Red Eye Flashcards

1
Q

How do you obtain accurate ocular history?

A
  1. Onset? Sudden or Progressive?
  2. Timeline? Hours, days, or intermittent?
  3. Family Hx of red eye?
  4. Medications?
  5. Hx of trauma or extraordinary events?
  6. Contact lens wear & schedule of contact lens wear?
  7. Recent infections?
  8. Loss of vision?
  9. Pain and description of pain.
  10. Discharge?
  11. Itching?
  12. Sensitivity to light?
  13. Change in symptoms w/ environment?
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2
Q
A

Acute angle closure glaucoma

(Can be differentiated from open angle glaucoma, because it creates a red eye)

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3
Q
A

Ciliary flush episcleritis

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4
Q
A

Viral conjunctivitis

(note the cobblestone appearance)

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5
Q

Why can’t you use steroids for this condition?

A

It will eat through the cornea

(herpes simplex keritisis)

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6
Q
A

Nodular scleritis

(Cornea will be normal with a slight left exam)

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7
Q
A
  • Dacryocystitis
  • This is not an infection and does not require antibiotics. Most clear on their own.
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8
Q

symptoms

A

tearing

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9
Q

treatment

A
  • 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
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10
Q
A
  1. Abnormal, triangular tissue growth that grows over the cornea from the nasal side.
  2. Associated with ultraviolet exposure (more commonly seen in tropical climates)
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11
Q

Treatment

A
  • 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)

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12
Q
A

Purulent conjunctivitis (bacterial)

Notice creamy-white discharge and conjunctival hyperemia (common in many infections of conjunctiva)

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13
Q

Most common complaint with patients presenting with pure electric providers?

A

Waking up with a crusted shut eyelid

(vision & cornea fine, red eye present)

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14
Q
A

Large keratic percipitate: clumps of white cells are sticking to the endothelium of the cornea

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15
Q
A

Corneal edema (corneal disruptions) that are obvious by the loss of a sharp corneal reflex to a more dulled & diffuse one.

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16
Q
A

Corneal leukoma (scar)

17
Q
A

Irregular corneal reflex- Epithelium disruption

(Irregular corneal reflex caused by a booklice irregularity from the normal a shark light reflect)

18
Q
A

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)

19
Q
A

Chronic proptosis due to orbital tumor

20
Q
A

Treatment: radiation, eye drops to keep it moist (otherwise it will dry out and perforate)

(they may develop nerve defect after)

21
Q

What is this? trmt?

A

Syringomas - milia

excise - will leave a scar

22
Q
A
  • 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)

23
Q

Treatment

A
  • Clears up on its own
  • Artificial tears may help
24
Q
A

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)

25
Q

Treatment

A

Surgery: shorten the eyelid or create acantholysis and suture the eyelid back

(they can tape it themselves while they await surgery)

26
Q
A
27
Q

Ectropion subjects new patient to______.

A

recurrent conjunctivitis

28
Q

Treatment

A

Surgery:

(Taking a skin graft from the upper lid, lower lid, behind the ear or supraclavicularly)

29
Q

Disease?

Cause?

A
  • Bell’s Palsy paralytic ectropion
  • CN VII

(can’t close their eye, eyebrow droops due to orbicularis m.)

30
Q

Treatment

A

Surgery

(sometimes they can’t close their eye afterwards, you can put gold weights in their upper eyelid to weigh it down)

31
Q
A

Hyperthyroidism does not necessarily cause lid retraction. The lid retraction makes this Graves disease.

32
Q

Treatment:

A

Stable for 6 months → surgical spacer placed between the levator and the top of the tarsus.

33
Q

What are the nine diagnostic steps for red eye?

A
  1. Determine the pattern of redness
  2. Conjunctival discharge
  3. detect opacity of the cornea or irregularities of the cornea surface
  4. Fluorescein strip : corneal abrasion
  5. Estimate anterior chamber depth
  6. The regularity of the pupils asymmetry of pupil size
  7. IOP
  8. Ptosis or lid malfunction
    9.
34
Q

Important symptoms of red eye?

A
  1. Severe pain
  2. Blurred vision
  3. Halos - acute onset
  4. Reduced visual acuity
  5. Ciliary flush
  6. Corneal edema or at the little disruption
  7. Pupillary abnormality
  8. Shallow anterior chamber
  9. elevated IOP
  10. Proptosis