Red Eye Flashcards
How do you obtain accurate ocular history?
- Onset? Sudden or Progressive?
- Timeline? Hours, days, or intermittent?
- Family Hx of red eye?
- Medications?
- Hx of trauma or extraordinary events?
- Contact lens wear & schedule of contact lens wear?
- Recent infections?
- Loss of vision?
- Pain and description of pain.
- Discharge?
- Itching?
- Sensitivity to light?
- Change in symptoms w/ environment?
Acute angle closure glaucoma
(Can be differentiated from open angle glaucoma, because it creates a red eye)
Ciliary flush episcleritis
Viral conjunctivitis
(note the cobblestone appearance)
Why can’t you use steroids for this condition?
It will eat through the cornea
(herpes simplex keritisis)
Nodular scleritis
(Cornea will be normal with a slight left exam)
- Dacryocystitis
- This is not an infection and does not require antibiotics. Most clear on their own.
symptoms
tearing
treatment
- You must wait 6 months to prove this usually due to an obstruction in the nose or the valve under the inferior turbinate
- parents can press on it to drain it
- Abnormal, triangular tissue growth that grows over the cornea from the nasal side.
- Associated with ultraviolet exposure (more commonly seen in tropical climates)
Treatment
- Treated by surgical excision, but only if it encroaches on the visual axis.
- must be 3.5 mm
(20% recurrence rate, experimental new procedure with amniotic membrane graft w/no recurrence)
Purulent conjunctivitis (bacterial)
Notice creamy-white discharge and conjunctival hyperemia (common in many infections of conjunctiva)
Most common complaint with patients presenting with pure electric providers?
Waking up with a crusted shut eyelid
(vision & cornea fine, red eye present)
Large keratic percipitate: clumps of white cells are sticking to the endothelium of the cornea
Corneal edema (corneal disruptions) that are obvious by the loss of a sharp corneal reflex to a more dulled & diffuse one.
Corneal leukoma (scar)
Irregular corneal reflex- Epithelium disruption
(Irregular corneal reflex caused by a booklice irregularity from the normal a shark light reflect)
Corneal ulcer - bacterial with hypopyon
The eye shows a white corneal opacity w/ and irregular corneal reflex, along w/ that there is a prominent layer of purulent materal at the inferior aspect of the anterior chamber (hypopyon)
Chronic proptosis due to orbital tumor
Treatment: radiation, eye drops to keep it moist (otherwise it will dry out and perforate)
(they may develop nerve defect after)
What is this? trmt?
Syringomas - milia
excise - will leave a scar
- Subconjunctival hemorrhage caused by a broken blood vessel
- No damage, no visual defects
(If there are more than four of these instances in one year you must refer to hematologist)
Treatment
- Clears up on its own
- Artificial tears may help
Entropion: preseptal orbicularis rolls over the pretarsal orbicularis and rolls the eyelid inwards.
Eyelashes rub on the eye and scratched the cornea
(ENtropion goes INward)
Treatment
Surgery: shorten the eyelid or create acantholysis and suture the eyelid back
(they can tape it themselves while they await surgery)
Ectropion subjects new patient to______.
recurrent conjunctivitis
Treatment
Surgery:
(Taking a skin graft from the upper lid, lower lid, behind the ear or supraclavicularly)
Disease?
Cause?
- Bell’s Palsy paralytic ectropion
- CN VII
(can’t close their eye, eyebrow droops due to orbicularis m.)
Treatment
Surgery
(sometimes they can’t close their eye afterwards, you can put gold weights in their upper eyelid to weigh it down)
Hyperthyroidism does not necessarily cause lid retraction. The lid retraction makes this Graves disease.
Treatment:
Stable for 6 months → surgical spacer placed between the levator and the top of the tarsus.
What are the nine diagnostic steps for red eye?
- Determine the pattern of redness
- Conjunctival discharge
- detect opacity of the cornea or irregularities of the cornea surface
- Fluorescein strip : corneal abrasion
- Estimate anterior chamber depth
- The regularity of the pupils asymmetry of pupil size
- IOP
- Ptosis or lid malfunction
9.
Important symptoms of red eye?
- Severe pain
- Blurred vision
- Halos - acute onset
- Reduced visual acuity
- Ciliary flush
- Corneal edema or at the little disruption
- Pupillary abnormality
- Shallow anterior chamber
- elevated IOP
- Proptosis
