Red Eye and Adnexal Oncology Flashcards
Give differential diagnoses for conditions causing a red eye
Uveitis Conjunctivitis Scleritis Acute glaucoma Keratitis/corneal ulcer Orbital cellulitis
Presentation of preseptal cellulitis
Systemically well
Pain, redness and swelling of eyelid
May be able to see an obvious bite/puncture mark
Presentation of uveitis
Red eye
Blurred vision
Light sensitivity
Part of the eye most commonly affected by uveitis
Anterior
can also affect intermediate and posterior
What is panuveitis?
Uveitis affecting the whole eye
Causes of uveitis
Systemic disease
Idiopathic
Infection
Malignancy
Treatment of uveitis
Topical anti-inflammatory steroid drops and eye drops to dilate pupil and reduce scarring if anterior
Systemic immunosuppressants if posterior
Presentation of acute angle glaucoma
Severe pain
Vomiting
Fixed, dilated pupil
Pupil non-responsive to light
Treatment of corneal abrasion
Usually resolves on its own in 2-3 days, can give antibiotics to reduce risk of secondary infection
Presentation of orbital cellulitis
Pain, redness and swelling of eyelid Systemically unwell Double vision Conjunctivitis/chemosis Exopthalmos Blurred vision
Common causes of orbital cellulitis
Sinusitis
Dental infection
Haematological spread of infection
Treatment of orbital cellulitis
IV/oral antibiotics
Examples of benign orbital tumours
Capillary haemangioma
Cavernous haemangioma
Pleomorphic adenoma
Optic nerve glioma
Examples of malignant orbital tumours
Lymphoma Metastatic regional spread Rhabdomyosarcoma Lacrimal gland carcinoma Osteosarcoma Liposarcoma Primary melanoma
Examples of benign eyelid tumours
Squamous cell papilloma Basal cell papilloma Melanocytic naevus Actinic keratosis Pyogenic granuloma Keratoacanthoma Capillary haemangioma Cavernous haemangioma
Examples of malignant eyelid tumours
Basal cell carcinoma Squamous cell carcinoma Sebaceous gland carcinoma Melanoma Kaposi sarcoma Merkel cell carcinoma
Presentation of squamous cell papilloma
Pedunculated or sessile
“raspberry texture”
Presentation of basal cell papilloma
Similar texture to squamous cell papilloma (“raspberry”)
Stuck-on appearance
Brown, flat, round/oval lesions
Early signs of transformation of lesions from benign to malignant
Asymmetry Irregular border Colour - not consistent, very dark Diameter > 6mm Evolving (growing)
Signs suggestive of nodular malignant melanoma
Elevated
Firm to touch
Growing
Presentation of pyogenic granuloma
Fast growing
Highly vascularised
Erythematous pedunculated mass
Presentation of actinic keratosis
Flat, scaly, hyperkeratotic skin
Related to sun exposure
Presentation of keratoacanthoma
Rapidly growing
Pink papule, hyperkeratotic crater
Associated with sun exposure and immunosuppression
May be spontaneous involution
Treatment of capillary haemangioma
Beta-blockers
Intra-lesional steroid
Surgery
Presentation of cavernous haemangioma
Well demarcated pink patch
Darkens with age
Does not involute
Features suggestive of basal cell carcinoma
Slow, inexorable growth over months Non-pigmented Elevated Ulcerated Pearly, rolled, irregular border Telangiectasia Lack of tenderness - painless
Clinical subtypes of basal cell carcinoma
Nodular
Ulcerative
Morpheaform/infiltrative
Treatment of basal cell carcinoma
Surgical excision (Mohs surgery) Imiquimod, efudex topical treatment Chemotherapy Cryotherapy Radiotherapy Photodynamic therapy
Presentation of squamous cell carcinoma
Scaly surface over a thick plaque
Growth over weeks (rather than months)
Presentation of sebaceous gland carcinoma
Recurrent chalazion Unilateral blepharitis Nodular, indurated lid margin Yellow discolouration Pagetoid spread along the conjunctiva
Types of cutaneous malignant melanoma
Lentigo maligna
Superficial spreading
Nodular
