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Ophthalmology > Red eye > Flashcards

Red eye Flashcards

1
Q

what are some common causes of a red eye?

A 
Conjunctivitis (blepharo-conjunctivitis )
Keratitis
Anterior uveitis
Scleritis / Episcleritis
Acute Angle Closure Glaucoma
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2
Q

what are some rarer causes of red eye?

A

subconjunctival haemorrhage

orbital disease - cellulitis

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3
Q

what are important ocular history questions to ask in a red eye presenting complaint?

A 
Pain
itch
discharge  / tearing
photophobia
visual loss
past ocular disorders
contact lenses
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4
Q

what is blepharitis?

A

inflamed eyelid

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5
Q

what two types of blepharitis are there?

A

anterior and posterior

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6
Q

what are some causes of an anterior blepharitis?

A

seborrhoeic (squamous) - scales on the lashes

staphylococcal - infection involving the lash folicle

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7
Q

how will an anterior blepharitis often present?

A

lid magin redder than the deeper part of the lid

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8
Q

what is a cause of posterior blepharitis?

A

meibomian gland dysfunction (MGD)

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9
Q

how does posterior blepharitis often present?

A

redness in deeper part of lid

lid margin often quite normal looking

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10
Q

what are the symptoms of blepharitis?

A

similar to conjunctivitis
gritty eyes / foreign body sensation
mild discharge

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11
Q

what are some signs of a seborrhoeic anterior blepharitis?

A

lid margin red
scales
dandruff
no ulceration - lashes unaffected

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12
Q

what are some signs of staphylococcal anterior blepharitis?

A

lid margin red
Lashes distorted, loss of lashes, ingrowing lashes - trichiasis
Styes, ulcers of lid margin
corneal staining, marginal ulcers (due to exotoxin)

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13
Q

How does Meibomian gland disease” present?

A

Lid margin skin and lashes unaffected
M.G. openings pouting & swollen
Inspissated (dried) secretion at gland openings
Meibomian Cysts (chalazia)

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14
Q

what diseases is Meibomian gland disease commonly associated with?

A

acne rosacea - 50%

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15
Q

what is the treatment for blepharitis?

A

lid hygiene - daily bathing
supplementary tear drops
oral doxycycline for 2-3 months

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16
Q

What are some infective causes of conjunctivitis?

A

viral
bacterial
chlamydial

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17
Q

what are some non-infective causes of conjunctivitis?

A

allergic
chemical/drugs
skin diseases - eczema

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18
Q

what are the symptoms of conjunctivitis?

A 
red eye 
foreign body sensation – gritty eye
discharge – sticky eye
Itch = allergy
VISION UNAFFECTED
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19
Q

what are the signs of conjunctivitis?

A

Red eye - note pattern of redness – diffuse more towards the fornices
Discharge -
Papillae or Follicles (bumps on inside of eyelid
Sub conj. haemorrhage
Chemosis = oedema
Pre-auricular glands (if viral)

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20
Q

what is a key sign in bacterial conjunctivitis?

A

sticky discharge

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21
Q

what are the most common infecting organisms in bacterial conjunctivitis?

A

staph. aureus
strep. pneumoniae
H. influenzae

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22
Q

when is follicular conjunctivitis seen?

A

viral
chalmaydial
drugs - propane / trruspot

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23
Q

what is chemosis?

A

conjunctival oedema

24
Q

what are some causes go chronic conjunctivitis?

A 
blepharitis
chlamydial infection
lacrimal disease
sensitivity of topical glaucoma medication
sub-tarsal foreign body
25
Q

what are some causes of infective corneal ulcers?

A

viral
fungal
bacterial
acanthamoeba

26
Q

where do central corneal ulcers present?

A

centrally

27
Q

what are some autoimmune causes of corneal ulcer?

A

Rheumatoid arthritis

hypersensitivity

28
Q

where do autoimmune corneal ulcers tend to present?

A

peripherally

29
Q

what are some symptoms of a corneal ulcer

A 
pain - needle like
photophobia
profuse lacrimation
possible reduced vision
red eye- circumcorneal
30
Q

what are some signs of a corneal ulcer?

A

redness - circumcorneal
abnormal corneal reflex
corneal opacity

31
Q

what investigations would you do for a suspected corneal ulcer?

A

corneal scrape for gram stain and culture
Staining with fluorescein
hypopon - white blood cells forming a fluid level in eye

32
Q

what shape to ulcers caused by H. simplex tend to be?

A

dendritic

33
Q

what diseases are associated with exposure keratitis

A 
thyroid problems
VII palsy (bells palsy)
34
Q

what disease is associated with Keratoconjunctivitis sicca - dry eye

A

sjogrens

35
Q

what vitamin deficiency can cause corneal ulcers?

A

Vitamin A

36
Q

what is the problem in neurotrophic keratitis?

A

reduced sensation in the eye

37
Q

what are some causes of neurotrophic keratitis?

A

Diabetes
H zoster
V1 problem

38
Q

what is the treatment of a bacterial corneal ulcer?

A

ofloxacin hourly

39
Q

What is the treatment for a herpetic corneal ulcer?

A

Aciclovir ointment 5 x day

40
Q

What is the treatment of an autoimmune corneal ulcer?

A

anti-inflammatory agents - oral / topical steroids

41
Q

what are some autoimmune causes of anterior uveitis?

A

Reiter’s, Ulc colitis, Ank Spondylitis, Sarcoidosis

42
Q

What are some infective causes of anterior uveitis?

A

T.B. Syphylis, Herpes simplex, Herpes zoster

43
Q

What are some malignant causes of anterior uveitis?

A

leukemia

44
Q

what are the symptoms of anterior uveitis?

A 
Pain (+ referred pain)
Vision may be reduced
Photophobia
Red eye (circumcorneal)
(often mistaken as conjunctivitis)
45
Q

what are the signs of anterior uveitis?

A 
Ciliary injection (i.e. circum-corneal )
Cells & flare in anterior chamber
Keratic precipitates
Hypopyon
Synechiae - Small or irregular pupil
46
Q

what is the management of anterior uveitis?

A

topical steroids - red forte 1% hourly tapering over 4-8 hours
mydriatics - Cyclopentolate 1% BD
Investigate for systematic association

47
Q

what is associated with episcleritis?

A

gout

48
Q

what is scleritis associated with?

A

serious systemic vasculitides e.g. Rh arthritis, Wegener’s

uveitis

49
Q

what are the signs and symptoms of scleritis?

A

painful

injection of deep vascular plexus - violaceous hue

50
Q

what test can be done for scleritis?

A

phenylephrine test

51
Q

what is the treatment for episcleritis?

A

self-limiting
lubricants
topical NSAIDs

52
Q

what is the treatment for scleritis?

A

oral NSAIDs
Oral steroids
steroid sparing agents

53
Q

is acute closed angle glaucoma common or rare?

A

rare

54
Q

What happens in acute closed angle glaucoma?

A

IOP rises do to the drainage angle being closed

55
Q

what are the signs and symptoms of acute closed angle glaucoma?

A 
severe pain and nausea
circumcorneal injection
cloudy cornea
mid dilated pupil
stony hard eye

Ophthalmology (9 decks)

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