Red eye Flashcards by Iquwuw Wkkw

thin layer between sclera and episclera

episclera

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differerence between sclera and conjuctvitis

scleritis asociated with systemic vasculitis

episcleiritis ,no dishcarge , no loss of va , resolves spontaneoulsy if left untreated , helped with NSAIDS e.g ibprofren

scelritis- usually painful , may be associated with loss of vision, pts usually have rhematoid arthirits or sytsemic vasculitis

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clinical signs of AAU/iritis

intense redness of the globe

irregular pupil that is stuck to the lense - posterior synachie

cells on the back durface of the corena - keratitic percipitrates

variable iop - often low - occasionally very low

fibrin clot in anterior chamber

reduced va

systemic associations = sarcodosis , paratoid gland swelling , 7th nerve plasy , erythema

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AACG presentation

elerdelry hyperopic

acute increase pressure of intraoucalr pressure

unilateral red eye and severe pain and profound loss of vision

signs red eye , corneal odema

mid dilated pupil , poor VA

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treatement of glaucoma

lower iop

using drops acetazolamide

intravenoous mannitol

irditomy

stops 2nd attack by by passing the pupil

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what would you see in an allergic ulcer

marginal keratitis

intense white lesion at the peripheral margin of the cornea

associated with redness , treatment = steroid , specalist advice

untreated lesions resolve spontenaously

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bacterial keratitis- presentation

corneal infection

bacterial keratitis

rare but severe , cornea= hazy with corneal abscess

treatment = intense fortified antibiotdis

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what does AAU occur with

inflammatroy bowel diseraser

psoratic atrophy

granulomatous disease
saracodis , tb

ask about joint problems, mouth ulcers , chest or sin problems

genitourninary symptoms

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charactersitics of AAU

unilateral

photphobia

reduced VA

acute painful red eye

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what corneal infections (keratitis) can cause red eyes

viral

bacterial

ancanthoneba

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what are allergic conrral disorders that can cause red eye

marginal kertatis

immunological keratiis (peripheral ulcerative keratitis)

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important things to remember with corneal foregin bodies

sub tarsal foreign boyd

always think of possibility of an intraocualr foregn bodu , if history of high velocity injury

best removed with a topical anesthetic

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what corenal viruses can cause red eyes

herpes simplex virus

symptoms - foreign body sensation ,photphobia , watery dishcarge

treatment is with anitvural acyclovoir

NOT TREATEMENT WITH STEROID

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Eyelid infections causing red eye

viral - herpes simplex

herpes zoster

papilloma

bacterial stye

infestations

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presentation of herpes zoster opthalmicus

vesiclo bulous eruption affecting opthalmic divison of trigeminal nerve

eye affected if tip of nose is involved (nasociallary nerve)

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blepharitis treatment

lid hygiene

lubricants

topical antibiotics

rubbed onto lid hyfgiene and other lid hygiene

topical steroids

oral antibiotics - meibomican gland expression to prevent chalazion

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symptoms of dry eye

discomfort

visual distubance

tear film instaboloyu

potential to damage ocular surface

factors , age , cl wear, systemic conditions sjorgen syndrome

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dry eye testing

fluroscin for epitheliel damage

TFBUT - seconds it takes for tear film to break up

schirmer test

meibomian gland expression

measures aqueous productioon

measures level of secretions in lipid layer of tear film

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eyelid malposition causing red eye

entropian

ectropian - eyelid pulling away from skin

difference between ADE and EDE

ADE- worse towards the end of day

EDE- worse on awakeing
(inidicates MGD)

blepharitis symptoms

gritty eyes

watery discharge

foreign body sensation

recurrent chalazion

possible presentations of blepharitis

thickend red inflamed eyelids

loss of eyelashes

flaky material (keratinsewd sqaumous) in eyebrows

chronic blepharitis , notched upper lid leading to tear film instablity

conjuctivitis presentation

vision not affected

discharge

watery/ sticky in viral infection

purlent in bcaterial infection

watery/muscous in viral

bloody discharge can occur in some sever viral + bactrail infections e.g. diptheria

viral infection - marked immune response - follicular

white lesions raised

allergic reactionn - capillary dilation

and increased permeability causing red lesions and papillae

what is viral conjuctivits associated with

adenovirus

preauricular lymphadenopthay

subconjuctival haemhorrhage associated with

sudden onset bright red eye blood can spread under conjuctiva so small haemhorrhage can extend to cover the globe if following trauma , check for orbital and ocular injury can be spontaneous in elderly

in ectropian what should you check for

in facial palsy check for eyeclosure corneal sensaton and for bells phenomena if these are absent requires urgent refferal

what are bacterial infections causing bacterial conj

staph , neisserhia , strep chlaymidia trachoma adult inclusion neonatal

what can severe herpes zoster opthalmicus cause

can lead to keratits with corneal clouding thinning

subconuuctival hamehoohrage is

inflammation of the conjuctiva

lice and nits attached to the eylids

lice infestation

lid malposition

entropian , eyelashes abrade corna caused by lid laxcity in the elderly and needs sx

what are the different types of allergic conjuctivits

acute type 1 hypersensitivity aucte type 1 hypersensitivity chronic allergic conuctivits pts usually atopic , athma , hayfever ezema in chronoic allergic conj

possible presentatiion of contact dermatitis

red eye discharge inflamed skin with ulceration

chronic allergic conjuctivits

vernal keratoconjuctivits severe allergic conjuctivits sticky musocus dishcarge large papillaue cornea ulcer tretament includes topical steroids

bacterial conjuctivits

often starts in 1 eye and spreads to the other eye topical antibiotics - use fusidic acid + chloremphenicol

trachoma

disease of poor hygieen causes conjucitval scarring and dry eyes in growing eyelashes corneal scarring and vascularisaton

chlaymidia adult incusion conj

adult inclusion conj causes genitourninary infection organism passed directly from eye from unwashed hands cuases unilateral follicular conuctiva in the eye

opthalmia nenaturium

conjuctivius in first 3 weeks of life passes through birth canal chalymida herpes simplex gonnhoriea staph aurues associated with corneal inflamation , essential to treat underlying geniotourninary infection treatment is with systemic ertyhmyocin

periorbial vs orbital

periorbial - confined to eyelids history of trauma insect bites usually requires oral antibiotics orbital lid swelling proptosis decreased eye movements high dose iv antibiotics for orbital

blephairits is unilateral or bilateral

bilateral

endoptjhalmitis

usually post operative but can be endogenous if no history of surgery ocular emergency = redness , pain , loss of VA sterile uverits = diagnosis of exclusion intraocualr antibiotic reuqired if perception of light only - urgent virectomy and intraoucalr antibiotics

serious red eye conditions

AACG , keratitis , scelritis and iritis

difference betwenen scleritis and episcelritis

slceirits very painful purple no blanching with phenelphrine episcleirit s not usually painful blanching with phenelphrine episcleritis often associated with certain inflammatory conditions

pingieclum

present on nasal limbus rarely requires treatment if inflamed short cuase of steroids sufficent

vernal keratconjuctivits

recurrent bilateral immune mediated history affects young peoplr usually seasonal can be palberal , limbal or mixed they need immudulation

ptergium

fibrovascular growth of degenerative bulbar tissue cross limbus and encroaches onto the corena no treatment if asymptomatic excision

atopic keratcons

typically present in adults usually perrenial corneal involvement can lead to blindness if left untreated often have a long history of atrophy