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Opthamology > Red Eye > Flashcards

Red Eye Flashcards

1
Q

DDx for acute red eye

A

Conjunctivitis
Corneal abrasion
Foreign body
Ocular burn
Corneal ulcer
Keratitis
Acute angle closure glaucoma
Anterior uveitis/iritis
Scleritis/episcleritis
Cellulitis (orbital/pre-orbital)
Subconjunctival haemorrhage

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2
Q

Clinical features of cellulitis

A

Fever, eyelid swelling, erythema, proptosis

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3
Q

Management of cellulitis

A

Blood for cultures
IV antibiotics and fluids
Refer urgently to optho

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4
Q

What is orbital/preseptal cellulitis

A

Infection spread from paranasal sinus/skin/lacrimal sac through trauma or haematogenous spread

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5
Q

What is Acute iritis / acute uveitis

A

Relapsing condition in young people associated to ankylosing spondylitis, ulcerative colitis, sarcoid, AIDs and Behcet’s syndrome

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6
Q

Signs and symptoms of acute iritis

A

Decrease visual acuity
Tender eye through upper eyelid
Small pupil that may look irregular due to previous adhesions
Erythema

Shining light in good eye causes pain in affected eye

Hypopyon and white preciptates

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7
Q

Acute iritis / uveitis treatment

A

Refer urgently to optho for steroid eye drops and follow up

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8
Q

Symptoms and signs of acute closed angle glaucoma

A

Blurred vision
Haloes around lights
Sever eye pain
nausea and vomiting
decreased visual acuity
semi dilated oval iris
eyes feel tender and hard through upper eyelid

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9
Q

What factors have increased risk of acute closed angle glaucoma

A

long sighted middle aged or elderly
anticholinergic drugs
pupil dilation at night (reading in dim light)

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10
Q

Acute closed angle glaucoma treatment

A

Urgent referral to ophthalmology

Pilocarpine every 15 mins - causes ciliary muscle contraction and humor drainage

Prophylactically put pilocarpine in other eye too

Analgesia

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11
Q

What causes conjunctivitis

A

Bacteria (strep pneumoniae, H influenza) or virus (adenovirus) or allergy

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12
Q

Signs and symptoms of conjuctivitis

A

May involve both eyes

Red and inflammed conjunctiva
Eye lid swelling
VISUAL ACUITY AND PUPILS NORMAL
NO PAIN
Bacterial - sticky tears
Viral - watery tears

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13
Q

Conjunctivitis treatment

A

Antibiotic eye drops / ointment - fusidic acid / chloramphenicol for 5 days

Do not share towels, pillows etc…
Return if symptoms don’t improve in 4 days

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14
Q

What is ulcerative keratitis

A

Corneal ulceration that causes pain and photophobia

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15
Q

Ulcerative keratitis presentation

A

Pain with photophobia
Hypopyon - if bacterial infection
Vesicles
Dendritic branching - if herpes simplex

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16
Q

Ulcerative keratitis management

A

DO NOT GIVE STEROID DROPS IN CASE OF MISDIAGNOSIS

SEND STRAIGHT TO OPTHAMOLOGY

17
Q

What is episcelritis

A

Inflammation beneath ONE AREA of the conjunctiva

18
Q

Episcleritis presentation

A

red eye
dull aching discomfort
visual acuity and pupils remain normal

19
Q

Episcleritis management

A

ORAL NSAIDs
Follow up
Consider steroid drops if it doesn’t resolve

20
Q

What is scelritis

A

Inflammation of deeper layers of sclera - can perforate sclera

21
Q

Scleritis presentation

A

May be caused by infection, rheumatology, idiopathic

DISPROPORTIONATE PAIN
scleral erythema
bluish discoloration

visual acuity and pupils remain normal

22
Q

Treatment of scleritis

A

Topical NSAIDS!

Corticosteroids, methotrexate if severe

Antibiotics if cause was infectious

23
Q

Blepharitis presentation and treatment

A

Eyelashes matted together and itchy
Topical antibiotics - chlorampenicol

24
Q

What causes a stye (external hordeolum) and treatment

A

Staphylococcal infection of eyelash roots
Antibiotics drops

25
Q

What is internal hordeolum

A

Chalazion - inflammatory reaction in blocked meibomian gland - may become infected

26
Q

Chalazion treatment

A

Topical antibiotics (chloramphenicol) and oral antibiotics (co-amoxiclav) - to treat infected meibomian gland

REFER IF ABCESS FORMS OF IF NODULE FORMS AND AFFECTS VISION

27
Q

What is dacrocystitis

A

Acute inflammation of the lacrimal sac may follow nasolacrimal duct

28
Q

Dacrocystitis presentation

A

Red and swollen under lacrimal sac
Obstruction
Pain
Watery eye
Pus
Fever

29
Q

Dacrocystitis treatment

A

Oral antibiotics (co-amoxiclav)

30
Q

Subconjunctival haemorrhage presentation

A

Painless
Well defined area of haemorrhage over sclera
May result from vomiting or sneezing or trauma/fracture

Opthamology (3 decks)

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