Red eye

Question 1

What lid problems can cause a red eye?

Answer 1

• blepharitis
• infection (bacterial or viral)
• lid malposition - (entropion = eyelid turning out, ectropion = eyelid turning in)

Question 2

What are the symptoms of belpharitis?

Answer 2

• gritty eye
• watery discharge
• feeling of foreign body presence
• can become sticky and infected with Staph causes all sorts of Sx

Question 3

How do you treat blepharitis?

Answer 3

• lid hygiene - baby shampoo
• topical ABX after hygiene
• oral Abx potentially for months
• lubricants to help with tear film

Question 4

Sudden onset bright red eye with no visible blood vessels and painless. Vision not affected. Tell me what it is and how to treat it?

Answer 4

subconjunctival haemorrhage

NO treatment required

Question 5

Symptoms of conjunctivits?

Answer 5

• red eye
• discharge - watery sticky = viral, purulent = bacterial, watery mucous = allergy, blood = severe infection
• spreads from one eye to the other
• VISION NOT AFFECTED

Question 6

3 common bacterial causes of conjunctivits?

Answer 6

• chlamydia - neonatal, inclusion adult, trachoma 3rd world.
• staph
• strep

Question 7

What can precipitate a recurrent conjunctivitis? Treatment?

Answer 7

• Nasolacrimal duct obstruction/blockage

- surgery

Question 8

important considerations with a query neonatal conjunctivits?

Answer 8

Correct diagnosis and prompt treatment is needed to prevent potential complete loss of vision.

Question 9

How does allergic conjunctivitis differ from viral or bacterial?

Answer 9

• very swollen conjunctiva
• itchy eyes
• Hx of atopy
• identifiable causative agent (pollen, atropine eye drops, etc)

Question 10

How should you treat a chemical conjunctivis? what chemicals are particularly bad?

Answer 10

• wash wash wash wash
• irrigate the eye until pH is back to normal
• seek specialist advice
• acid or alkali chemicals can fuck you up the most

Question 11

How do you treat a bacterial conjuncitivitis?

Answer 11

topical chloramphenicol or fucidic acid

Question 12

How do you treat an adult inclusion chalmydia conjunctivitis?

Answer 12

-systemic erythromycin

Question 13

What is an infection of the cornea called?

Answer 13

Keratitis

Question 14

keratitis can be viral, bacterial, acanthamoeba or allergic. Tell me about the viral one???

Answer 14

Herpes simplex keratitis - caused by HSV
stained with flurescien
Sx - foreign body, photophobia, watery discharge, RED EYE
Tx - acyclovir

Question 15

What is important to think about when considering treating an eye disease with topical steroids?

Answer 15

• it can make herpes simplex keratitis MUCH WORSE

- never treat an eye disease with topical steroids w/o seeking specialist advice

Question 16

what’s the uvea about? what is it? what gets inflamed when there is uveitis? why name name groups of things a different noun now?

Answer 16

Uvea is made up of the iris, ciliary body and choroid.

Acute anterior uveitis occurs in sero-negative arthropathies and granulomatosis disease

Question 17

What sero-negative arthropathies and granulomatosis diseases are associated with acute anterior uveitis?

Answer 17

Arthropathies:

• ank spond
• IBD
• psoriatic arthopathy

Granulmatosis:
-sarcoidosis

Question 18

What are the symptoms of acute anterior uveitis?

Answer 18

• painful red eye
• unilateral usually
• photophobia
• irregular pupil (stuck to the lens called posterior synechiae)
• may have reduced vision
• ask about joint, skin, mouth ulcers and GU sx

Question 19

How does episcleritis present?

Answer 19

• localised patch of redness from irritation
• no discharge
• no change in vision
• resolves spontaneously
• NSAIDS may help

Question 20

Tell me about scleritis?

Answer 20

much more rare than episcleritis.
associated with RA or other systemic vasculitic disease
-very painful
-loss of vision may happen too
-check for systemic signs of RA and other vasculitis