Opthalmology - Red Eye

Question 1

Dendritic Ulcer
- Tx

Answer 1

Dendritic Ulcer

• Tx
  1. ACV 5x
• 1/52

Question 2

Scleritis
- Acanthameba

1. Cause
2. Tx

Answer 2

Scleritis
- Acanthameba

1. Tap water and contact lenses

Question 3

Iritis

1. Associated conditions
2. Tx

Answer 3

Iritis

• Associated conditions
  1. HLA B27
  2. Sarcoidosis
• Tx
  1. Steroids
  2. Mydriatics
• Cyclopentolate

Question 4

Subconjunctival haemorrhage
- S&S
- Mx

Answer 4

Subconjunctival haemorrhage

• S&S
  1. Comfortable
  2. Red eye
• Mx
  1. Resolves without treatment
  2. Check INR

Question 5

Pterygia and pigueculum

• Sx
• Mx

Answer 5

Pterygia and pigueculum

• Sx
  0. Fibrovascular growths from the sun
  1. Inflammation
• Mx
  1. Surgical removal

Question 6

Foreign Body in eye

• S&S
• Mx

Answer 6

Foreign Body

• S&S
  1. Gritty sensation
  2. Visible object
• Mx
  1. Evert eyelid
  2. LA
  3. Orange needle removal
  4. Chloramphenicol

Question 7

Corneal abrasion
- S&S
- Mx

Answer 7

Corneal abrasion

• S&S
  1. Painful
• Mx
  1. Fluoroscene dye
  2. Topical ABx
  3. Chloramphenicol

Question 8

Red Eye
- Examination

Answer 8

Red Eye
- Examination

1. Snellen chart
2. Ophthalmoscope
   - Blue Light
3. Magnifying aid
4. Fluorescein
   - Abrasions
5. Slit lamp

Question 9

Red eye ddx

• Visual losses
• Gritty sensations
• Itching eyes

Answer 9

Red eye ddx

• Visual losses
  1. Corneal ulceration
  2. Glaucoma
  3. Iritis
• Gritty sensations
  1. Conjunctivitis
  2. Dry eye
  3. FB
• Itching eyes
  1. Allergic eye disease
  2. Blepharitis

Question 10

Bacterial conjunctivitis

• S&S
• Mx

Answer 10

Bacterial conjunctivitis

• S&S
  1. Discomfort
  2. Purulent discharge
  3. Clear cornea and good VA
• Mx

1. Swab
2. Oc chloramphenicol
   - 1% QDS
   - 1/52

Question 11

Viral conjunctivitis

• S&S
• Mx

Answer 11

Viral conjunctivitis

• S&S
  1. Gritty and uncomfortable
  2. Coryzal
  3. Watery discharge

4. Several weeks duration
5. Can be painful corneal involvement
6. Associated lymphadenopathy

• Mx
  1. Self limitting
  2. Viral swab

3. Lubricants
4. ABx for 2º ifx
5. Steroids for cornea

Question 12

Chlamydial conjunctivitis

-S&S
- Mx

Answer 12

Chlamydial conjunctivitis

-S&S
1. Mucopurlent discharge
2. Chronic
3. Venereal symptoms

4. Conjunctival injection

• Mx
  1. Swab
  2. Refer to GUM

3. Topical ABx
4. Systemic abx
   - Azithromycin
   - Tetracycline

Question 13

Thyroid Eye Disease
- Signs

Answer 13

Thyroid Eye Disease
- Signs

1. Oedema
2. Lid retraction

Question 14

Dysthyroid Optic Neuropathy (DON)
- Pathology

Answer 14

Dysthyroid Optic Neuropathy (DON)
- Pathology

1. Hydraulic or mass effect
2. Optic nerve compromised
   - Loss of vision
   - Loss of colour vision
   - Visual field defect

Question 15

Thyroid eye disease
- Mimics

Answer 15

Thyroid eye disease
- Mimics

1. CCF
   - Carotic cavernous fistula
2. Lymphoma

Question 16

Grave’s Disease
- Incidence

Answer 16

Grave’s Disease
- Incidence

1. 100-200 per 100,000
2. 8:1 - F:M

Question 17

Thyroid eye disease
- Symptoms

Answer 17

Thyroid eye disease
- Symptoms

1. Watering
2. Redness
3. Diplopia
4. Pain
5. Depression
6. Visual field/colour loss

Question 18

Graves’ disease
- Associations

Answer 18

Graves’ disease
- Associations

1. RA
2. DMT1
3. Sjogren’s
4. Pernicious anaemia
5. Vitiligo

Question 19

Lid retraction
- Physiology

Answer 19

Lid retraction

• Physiology
  1. Upper lid 1-1.5 cm above limbus
  2. Lower lid at level of limbus

Question 20

Burnt out TED
- Symptoms

Answer 20

Burnt out TED
- Symptoms

1. Inflammatory element has gone
2. Only lid retraction remains

Question 21

Lid lag
- Signs

Answer 21

Lid lag
- Signs

1. Von Graefe sign
   - Lid lag on down gaze
2. Pseudoptosis
   - Contralateral lid retraction present