Red Eye Flashcards
causes of red eye
conjunctivitis, acute closed angle glaucoma, iritis, scleritis, episcleritis, trauma, keratitis, subconjunctival haemorrhage
presentation acute closed angle glaucoma
acute uniocular attacks with headache, nausea, painful red eye, blurred vision, haloes around light
normal intraocular pressure
15-20
signs acute closed angle glaucoma
oval non reactive pupil, loss of red reflex, hypermetropia
cause acute closed angle glaucoma
blocked flow of aqueous from anterior chamber via canal of Schlemm. intraocular pressure rises to >30mmHg
treatment acute closed angle glaucoma
pilocarpine 2-4% drops. acetazolamide stat. mannitol. topical steroids and antihypertensives. peripheral iridectomy
what is iritis
inflammation of anterior uvea- anterior uveitis (ciliary body is involved)
features iritis
pain- aching may be aggravated by reading, red, photophobia, watery, blurred vision
signs iritis
redness, inflammatory cells and flare- exudate detected by slit lamp examination, keratic precipitates, miosis, intraocular pressure can be low high or normal, fundus
causes iritis
herpes virus, trauma, fuchs heterochromic cyclitis, arthritides, ankylosing spondylitis, reiters syndrome, psoriatic arthritis, IBD, juvenile chronic arthritis, sarcoidosis, behcets, syphilis
investigations iritis
ESR, FBC, ACE level, HLA typing
treatment iritis
topical steroids- prednisolone drops, betamethasone, dexamethasone. cyclopentolate (dilates eye), intravitreal and biological agents
what test is +ve in iritis
talbots test
complications iritis
cataract, glaucoma, macular oedema
bacterial conjunctivitis signs
red eye with purulent discharge
viral conjunctivitis signs
red eyes with watery discharge
commonest virus in conjunctivitis
adenovirus
bacterial causes conjunctivitis
staph aureus, staph epidermidis, strep pneum, H influena, chlamydia trachomatis
is the acuity affected in conjunctivitis
no
what happens to the pupil in conjunctivitis, ant uveitis/iritis, acute glaucoma
normal, small, large
treatment conjunctivitis
chloramphenicol drops or fusidic acid
do you get papillae or follicles in bacterial conjunctivitis
papillae in bacterial, follicles in viral and chlamydial
features of allergic conjunctivitis
rapid onset. itch, lid swelling, conjunctival oedema
what can allergic conjunctivitis be due to
pollen or other allergens. settles after a few hours
treatment allergic conjunctivitis
antihistamine drops eg emastidine
what happens to acuity in anterior uveitis and acute closed angle
reduced
what are episcleritis and scleritis
inflammation of the opaque ocular outer wall- white of the eye
features episcleritis and scleritis
aching and redness, which are more severe in scleritis
in epi or scleritis can the sclera look blue
in episcleritis- engorged vessels that can be moved over the area. scleritis- engorged vessels run deeper
presentation episcleritis
eye aches dully and tender. acuity ok. no discharge.
what can episcleritis be associated with
rarely- systemic disease- rheumatic fever, PAN, SLE
treatment episcleritis
self limiting. topical or systemic NSAIDs
which is a more serious condition- scleritis or episcleritis
scleritis
presentation scleritis
severe pain, common to be associated with systemic disease, visual disturbance not uncommon
what is scleritis
vasculitis of the sclera
what can happen to sclera in scleritis
thinning also corneal thinning and perforation can occur
underlying systemic disorders in scleritis
connective tissue disorders, RA, SLE, herpes zoster ophthalmicus
treatment scleritis
topical and systemic steroids, NSAIDs, immunosuppressants
what is keratitis
corneal inflammation- white area on the cornea
compications keratitis
scarring and vascularisation- corneal opacification and astigmatism- visual loss
