Red eye

Question 1

Scleritis associated with systemic diseases

Answer 1

SLE
RA
sarcoidosis 
IBD 
granulomatosis with polyangiitis (wegners disease)

Question 2

uveitis

Answer 2

Seronegative spondyloarthropathies
Bechet’s disease
Sarcoidosis
MS

Question 3

chronic uveitis

Answer 3

sarcoidosis 
syphilis 
herpes virus 
TB 
Lyme disease

more granulomatous (has more macrophages) and has a less severe and longer duration of symptoms, lasting more than 3 months.

Question 4

uveitis type

Answer 4

• Bilateral uveitis is associated with chronic systemic conditions.

Unilateral tend to be acute, idiopathic or infectious

Question 5

uveitis complications

Answer 5

○ Band keratopathy (calcium deposits in the cornea).
○ Cataract (secondary to the disease process or corticosteroid treatment).
○ Glaucoma (secondary to the disease process or corticosteroid treatment).
○ Cystoid macular oedema (the most common cause of visual impairment in people with uveitis).
○ Posterior synechiae (adhesions between the posterior iris and the anterior lens surface).
○ Hypotony (low intraocular pressure).
○ Macular cyst/hole, macular puckering or macular ischaemia.
○ Retinal detachment (exudative and tractional) or retinal scars.
○ Choroidal and retinal neovascularization.
○ Optic neuropathy or optic atrophy.
○ Vitreous opacities and vitreous haemorrhage.
○ Phthisis (shrinkage of the globe).

Question 6

scleritis symptoms

Answer 6

• Reduced visual acuity
  
  • Abnormal pupil reactions
  • Tenderness to palpation of eye
  • Photophobia
  • Eye-watering
  • Pain with eye movement

Question 7

keratitis

Answer 7

• Painful red eye
  
  • Photophobia
  • Vesicles around the eye
  • Foreign body sensation
  • Watering eye
  • Reduced visual acuity. Vary from subtle to significant

Question 8

keratitis complication

Answer 8

• Herpes keratitis usually affects only the epithelial layer of the cornea.
  
  • If there is inflammation of the stroma (the layer between the epithelium and endothelium), this is called stromal keratitis. This is associated with complications such as stromal necrosis, vascularisation and scarring and can lead to corneal blindness.

Question 9

indications of a serious, and potentially sight-threatening, cause of the person’s red eye include:

Answer 9

○ Reduced visual acuity.
○ Deep pain within the eye.
○ Unilateral red eye.
○ Contact lens use.
○ Photophobia. This can be a symptom of acute uveitis, corneal ulcer, contact lens-related red eye or corneal foreign body. Systemic causes of photophobia, such as meningitis should also be considered. For further information, see the CKS topic on Meningitis.
○ All high-velocity injuries (for example injuries occurring while hammering or chiseling), or injuries involving glass.
○ Chemical eye injury.
○ Ciliary injection. This pattern of redness may be seen in corneal ulcer, contact lens related red eye, corneal foreign body and anterior uveitis.
○ Fluorescein staining. This can indicate corneal ulcer or abrasion.
○ Unequal or misshapen pupils, or abnormal pupillary reactions. Abnormal pupil reactions are seen in acute glaucoma and anterior uveitis.
○ Pain on pupillary constriction. This can be elicited on testing the direct light reaction, consensual light reaction or finger-to-nose convergence test.
Conjunctivitis in an infant in the first 28 days of life.