Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

m4 EYE > Red eye: Infections > Flashcards

Red eye: Infections Flashcards

1
Q

Blepharitis

A

Glands around eye gets clogged and secretions build up -> inflammation of lid margin
- Caused by Staph aureus or Meibomian gland abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of blepharitis

A

Lid crusting
Redness
Telangiectasia
Misdirected lashes
FB sensation
Itch
A/w chalazion and stye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of blepharitis

A
  • Lid hygiene, diluted baby shampoo
  • Topical Abx (Fucithalmic or tetracycline eye ointment)
  • Lubricants
  • Oral doxycycline if severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chalazion

A

Nodule within tarsal plate (Meibomian cyst) -> Inflammation (redness, bump) of eyelid gland that has been clogged
If Infected –> + painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Complications of chalazion

A
  • Orbital cellulitis
  • Pre-septal cellulitis
  • Cavernous sinus thrombosis
  • Mass effect on cornea causing astigmatism and BOV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of chalazion

A
  • Self-resolves within several days to weeks
  • Lid hygiene
  • Warm compress and topical Abx
  • Incision and curettage if recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stye

A
  • Staph aureus abscess of lash follicle and its associated gland
  • Red, swollen, painful, tender nodule in lid margin pointing through skin

Tx with hot compress, epilation of lash a/w the infected follicle and topical Abx ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms of chalazion

A

Hard, firm
Painless (unless infected)
Nodule over the tarsus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Difference between chalazion and stye

A

Cause
Chalazion is due to inflammation of an eyelid gland that has become clogged but is not infected

Stye is due to a bacterial infection of a lash follicle in the eyelid by Staphylococcus aureus

Symptoms
Chalazion is a firm, non-tender, painless (if not infected) lump while stye is painful, swollen and tender to touch

Location
Stye is most commonly found at or near eyelash follicle while chalazion is most commonly found above eyelashes of upper lid
*chalazion is more obvious when eyelid is inverted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Preseptal vs orbital cellulitis

A

Orbital cellulitis is the infection of the ocular adnexal tissue posterior to the orbital septum while preseptal cellulitis is infection that only involves structures anterior to the septum, such as eyelid tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of orbital/preseptal cellulitis

A

Adjacent infection in surrounding structures
- Sinusitis (ethmoid/maxillary)
- Eyelids (stye/chalazion)
- Lacrimal sac
- Dental infections

External causes
- Trauma (bites)
- Surgery

Pathogens
- Haem influenza B
- Staph aureus
- Strep pyogenes

Ophthalmic causes (e.g. endophthalmitis with extraocular extension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of preseptal cellulitis

A

Pain of the eyelid
Eyelid redness and swelling
Induration
*NO eye involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Symptoms of orbital cellulitis

A

Symptoms of preseptal cellulitis
AND
- Proptosis
- Chemosis
- thickened eyelid
- Ophthalmoplegia -> Double vision
- Decreased visual acuity -> BoV*
- Pain on eye movements + EOM involvement*
- RAPD
- Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of preseptal cellulitis

A

PO Augmentin
Warm compress
Topical Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of orbital cellulitis

A

Admit, refer
Analgesia
FBC, gram stain & culture
CT scan of sinuses and orbits
- confirm ddx
IV Abx (Ceftriaxone/ Vancomycin)
Resolve underlying etiology
Surgery to drain abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What classification to be used for preseptal/orbital cellulitis?

A

Chandler’s classification
- describes level of involvement of cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stages of Chandler’s classification

A

Stage 1: Preseptal cellulitis
Stage 2: Orbital cellulitis
Stage 3: Subperiosteal abscess
Stage 4: Orbital abscess
Stage 5: Cavernous sinus thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pertinent examinations to do in eye cellulitis

A

Pupils
RAPD
EOM
VA, VF
Color vision
Chemosis
Proptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Complications of orbital cellulitis

A

Optic nerve compression
Subperiosteal or orbital abscess
Meningitis
Cavernous sinus thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Types of allergic conjunctivitis

A

Seasonal/perennial conjunctivitis
Atopic keratoconjunctivitis (AKC)
Vernal keratoconjunctivitis (VKC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Symptoms of allergic conjunctivitis

A
  • Intense itch**
  • Intermittent history of red eyes
  • Lid swelling and redness
  • Watery/ mucoid discharge
  • Thick ropy mucoid discharge
  • Background of other atopies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Clinical signs in allergic conjunctivitis

