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Ophthalmology > Red eye 2 > Flashcards

Red eye 2 Flashcards

1
Q

What is keratitis ?

A

Inflammation and damage of the cornea

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2
Q

What are the 2 main types of keratitis ?

A

Infectious and non-infectious (non is not very common)

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3
Q

What are the causes of infectious keratitis ?

A
  • Viral - herpes, adenovirus
  • Bacterial - staph A mainly, also sometimes pseudomonas aerginosa
  • Fungal
  • Acanthamoeba
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4
Q

What are the causes of non-infectious keratitis ?

A
  • RA
  • Hypersensitivity
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5
Q

What is the main complication that often occurs when someone develops keratitis ?

A

Ulcers - corneal and dendritic

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6
Q

What is a major risk factor for the development of keratitis ?

A
  • Contact lens use
  • Less commonly due to a scratch on the cornea
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7
Q

What are the main organsism associated with contact lens induced keratitis ?

A
  • Pseudomonas aeguinosa
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8
Q

What are the symptoms of keratitis/corneal ulcers?

A
  • Pain and redness (around the cornea)
  • Foreign body/gritty sensation
  • Corneal or dendritc ulcers
  • Profuse lacrimnation
  • Photophobia
  • Hypopyon (inflam cells in the anterior chamber looks white)
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9
Q

What causes dendritic ulcers in keratitis ?

A

Herpes infections

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10
Q

Why is it important to distinguish between a herpes infection causing keratitis and an autoimmune cause causing it ?

A

Because if steroids are given they can cause a corneal melt or perforation of the cornea in herpes infections

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11
Q

What is an adenovirus keratitis usually preceded by ?

A

URTI

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12
Q

What is the treatment for bacterial, viral or autoimmune keratitis ?

A
  • Bacterial = ofloxacin
  • Viral = aciclovir
  • Autoimmune = oral/topical steroids
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13
Q

How is the cause of corneal ulcers/keratitis diagnosed ?

A

Corneal scrap

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14
Q

What investigation can be done to identify a corneal ucler/abrasion ?

A

Fluorescein dye with slit lamp

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15
Q

What are the 2 main types of orbital cellulitis ?

A
  • Preseptal
  • Orbital
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16
Q

What is pre-septal cellulitis ?

A
  • It is an infection of the soft tissues anterior to the orbital septum - this includes the eyelids, skin and subcutaneous tissue of the face, but not the contents of the orbit.
  • It is characterised by eyelid erythema and oedema
17
Q

What is orbital cellulitis ?

A

Inflammation due to infection of the soft tissues (fat and muscles) of the orbit posterior to the orbital septum

18
Q

What are the main risk factors for the development of orbital cellulitis ?

A
  • It is usually caused by a spreading URTI from the sinuses
  • Recent eyelid infection/ insect bite on eyelid (Peri-orbital cellulitis)
  • Ear or facial infection
19
Q

Are eye movements ok in pre-septal cellulitis ?

A

Yes

20
Q

What are the signs/symptoms of orbital cellulitis ?

A
  • Oedema and erythema around the eye
  • Eyelid oedema and ptosis
  • Visual disturbance
  • Severe ocular pain & Painful eye movements
  • Ophthalmoplegia - cant move the eye
  • Proptosis - abnormal protrussion/displacment of the eye
  • Fever
  • Headache
  • N&V in meningeal involvement (rare tho)
21
Q

The features of orbital cellulitis and preseptal cellulitis are very similar, however what features of orbital cellulitis must be absent for it to be preseptal cellulitis ?

A

Orbital signs (pain on movement of the eye, restriction of eye movements, proptosis, visual disturbance, chemosis, RAPD) must be absent in preseptal cellulitis - their presence would indicate orbital cellulitis

22
Q

What investigations should be done in someone with suspected orbital cellulitis ?

A
  • Bloods - raised inflammatory markers
  • Swab of any discharge present
  • Contrast CT of the orbit may help to differentiate between preseptal and orbital cellulitis & determine if there is an abscess. It should be performed in all patients suspected to have orbital cellulitis
23
Q

What is the treatment of orbital ceullitis ?

A
  • Cared for by ophthalmology and ENT
  • But drain if there is an abscess
  • Give - Flucloxacillin + ceftriaxone +/- metronidazole

Ophthalmology (23 decks)

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