Opthalmology Flashcards
Define blepharitis
Inflammation of the eyelid margins
Features of blepharitis
- bilateral
- grittiness and discomfort, particularly around the eyelid margins
- eyes may be sticky in the morning
- eyelid margins may be red. 5. Swollen eyelids may be seen in staphylococcal blepharitis
- styes and chalazions
- secondary conjunctivitis
Diagnosis of blepharitis
Clinical diagnosis
Define conjuctivitis
Inflammation of the conjunctiva due to allergic or immunological reactions, infection (viral, bacterial or parasitic), mechanical irritation, neoplasia, or contact with toxic substances
Symptoms of infective conjunctivitis
- Sore – grittiness, burning sensation
- red eyes
- sticky discharge
Symptoms of allergic conjunctivitis
- Bilateral symptoms conjunctival erythema, conjunctival swelling (chemosis)
- Itch is prominent
- the eyelids may also be swollen
- Discharge
Ix for infective conjunctivitis
Infective conjunctivitis:
- Swabs taken if referral not required
What is corneal abrasion?
Corneal abrasions are defects in the epithelial surface of the cornea
Symptoms for corneal abrasion
- Eye pain
- Tearing
- Photophobia
- Blurred vision
- Ciliary flush - A ring of red or violet around the cornea.
Ix for corneal abrasion
Fluorescein staining
Define keratitis
Inflammation of the cornea.
Microbial kearatitis - Potentially sight threatening
Features of keratitis
- red eye: pain and erythema
- photophobia
- foreign body, gritty sensation
- hypopyon ( yellowish exudate in lower part of anterior chamber of eye)
Ix for keratitis
Diagnostic: slit-lamp
Referral for keratitis
- assessing contact lens wearers who present with a painful red eye is difficult
- an accurate diagnosis can only usually be made with a slit-lamp, meaning same-day referral to an eye specialist is usually required to rule out microbial keratitis
What is pterygium?
A pterygium is a raised, triangular or wedge-shaped, benign growth of conjunctiva tissue.
Symptoms of pterygium
Mild irritation (redness, dryness, foreign body sensation),, tearing
What is Chalazion?
Meibomian cyst (Chalazion)
Symptoms of Chalazion
Firm painless lump in the eyelid
Localized eyelid swelling that has developed slowly over several weeks.
Investigation of Chalazion
Invert the eyelid a discrete immobile granuloma nodule should be seen.
What is orbital cellulitis?
Result of an infection affecting the fat and muscles posterior to the orbital septum.
MEDICAL EMERGENCY
Features of orbital cellulitis
- Redness and swelling around the eye
- Severe ocular pain
- Visual disturbance
- Proptosis
- Ophthalmoplegia/pain with eye movements
- Eyelid oedema and ptosis
- Drowsiness +/- Nausea/vomiting in meningeal involvement (RARE)
Ix for orbital cellulitis
- FBC – WBC elevated, raised inflammatory markers.
- Clinical examination involving complete ophthalmological assessment – Decreased vision, afferent pupillary defect, proptosis, dysmotility, oedema, erythema.
- CT with contrast – Inflammation of the orbital tissues deep to the septum, sinusitis.
- Blood culture and microbiological swab to determine the organism. Most common bacterial causes – Streptococcus, Staphylococcus aureus, Haemophilus influenzae B.