Red eye I

Question 1

what are the 9 diagnostic steps of red eye?

Answer 1

1. VA
2. pattern of redness (ciliary flush, hyperemia, hemorrhage)
3. conjunctival discharge
4. corneal opacification, infiltrate, edema, KPs
5. corneal epithelial defects: florescein
6. A/C depth
7. pupil irregularities: anisocoria, reactivity
8. IOP
9. proptosis, lid malfunction, EOM limitations

Question 2

what is the treatment for pre-septal cellulitis?

Answer 2

outpatient, systemic abx

Question 3

what is the treatment for orbital cellulitis?

Answer 3

hospitalization, ENT consult

Question 4

90% of orbital cellulitis cases are due to what cause?

Answer 4

extension from bacterial sinusitis

Question 5

what is the management for orbital cellulitis?

Answer 5

• IV abx
• surgical debridement
• surgical intervention if unresponsive to abx after 24 hrs

Question 6

what are the complications of orbital cellulitis?

Answer 6

• cavernous sinus thrombosis
• meningitis
• brain abscess

Question 7

what are the symptoms and signs of herpes zoster?

Answer 7

SYMPTOMS:

• intense pain
• itching
• photophobia if uveitis

SIGNS:

• vesicles
• crusting with exudate
• spares midline
• conjunctivitis, keratitis, uveitis, glaucoma

Question 8

herpes zoster is the most common reason for what condition in the US?

Answer 8

infectious corneal blindness

Question 9

what are the manifestations of a nasolacrimal duct obstruction?

Answer 9

• tearing and mattering (most common)
• amniotocele, mucocele
• dacrocystitis (acute mucocele / pyocele)

Question 10

what is the treatment for nasolacrimal duct obstruction?

Answer 10

• topical abx
• massage tear sac daily
• probing and irrigation
• systemic abx if infected

Question 11

what is blepharitis? what is the treatment?

Answer 11

• chronic inflammation of lid margin
• proper lid hygiene: warm moist compresses, cleansing with non irritating shampoo
• abx solution QID only at night

Question 12

what is the most common manifestation of connective tissue disease?

Answer 12

aqueous tears deficiency states

Question 13

what is a stye / hordoleum?

Answer 13

acute inflammation of glands of eyelid (zeis / moll / meibomian)

Question 14

what is a chalazion?

Answer 14

chronic general sterile inflammation of a meibomian gland either spontaneous or secondary to internal hordoleum

Question 15

what is the treatment for a stye or chalazion?

Answer 15

promote drainage with moist compresses QID and abx

Question 16

what are the best drugs for allergic conjunctivitis?

Answer 16

corticosteroids

Question 17

what are the systemic treatments for allergic conjunctivitis?

Answer 17

• oral antihistamines