Red Eye Flashcards
What condition is seen here?
In paediatrics, what is ususally the cause?
Orbital cellulitis
Sinus infection
What condition is seen here?
These are usually of no great significance unless they are what?
Subconjunctival haemorrhage
Recurrent
The eyelids are important in ocular defence. What are some of their functions?
Blink reflex
Meibomian secretions: oily, and act as tear film stabilisers
What are some structures of the eye which are important in defence?
Eyelids
Tears
Conjunctiva
Epithelium
Tears are important in defence, what are some of their functions?
What are some causes of reduced tears?
Mucus trapping, and the production of lysozyme, immunoglobins IgA and IgG and complement
Connective tissue diseases, especially Sjogren’s, and also radiotherapy
What is the only acute condition which involves increased pressure?
Acute closed angle glaucoma
If patients have the sensation of a foreign body in the eye, where does this suggest the pain is coming from?
If the patient has an achy pain, where does this suggest the pain is coming from?
Intra-ocular problem
Referred pain from intra-ocular inflammation
When patients have a red eye associated with persistent visual loss, what conditions could this suggest?
Acute closed angle glaucoma, uveitis, corneal ulcer
What is acatoemeba?
What does it do?
Who is it seen in?
A parasitic microbe
Eats the keratocytes in the cornea and is non-responsive to any antibiotics
Associated with contact lens wear
Blepharitis is inflammation of where?
It can be one of two types, what are these?
The eyelids
Anterior or posterior
What type of blepharitis is seen here?
What are the two different types of this?
Anterior
Sebrorrhoeic (squamous) = scales on the lashes
Staphylococcal = infection involving the lash follicle
A lid margin redder than the deeper part of the lid describes which type of blepharitis?
Redness in the deeper part of the lid, with the margin often looking normal describes which type of blepharitis?
Anterior
Posterior
What type of blepharitis is this?
What causes it?
Posterior
Meibomian gland dysfunction
Give 3 symptoms of blepharitis?
Gritty eyes
Feeling of foreign body sensation
Mild discharge
Blepharitis has associations with which 3 other causes of red eye?
Conjunctivitis, keratitis, episcleritis
Lid margin is red, lots of scales, dandruff, no ulceration, unaffected eyelids- what type of blepharitis is this?
Lid margin is red, lashes are distorted/lost/ingrowing (trichiasis), ulcers on the lid margin, corneal staining- what type of blepharitis is this?
Anterior, seborrhoeic type
Anterior, staphylococcal type
Posterior blepharitis has an association with what other condition in 50% of cases?
Rosacea
What is the treatment for blepharitis?
Lid hygiene
Supplementary tear drops
Oral doxycycline for 2-3 months
What are the 3 main symptoms of conjunctivitis?
What othe symptoms may there be if it is an allergic type?
Is vision affected in conjunctivitis?
Red eye, foreign body sensation, discharge
Itch
No
Is bacterial conjunctivitis papillary or follicular?
What is the treatment?
Papillary
Self limiting and will clear in 14 days, topical chloramphenicol will clear it quicker
What are the causes of follicular conjunctivitis?
Viruses
Chlamydia
Drugs
Chronic conjunctivitis can last how long?
What are some causes?
Weeks - months
Blepharitis, chlamydia, keratoconjunctivitis sicca, lacrimal disease, subtarsal foreign body
What is keratitis?
What are the 3 layers of the cornea from outer to inner?
Inflammation of the cornea
Epithelium, stroma, endothelium
Corneal ulcers which are central are usually a result of what?
Corneal ulcers which are peripheral are usually what kind?
Infection
Autoimmune
Give 5 symptoms of corneal ulcers?
Pain (needle like)
Photophobia
Profuse lacrimation
Possible reduced vision
Red eye
Infection with what can decrease corneal sensation?
Herpes virus
What are 4 signs of corneal ulcers?
Redness
Abnormal corneal reflection
Corneal opacity
Hypopyon
What type of corneal ulcer is this?
Bacterial
What type of ulcer is this?
Herpes simplex dendritic ulcer
What type of corneal ulcer is this?
Autoimmune
What is exposure keratitis?
What are some causes?
Keratitis due to dryness of the cornea from incomplete/inadequate eyelid closure
Thyroid eye disease, CNVII palsy
What is keratoconjunctivitis sicca?
In what condition is this mostly seen?
Dryness of the conjunctiva and cornea
Sjogren’s
What vitamin deficiency can cause keratitis?
Vitamin A
What investigation should be used for a corneal ulcer?
Corneal scrape for gram stain and culture
What is the treatment for a corneal ulcer caused by…
A) Bacteria?
B) Virus?
C) Autoimmune?
A) Ofloxacin hourly
B) Aciclovir 5x daily
C) Steroids
What are some autoimmune causes of anterior uveitis?
Reiter’s syndrome, AS, UC, sarcoidosis
What are some infective causes of anterior uveitis?
TB
Syphillis
Herpes Simplex
Herpes Zoster
What malignancy may cause anterior uveitis?
What are some rarer causes of anterior uveitis?
Leukaemia
Idiopathic, traumatic
Anterior uveitis involves inflammation of where?
Iris, choroid and ciliary body
What are some symptoms of anterior uveitis?
What is this often misdiagnosed as?
Pain, reduced vision, red eye, photophobia
Conjunctivitis
What are the treatment options for anterior uveitis?
When should it be investigated?
Topical steroids and mydriatics
If recurrent or chronic, investigations for an underlying systemic disease should occur
What is this sign known as?
What forms this?
In what condition may this be seen?
Keratic precipitates
Inflammatory cells stuck on the back of the cornea
Anterior uveitis
Is episcleritis common?
Is it associated with serious conditions?
What condition can it be associated with?
How is it treated?
Yes
No
Gout
Self-limiting, can give topical NSAIDs, lubricants and mild steroids
Is scleritis a serious disease?
What conditions is it associated with?
Is it painful?
What other eye condition can it be associated with?
Yes
Systemic conditions such as RA or GPA
Yes
Anterior uveitis
How is scleritis treated?
Oral NSAIDs, steroids and steroid sparing agents
What condition is this?
Scleritis
What condition causes red eye and may present with severe pain causing nausea and vomiting. The pupil is fixed and dilated and the eye is stony hard?
Acute closed angle glaucoma
What condition is seen here?
Acute closed angle glaucoma
Which cases of red eye must be referred urgently?
If they are affeting vision or causing marked photophobia
