Red Eye Flashcards
How do we diagnose the cause of Acute Red Eye?
We base it on pain, redness, discharge & vision
What are the causes of acute red eye?
- Uveitis
- Conjunctivitis (Bacterial, viral, allergic)
- Scleritis
- Acute (closed angle) Glaucoma
- Keratitis/Corneal Ulcer
- Orbital Cellulitis
What is conjunctivitis?
Inflammation of the thin vascular membrane covering the inner surface of the eyelid and the sclera
What are the types of conjunctivitis?
Bulbar - affects conjunctiva over the sclera
Palpebral - affects conjunctiva on inside of lids
(Can be both)
What is the presentation of Conjunctivitis?
- No pain
- Peripheral & diffuse redness
- Vision unaffected
- Discharge
Bacterial = Pus
Viral = Watery
Allergic = Mucous
What is uveitis?
Inflammation of the middle vascular layer of the eye (ciliary body, iris & choroid)
How does uveitis present?
- None/mild irritation
- Pericorneal Redness
- No Discharge
- Blurred Vision
What are the types of Uveitis?
Ant - Iris
Intermediate - Ciliary Body
Post - Choroid
Panuveitis
What are the specific signs of anterior & intermediate uveitis?
Anterior
- Inflammatory cells leak from iris into Aqueous humor
- > Hazy cell filled Ant chamber and Hypopyon (cells settled inferiorly in ant chamber)
Intermediate
- Inflammatory cells leak from ciliary body in Vitreous Humour
- > Patient has hazy vision or “floaters”
Causes of Uveitis?
- Idiopathic
- Systemic Disease, often autoimmune (SLE/Sarcoid)
- Infection (TB, CMV, Herpes Simplex, Syphilis)
- Masquerade
Not actually uveitis e.g. intraocular lymphoma or leukaemia
Treatment of uveitis?
Depends on cause
- Systemic Steroids
- Systemic Immunosuppresants
- Infection treatment
- Topical Anti-inflammatories
How does scleritis present?
- Severe Boring type pain
- Diffuse redness
- Normal vision
- No discharge
How does Acute angle closure glaucoma present?
- Severe pain & headache
- Vomiting
- Fixed mid-dilated pupil
- Pericorneal Redness
- Vision loss
- Possible discharge
What causes acute angle-closure glaucoma?
Some event triggers closure of the angle in a predisposed eye leading to a back up of aqueous humor –> Raised IOP
How does a corneal abrasion or ulcer present?
- Severe pain on eye closing
- Pericorneal redness
- Possible discharge
- Visual loss