Red eye Flashcards
What are the 4 ‘coats’ of the external eye
eyelid
conjunctiva
episclera
sclera
Herpes zoster ophthalmicus treatment
Oral acyclovir
topical steroids for inflammation
What pathogens can cause conjunctivitis?
Bacterial: simple bacterial, gonococcal
Viral: adenoviral, molluscum, herpes simplex/zoster
Chlamydial: adult, neonatal, trachoma
Allergic/vernal
Gonococcal conjunctivitis treatment
systemic cephalosporins
topical antibiotic drops
Describe pharyngoconjunctival fever
adenovirus types 3 + 7
typically affects children
URTI
keratitis in 30% - mild
Describe epidemic keratoconjunctivitis
adenovirus types 8 + 19
very contagious
no systemic symptoms
keratitis in 80% - can be severe
What are the 2 types of adenoviral keratoconjunctivitis?
Pharyngoconjunctival fever
Epidemic keratoconjunctivitis
What causes Trachoma?
Serotypes A, B, Ba and C of Chlamydia Trachoma
Trachoma treatment
systemic azithromycin
What causes Adult chlamydial keratoconjunctivitis
infection with Chlamydia trachomatis serotypes D to K
Adult chlamydial keratoconjunctivitis treatment
topical tetracycline and oral tetracycline or macrolide
What is allergic rhinoconjunctivitis?
hypersensitivity reaction to specific air borne antigens
associated nasal symptoms
What is hyphema?
collection of blood in the anterior chamber of the eye
Scleritis treatment
oral steroids
immunosuppressive agents (cyclophosphamide, azathioprine, cyclosporin)
combines IV steroids + cyclophosphamide if unresponsive
How does scleritis progress?
avascular patches
scleral necrosis and visibility of uvea
spread and coalescence of necrosis
What contrast agent is used to visualise the cornea/kerat-?
fluoroscein
What is arc eye/photokeratitis?
inflammation of the cornea caused by UV radiation (often from welding)
What can cause keratitis?
bacterial
viral
acanthamoeba
fungal
(contact lenses with poor hygiene)
What is endophthalmitis?
an inflammation of the inner coats of the eye, resulting from intraocular colonisation of infectious agents with exudation within intraocular fluids
can cause blindness
Acute angle closure symptoms and signs
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
Describe pupil block in acute angle closure
increase in physiological pupil block
dilatation of pupil renders peripheral iris more flaccid
increase pressure in peripheral
Acute angle closure treatment?
lie patient supine
Acetazolamide 500mg IV
Pilocarpine 2% to both eyes
Topical pressure-lowering drops (check for contraindications)
Topical steroids
Laser peripheral iridotomy
