Red Eye Flashcards
Hyperopia
Far-sighted. Eye is shorter than it should be.
3 vision-threatening causes of red eye
Angle closure glaucoma, iritis, corneal ulcer
Questions to ask in history for red eye (6)
- Presence / location of pain
- Presence of visual loss
- History of associated problems – exudate, trauma, contact lens use, URI or exposure to other w/ URI (suggests viral conjunctivitis)
Proparacaine
What does it do?
What is it used for?
- Numbs eye. Only helps w/ surface pain (corneal problems).
- Look for corneal ulcer.
- Apply proparacaine before acuity test b/c otherwise px won’t be able to open eye.
What is Fluorescein used for?
Fluorescein makes denuded / dead tissue light up. Shows corneal abrasion.
Why should you not use proparacaine and fluorescein at the same time?
Look for white dot after giving proparacaine.
If absent, then give fluorescein.
If you add both together, you may misdiagnose a corenal ulcer as a corneal abrasion.
Subconjunctival hemorrhage Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Causes Treatment
No pain
No exudate
Normal visual acuity
No findings w/ fluorescein
Caused by N/V, sneeze, cough, constipation
No treatment is necessary, but artificial tears may help any irritation.
Conjunctivitis Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Causes Sxs based on cause Treatment
Mild surface pain / irritation
Positive exudate
Normal visual acuity
Pain relief w/ anesthetic
No findings w/ fluorescein
Causes - bacterial, viral, allergic, chemical
Viral – head cold, others have it, not much pus, one eye then other
Bacterial – lots of pus, no head cold, no other people have it
Allergic – itchy
•Supportive care for viral: cool compresses, artificial tears (more useful when cold, so put in fridge).
•Topical AB’s for bacterial. Usually gets better even w/o AB’s.
•Antihistamines for allergic
Corneal ulcer Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Causes
Surface pain No exudate Decreased visual acuity Pain relief w/ anesthetic Positive findings w/ fluorescein Cause - contacts overnight, storing contacts in water, swimming w/ contacts in
Corneal abrasion Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Causes
Surface pain No exudate Decreased visual acuity Pain relief w/ anesthetic Positive findings w/ fluorescein Caused by trauma
Iritis Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Other findings (4) Cause (7) Treatment
Deep pain No exudate Decreased visual acuity No pain relief w/ anesthetic No findings w/ fluorescein Other findings - photophobia, scarring on lens (senichiae; caused by fibrin deposition) inflammation inside the eye, normal cornea. Caused by inflammation / infection: RA, ankylosing spondylitis, sarcoid, syphilis, herpes, IBD, TB Treatment - steroids
Angle closure glaucoma Location of pain Exudate Visual acuity Pain relief w/ anesthetic? Findings w/ fluorescein Sxs (3) Other findings Cause
Deep pain
No exudate
Decreased acuity
No pain relief w/ anesthetic
No findings w/ fluorescein
Sxs include sudden pain, decreased vision, nausea, and vomiting (due to high pressure).
Other findings - pupil fixed and mid-dilated, cornea becomes swollen
Cause - Phenylephrine may cause angle closure, along with other drugs that cause pupil dilation.
What causes hyper acute bacterial conjunctivitis?
Gonorrhea. Medical emergency. Must refer.
What does scratchy pain suggest?
Corneal problems
What does deep pain suggest?
Iritis or glaucoma
