the cornea indicate?
HSK - herpes simplex keratitis
results in Red Eye
How can viral conjunctivitis be differentiated from bacterial conjunctivits?
Viral: causes injection (hyperemia) and Red Eye
Bacterial: causes pus formation
What is adnexal disease?
Disease affecting the eyelids, lacrimal apparatus, and orbit. Causes Red Eye.
What is the most common cause of Red Eye?
Subconjunctival Hemorrhage
occurs between the conjunctiva and sclera
What are the most common causes of subconjunctival hemorrhage?
increase in ocular venous pressure, coughing, sneezing, vomiting or vigorous eye rubbing
What is a pterygium?
Abnormal growth of tissue advancing over the cornea. Associated with ULTRAVIOLET exposure and seen more commonly in tropical climates.
What is Keratoconjunctivitis Sicca?
Fancy word for “Dry Eyes”. Not very serious, usually involves the conjunctiva and sclera. Sjogren and RA can cause it.
Most important component on physical exam when assessing a Red Eye.
Visual Acuity
What are the 9 diagnosit steps to evaluate red eye? (I’m not sure how well we have to know this)
- Check VA
- Inspection: try to determine if subconjunctival hemorrhage, conjunctival hyperemia, ciliary flush, or combined
- Detect discharge: profuse or scant? Purulent (pus), mucopurulent, or serous
- Detect corneal opacities, keratic precipitates, corneal edema, corneal scarring (leukoma), and irregular corneal light reflex
- Check for staining with fluorescein
- Estimate AC depth, look for hyphema or hypopion
- Check pupils
- If elevated IOP is suspected, and reliable tonometry available, use it. Don’t forget palpation can detect a hard eye
- look for proptosis, lid malfunction, or any limitation of eye movement
What is proptosis?
Bulging eye
What do these red eye signs indicate:
- Hyperemia
- DIscharge
- Purulent
- Mucopurulent
- Serous
- Scant White Stringy Discharge
- Oily discharge + Greasy Lid
- Non specific
- Important for DDx
- Bacterial
- Bacterial or Viral or both
- Viral
- Allergy
- blepharitis (eyelid inflammation) or Acne Rosacea (irritated or gritty, eyes and eyelids, the eyelids may develop cysts)
What type of infection must be ruled out with a purulent exudate?
Neisseria Gonorrheae
What condition presents on physical exam with viral conjunctivitis?
Preauricular Lymphadenopathy
What is the corneal limbus?
The border of the cornea and the sclera.
What usually causes ciliary flush?
Injection of deep conjunctival and episcleral vessels overlying the ciliary region near the limbus
What is a posterior synechiae?
Inflammatory adhesions between the lens and the iris.
What can cause a rapid increase in intraocular pressure (IOP)?
Acute Angle Closure Glaucoma
Why is proptosis considered a danger sign in patient’s with a red eye?
May indicate orbital or cavernous sinus disease.
What are two causes for seeing “colored halos”?
- Corneal Edema
2. Acute Narrow Angle Glaucoma
This infectious agent can cause pharyngoconjunctival fever leading to a red eye.
Adenovirus (type 3 and 7)
Condition that can be an allergic response to medication and cause severe conjunctivitis, scarring, and blindness.
Stevens-Johnson Syndrome
form of Erythema Multiforme that involves the eyes
What is a hordeolum?
Another name for a stye. Acute inflammation of the glands or hair follicles of the lid, external or internal
What is a Chalazion?
chronic inflammation of the meibomian glands, may follow a hordeolum
How do you treat a hordeolum or chalazion?
Warm compress w/ antibiotics, can cut the growth to let it drain.
Treatments for:
- bacterial conjunctivitis
- allergic conjunctivitis
- viral conjunctivitis
- Antibiotics w/ hot compress
- Cold compress
- just avoid spreading
What should you never prescribe to patients with eye pathology.
TOPCIAL ANESTHETICS!
When are corticosteroid, or steroids in general contraindicated with eye treatment?
Infectious eye treatment. Often makes the condition worse.
