red eye (+ infections)

Question 1

causes red eyes

Answer 1

closed glaucoma // ant uveitis // scleritis // conjunctivitis // epislceritis // subconjunctival haemorrhage // endopthlamitis

Question 2

what causes subconjunctival haemorrhages

Answer 2

coughing, trauma, vomitting

Question 3

what gene is assoc with anterior uveitis

Answer 3

HLA B27

Question 4

conditions assoc anterior uveitis

Answer 4

ank spondy // reactive arthritis // UC, crohns // Behcets // sarcoidosis

Question 5

symptoms anterior uveitis

Answer 5

acute inset // ocular pain // photophobia // blurred vision // lacrimation // red eye // acuity: normal –> impaired

Question 6

o/e anterior uveitis (4)

Answer 6

ciliary injected flush (red ring) // irregular pupil (synechia) // hypopyon (pus in ant chamber) // keratic precipitate (spots in front of pupil on cornea)

Question 7

mx anterior uveitis

Answer 7

urgent referral // cyclopegics (dilate pupil) eg atropine, cyclopentolate // steroid drops

Question 8

what is episcleritis

Answer 8

inflamm of episclera in one or both eyes

Question 9

assoc episcleritis

Answer 9

IBD (esp crohns), RA

Question 10

symptoms episcleritis

Answer 10

red eye // NOT painful (irritation) // watering + mild photophobia

Question 11

o/e episcleritis

Answer 11

injected vessels in episcleritis - move when gentle pressure applied

Question 12

inxv episcleritis

Answer 12

phenylephrine drops (will whiten vessels)

Question 13

mx episcleritis

Answer 13

conservative +/- artificial tears

Question 14

assoc scleritis

Answer 14

RA!!! // lupus // sarcoid // GPA

Question 15

symptoms scleritis

Answer 15

red eye // PAINFUL // watering + photophobia // gradually decreasing vision

Question 16

mx scleritis

Answer 16

same day ophtho // 1 = oral NSAIDs // 2 = oral steroids // 3 = immunosuppresions

Question 17

symptoms bacterial conjunctivitis

Answer 17

red eye // pussy discharge // sticky eye // gritty

Question 18

symptoms chlamydial conjunctivitis

Answer 18

bacterial + // common in young people // STI symptoms // ‘grains of rice’ vesicles on eyelids

Question 19

common organisms bacterial conjunctivitis

Answer 19

staph A // chlamydia // strep pneumo // H. influ (kids)

Question 20

symptoms viral conjunctivitis

Answer 20

red eye // watery discharge // recent URTI // pre-auricular lymph node

Question 21

mx infective conjunctivitis

Answer 21

self limiting 1-2 weeks // chloramphenical drops 2-3 hourly

Question 22

mx infective conjunctivitis pregnancy

Answer 22

topical fusidic acid

Question 23

mx infective conjunctivitis in contact lens users

Answer 23

topical fleuroscein for corneal stain // do not wear lenses with conjunctivitis

Question 24

symptoms allergic conjunctivitis

Answer 24

usually with hayfever or atopy // bilateral red eye + conjunctival swelling // v itchy // swollen eyelid

Question 25

mx allergic conjunctivitis

Answer 25

1 = topical or systemic antihistamine // 2nd = topical mast cell stabiliser eg Sodium cromoglicate and nedocromil

Question 26

what is herpes zoster ophthalmicus

Answer 26

reactivation of varicella zoster in ophthalmic division CNV

Question 27

symptoms herpes zoster ophthalmicus

Answer 27

vesicular rash around eye +/- eye involvmenet // hutchinson sign: rash on side or tip of nose - strongly indicates ocular involvement

Question 28

mx herpes zoster ophthalmicus

Answer 28

oral aciclovir 7-10 days (start within 72 hours) // IV if severe // topical steroid if eye involvement

Question 29

complications herpes zoster ophthalmicus

Answer 29

conjunctivitis, keratitis, episcleritis, ant uveitis // ptosis // neuralgia

Question 30

what is keratitis

Answer 30

inflammation of cornea

Question 31

what typically causes bacterial keratitis

Answer 31

staph A or pseudomonas (contact lenses)

Question 32

what causes ameobic keratitis

Answer 32

acanthamboic = contact lenses or contaminated soil or water

Question 33

viral causes keratitis

Answer 33

herpes simplex // adenovirus // contact lenses

Question 34

symptoms keratitis

Answer 34

red eye + pain // photophobia // gritty sensation // hypopyon (common in bacterial)

Question 35

symptom assoc with ameobic keratitis

Answer 35

extremely painful

Question 36

mx contact lenses with keratitis

Answer 36

urgent referral if wear lenses + red eye

Question 37

invx herpes simplex keratitis

Answer 37

fluroscein stain –> dendritic ulcer (looks like a tree)

Question 38

mx herpes keratitis

Answer 38

urgent referral // topical aciclovir

Question 39

mx bacterial keratitis

Answer 39

do no wear lenses // 1 = topical quinolone eg ofloxacin // cycloplegic (dilate pupil) for pain eg cyclopentolate

Question 40

complications keratitis

Answer 40

corneal scar, perforation, endopthlamitis, vision loss

Question 41

RF corneal ulcer

Answer 41

contect lens // vt A def

Question 42

causes corneal ulcer

Answer 42

keratitis - bacterial ,fungal, viral, acanthemboia

Question 43

symptoms + invx corneal ulcer

Answer 43

painful eye // photophobia // watery // fluorescein stain

Question 44

what is Endophthalmitis

Answer 44

serious inflammation of the eye –> vision loss or loss of eye

Question 45

causes Endophthalmitis

Answer 45

infection (staph epi) post cataract surgery

Question 46

mx Endophthalmitis

Answer 46

intravitreal abx eg amikacin/ ceftazidime/ vancomycin

Question 47

what is chorioretinitis

Answer 47

inflammation of blood vessels on retina

Question 48

causes