Red Eye

Question 1

Eyelid differentials

Answer 1

Blepharitis -inflamed, gritty, chronic (R&R)
Herpes simplex - red, pain, photophobia, watery
Herpes zoster ophthalmicus -vesicles rash trigeminal, corneal ulcer (reduced vision, pain)
Bacterial (stye, impetigo)
Ectropion
Entripion

Question 2

Conjunctiva

Answer 2

Subconjunctival haemorrhage
Viral (adenovirus) conjunctivitis- sudden onset red eye, watery
Bacterial - purulent discharge
Chlamydia- trachoma, follicular. Rx: topical erythromycin + oral doxycycline
Allergic conjunctivitis- type 1 hypersensitivity - v itchy, painful, red, watery

Question 3

Cornea

Answer 3

Keratitis = corneal inflammation
Corneal FB -> rust ring
Corneal abrasion - pain, watery, blurred vision, ciliary flush
Viral keratitis (HSV) - FB sensation, photophobia, watery, dendritic ulcer
Bacterial keratitis - painful red eye, LOV, hazy cornea, central abscess
Corneal ulcer - FB sensation -> photophobia, blurred vision, discharge. Ix: smear, culture, fluoresciene stain
Marginal keratitis - white lesions in periphery of cornea + sore red eye

Question 4

Acute anterior Uveitis
Symptoms:
A/W
Slit lamp:
Treatment:
Complications:

Answer 4

Acute, unilateral painful red eye, photophobia, blurred vision

Sero-negative: ank spond, IBD, behcets, psoriatic arthropathy
Granulomatous: sarcoidosis, syphilis

Ciliary flush, hypopyon, visible fluid levels, white precipitates on back of cornea

Prednisolone drops + atropine drops (dilate)

Cataract, retinal scarring, retinal detachment, macular oedema, glaucoma