Red eye Flashcards
causes of a red eye
conjunctivitis / blepharoconjunctivitis keratitis anterior uveitis scleritis / episcleritis acute closed angle glaucoma subconjunctival haemorrhage orbital cellulitis
what happens in subconjunctival haemorrhage
vessels split, blood filled blister
not as bad as it seems
RF: trauma, antithrombotics, valsalva
features of subconjunctival haemorrhage
self limiting but will remain red throughout healing eg 1-2 weeks
investigate if recurrent
asymptomatic
features of orbital cellulitis
rare
sight threatening
emergency
can track back to brain and create abscess
what is a cicatricial ectropion
contracture of skin pulling lid away from the globe e.g. scarring, skin tumour
can cause dry eyes –> corneal ulcer –> sight threatening
pain with a gritty sensation is extra/intra-ocular in origin
extra ocular
pain with an achy sensation is extra/intra-ocular in origin
intra ocular
what is blepharitis
inflamed eyelids
describe signs of anterior blepharitis
margin of lid is redder than deeper part of lid
symptoms of blepharitis are similar to those of conjunctivitis, true or false
true
gritty eye sensation
mild discharge
types of anterior blepharitis
seborrhoeic - red margin, scaly, dandruff, lashes unaffected
staphylococcal - red margin, ulcers, styes, corneal staining, lashes affected
describe posterior blepharitis
deeper part of lid is redder than the margin
pathology behind posterior blepharitis
Meibomian gland dysfunction
signs of posterior blepharitis / meibomian gland dysfunction
swollen gland openings
meibomian cyst = chalazion
with which dermatological condition is posterior blepharitis associated with
rosacea
management of blepharitis
eyelid hygiene
hot towel compresses
ter drops
tetracyclines 2-3 months
chalazions may cause temporary astigmatism, true or false
true
what is conjunctivitis
inflammation of the conjunctiva
symptoms of conjunctivitis
red eye gritty discharge / sticky itchy unaffected vision
signs of conjunctivitis
red eye chemosis discharge papillae / follicles subconjunctival haemorrhage
what are the types of conjunctivitis
infective
non-infective
list infective causes of conjunctivitis
bacterial
viral
chlamydial
list non-infective causes of conjunctivitis
allergy
drugs / chemical
dermatological
describe follicles seen in follicular conjunctivitis
avascular mounds of plasma cells + lymphoid tissue
‘grains of rice’ - white nodules filled with lymphocytes
causes of follicular conjunctivitis
viral
chlamydial
drugs
describe papillae seen in papillary conjunctivitis
vascular reaction
red spot with central vessel
causes of papillary conjunctivitis
pABillae -
A - Allergic
B - Bacterial
what is herpes zoster ophthalmicus
shingles in CNV1
what is Hutchinson’s sign
involvement of the tip of the nose in shingles means the cornea is highly likely to be affected
what is keratitis
inflammation of the cornea
what are the layers of the cornea
epithelium
stroma
endothelium
types of corneal ulcers
central
peripheral
others
causes of central corneal ulcers
viral - herpetic - dendritic ulcer
fungal
bacterial
acanthamoeba
causes of peripheral corneal ulcers
poorly controlled rheumatoid arthritis
hypersensitivity
vasculitis
other causes of corneal ulcers
exposure keratitis
Sicca - sjogrens
subtypes of anterior uveitis
autoimmune infective metabolic malignant others - idiopathic, trauma
autoimmune causes of anterior uveitis
Reiter’s syndrome
UC
Ankylosing spondylitis
sarcoidosis
infective causes of anterior uveitis
TB
HSV
HZV
syphilis
metabolic cause of anterior uveitis
DM
malignant cause of anterior uveitis
leukaemia
symptoms of anterior uveitis
red painful eye
photophobia
referred pain to brow
signs of anterior uveitis
injecting vessels around cornea
hypopyon
keratic precipitates
synechiae
what is synechiae
irregular pupil shape from iris being tethered and stuck to lens
management of anterior uveitis
topical steroids
mydriatics
what condition is episcleritis associated with
gout
episcleritis is self limiting, true or false
true
may give topical NSAIDs
what conditions is scleritis associated with
rheumatoid arthritis
GPA
describe features of scleritis
painful
very serious
associated with uveitis
what can be used to differentiate between scleritis and episcleritis
phenylephrine - vasoconstrictor
episcleritis is phenylephrine positive/negative and scleritis is phenylephrine positive/negative
episcleritis - positive - vessels blanch and redness disappears
scleritis - negative - vessels and redness remain
which refractive error increases risk of closed angle glaucoma
hypermetropia
symptoms and signs of acute closed angle glaucoma
acute red eye sudden loss of vision pain headache N+V stony hard eye injected vessels cloudy cornea mid dilated pupil
what are types of posterior uveitis
vitritis
vasculitis
retinitis/choroiditis
