Red Eye

Question 1

Most common organism causing viral conjunctivitis

Answer 1

Adenovirus

Question 2

Most common organism causing Bacterial conjunctivitis

Answer 2

1- Staph aureus
2- Strep pneumonia
3- H. Influnza.

Question 3

Treatment of choice for bacterial conjunctivitis

Answer 3

1- Ciprofloxacin\Gatifloxacin
2- Sulfactamide
4- Gentamicin drops.

Question 4

Differentiate between viral conjunctivitis VS allergic conjunctivitis:

Answer 4

Clear and watery in both.

• Itchy, swelling & associated with chemosis in allergic.

Question 5

Treatment of choice for allergic conjunctivitis:

Answer 5

1- Topical: antihistamine, corticosteroid, NSAID, Mast cell stabilizer
2- Oral: antihistamine.
3- Other: Immunotherapy
4- Non-pharmacological: Avoid allergen.

Question 6

How to differentiate between the appearance of episcleritis, scleritis, and Subconjunctival hemorrhage?

Answer 6

• Episcleritis: Segmental - Pink
• Scleritis: Diffuse\Segmental - Dark red, blue or purple
• Hemorrhage: Bright red

Question 7

What are the most prominant differences between scleritis and episcleritis?

Answer 7

1- pain severity: scleritis is more painful & radiated
2- Vision loss: sometimes in scleritis
3- Photophobia: in scleritis
4- appearance.

Question 8

Treatment of choice for episcleritis:

Answer 8

1- Supportive + Artificial tears.

2- Topical steroids in severe cases

Question 9

When to refer patients with Episcleritis?

Answer 9

1- Recurrent
2- Unclear if early scleritis
3- worsening

Question 10

When to refer patients with scleritis?

Answer 10

Immediately within 24 hours of diagnosis.

Question 11

Treatment of choice in scleritis:

Answer 11

Oral NSAID

Question 12

Red eye diseases associated with systemic diseases include:

Answer 12

1- Episcleritis (early diseases)
2- Scleritis (Vasculitis - Autoimmune)
3- Uveitis (Seronegative)

Question 13

What are the structures involved (inflamed) in Anterior uveitis:

Answer 13

• cilliary body

- iris

Question 14

How does the eye look like in anterior uveitis?

Answer 14

Curcumocorneal redness with meiosis

Question 15

Treatment of choice in anterior uveitis

Answer 15

1- Myadritics to release spasm

2- corticosteroid drops to reduce inflammation.

Question 16

Most common risk factor for keratitis:

Answer 16

Contact lens

Others: Corneal ulcer (infectious - traumatic)

Question 17

How does the eye look like in keratitis?

Answer 17

1- Diffuse erythema 
2- ciliary injections 
3- pupil constriction 
4- hazy cornea. 
5- discharge

Question 18

Keratitis is considered an emergency referral because patients usually present with:

Answer 18

Vision loss, photophobia and pain.

Question 19

Acute red eye, Unilateral, Painful eye associated with vision loss in old patient.
This history gives clue of:

Answer 19

Closed angle glaucoma.

Question 20

What is the first step in treatment of closed angle glaucoma and why is it used?

Answer 20

1- IV\Oral carbonic anhydrase inhibitor
2- Topical B-blocker
3- Hyper-osmotic agent

to regain normal intraocular pressure

Question 21

What are the risk factors for subconjunctival hemorrhage?

Answer 21

1- coughing\sneezing
2- Dry eye with minor trauma
3- Trauma
4- blood thinners

Question 22

Is Subconjuctival hemorrhage an emergency case?

Answer 22

Only when there’s penetrating injury or recurrent (might indicate bleeding disorder)

Question 23

Which of the following cases is emergency and which is urgency referral?
[close angle glaucoma - Hyphema & hypopnea - Iritis - Keratitis - Scleritis - abrasion & foreign body]

Answer 23

Emergency: close angle - hyphema\hypopnea - bacterial keratitis

Urgency: iritis - viral keratitis - scleritis - abrasion\foreign body.

Question 24

What is the most common viral organism to cause keratitis?

Answer 24

HSV - VZ

Question 25

A hazy corena can be due to:

Answer 25

1- closed angle glucoma
2- keratitis
3- anterior uveitis

Question 26

Discharge in the eye can present in which diseases?

Answer 26

• keratitis

- conjunctivitis

Question 27

How is the pain in scleritis usually described?

Answer 27

Severe boring eye pain radiating to head and neck

Question 28

How to treat herpetic keratitis?

Answer 28

• Trifluridine

- vidarabine.

Question 29

What is contraindicated in herpetic keratitis?

Answer 29

Corticosteroid drops

Question 30

How do patients with closed angle glucoma usually see?

Answer 30

They don’t see well due to edema and halos around lights.

Question 31

What is the 2nd step after controlling the intraocular pressure in closed angle glucoma?

Answer 31

Laser iridectomy.

Question 32

subconjunctival hemorrhage is painful or painless?

Answer 32

Usually painless unless there’s a cause like penetrating injury and thus requires referral.

Question 33

How to differentiate the type of conjunctivitis If itching is mild or severe

Answer 33

Mild is usual viral, sometimes non-existent

Moderate to severe is usually allergic.