Red eye

Question 1

What are the 4 ‘coats’ of the external eye

Answer 1

eyelid
conjunctiva
episclera
sclera

Question 2

Herpes zoster ophthalmicus treatment

Answer 2

Oral acyclovir
topical steroids for inflammation

Question 3

What pathogens can cause conjunctivitis?

Answer 3

Bacterial: simple bacterial, gonococcal

Viral: adenoviral, molluscum, herpes simplex/zoster

Chlamydial: adult, neonatal, trachoma

Allergic/vernal

Question 4

Gonococcal conjunctivitis treatment

Answer 4

systemic cephalosporins
topical antibiotic drops

Question 5

Describe pharyngoconjunctival fever

Answer 5

adenovirus types 3 + 7
typically affects children
URTI
keratitis in 30% - mild

Question 6

Describe epidemic keratoconjunctivitis

Answer 6

adenovirus types 8 + 19
very contagious
no systemic symptoms
keratitis in 80% - can be severe

Question 7

What are the 2 types of adenoviral keratoconjunctivitis?

Answer 7

Pharyngoconjunctival fever

Epidemic keratoconjunctivitis

Question 8

What causes Trachoma?

Answer 8

Serotypes A, B, Ba and C of Chlamydia Trachoma

Question 9

Trachoma treatment

Answer 9

systemic azithromycin

Question 10

What causes Adult chlamydial keratoconjunctivitis

Answer 10

infection with Chlamydia trachomatis serotypes D to K

Question 11

Adult chlamydial keratoconjunctivitis treatment

Answer 11

topical tetracycline and oral tetracycline or macrolide

Question 12

What is allergic rhinoconjunctivitis?

Answer 12

hypersensitivity reaction to specific air borne antigens
associated nasal symptoms

Question 13

What is hyphema?

Answer 13

collection of blood in the anterior chamber of the eye

Question 14

Scleritis treatment

Answer 14

oral steroids
immunosuppressive agents (cyclophosphamide, azathioprine, cyclosporin)
combines IV steroids + cyclophosphamide if unresponsive

Question 15

How does scleritis progress?

Answer 15

avascular patches
scleral necrosis and visibility of uvea
spread and coalescence of necrosis

Question 16

What contrast agent is used to visualise the cornea/kerat-?

Answer 16

fluoroscein

Question 17

What is arc eye/photokeratitis?

Answer 17

inflammation of the cornea caused by UV radiation (often from welding)

Question 18

What can cause keratitis?

Answer 18

bacterial
viral
acanthamoeba
fungal

(contact lenses with poor hygiene)

Question 19

What is endophthalmitis?

Answer 19

an inflammation of the inner coats of the eye, resulting from intraocular colonisation of infectious agents with exudation within intraocular fluids
can cause blindness

Question 20

Acute angle closure symptoms and signs

Answer 20

sudden onset painful and red eye
severe pain +/- vomiting
decreased visual acuity due to corneal oedema
may see rainbow halos round lights
semi-dilated oval pupil
stony hard eyeball

emergency

Question 21

Describe pupil block in acute angle closure

Answer 21

increase in physiological pupil block
dilatation of pupil renders peripheral iris more flaccid
increase pressure in peripheral

Question 22

Acute angle closure treatment?

Answer 22

lie patient supine
Acetazolamide 500mg IV
Pilocarpine 2% to both eyes
Topical pressure-lowering drops (check for contraindications)
Topical steroids
Laser peripheral iridotomy