A

Conjunctival chemosis
Conjunctival injection
Epithelial erosions or epithelial defect
Papillae or cobblestone papillae
Horner trantas dots
Limbitis
Shield ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Examination findings for vernal keratoconjunctivitis

A

Giant papillae of only superior tarsal conjunctival
Limbitis
Shield ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Examination findings for atopic keratoconjunctivits

A

Papillary hypertrophy of superior and inferior tarsal conjunctival with increased risk of eyelid thickening and scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Chronic changes/cx of untreated VKC or AKC

A

Loss of eyelashes
Conjunctival scarring
Corneal neovascularization
Corneal ulcer
Corneal scarring
Keratoconus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Management of allergic conjunctivitis

A

Systemic management
- Allergen avoidance
- Skin prick test
- Control of other allergies

Ocular management
- Topical mast cell stabilisers
- Topical anti-histamines
- Topical lubricants
- Cold compress
- Topical steroids
- Topical immunomodulators — cyclosporin, tacrolimus
- Systemic steroids in severe cases
- Supratarsal injection of steroid for recalcitrant cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Most common causative virus of viral conjunctivitis

A

Adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Symptoms of viral conjunctivitis

A
  • Conjunctiva intensely hyperemic (Red eyes)
  • Sticky watery muco-serous discharge
  • Tearing
  • Burning sandy gritty feeling in eye
  • Recent URTI
  • Contact history
  • Usually starts in one eye then moves to other eye
29
Q

Signs of viral conjunctivitis

A
  • Conjunctival injection
  • Conjunctival follicular reaction
  • Pseudomembranes seen on lid eversion
  • Check for corneal involvement — punctate epitheliopathy, epithelial defect
30
Q

Complications of viral conjunctivitis

A
  • Corneal epitheliopathy
  • Keratitis
31
Q

Treatment for viral conjunctivitis

A

Self-resolving
Very contagious!
Topical lubricants
Topical steroids for keratitis if risk of scarring

32
Q

Common causative organisms of bacterial conjunctivitis

A

Staph aureus
Staph epidermidis
Strep pneumoniae
Haemophilus influenzae

33
Q

Risk factors of bacterial conjunctivitis

A
  • Contact lens usage
  • Swimming in contaminated waters
  • Risky sexual lifestyle (Gonorrhea/ Chlamydia)
34
Q

Symptoms of bacterial conjunctivitis

A

Redness
Grittiness
Burning
Extensive mucopurulent discharge
Bilateral
‘Eyes stick together’

35
Q

Signs of bacterial conjunctivitis

A
  • Crusty lids
  • Conjunctival hyperaemia
  • Purulent discharge from eye
  • Mild papillary reaction
  • Lids and conjunctiva may be oedematous
36
Q

Treatment for bacterial conjunctivitis

A
  • Stop using contact lens/ swimming
  • Topical Abx (Chloramphenicol/ Erythromycin)
37
Q

Common causative virus of viral keratitis

A

HSV 1
HSV 2
Varicella zoster virus

38
Q

What is herpes simplex keratitis?

A
  • Reactivation of latent HSV type 1
  • Migrates down branch of trigeminal nerve to cornea (Esp nasociliary branch)

Look for ‘Hutchinson’s Sign’ (Tip of nose)

39
Q

Symptoms of herpes simplex keratitis

A

Red eye
Tearing
Photophobia
Pain
Hyperaemia
BoV
Watery discharge

40
Q

Risk factors of herpes simplex keratitis

A

Immunocompromised states

41
Q

Signs of herpes simplex keratitis

A
  • Corneal sensation reduced (Touch with cotton wool)
  • Conjunctival injection
  • Dendritic corneal ulcer with terminal bulb: Faint branching grey opacity on penlight examination, best seen stained with fluorescein
  • Geographic ulcer (coalesce of multiple dendritic ulcers)
42
Q

Treatment for herpes simplex keratitis

A

Topical acyclovir
PO acyclovir
- immunocompromised patients
- long term prophylactic treatment of recurrent HSV keratitis1

43
Q

Complications of herpes simplex keratitis

A

Recurrence

44
Q

What is herpes zoster ophthalmicus?

A

Caused by reactivation of varicella zoster virus and manifests as a painful vesicular rash along the ophthalmic division (V1) of the trigeminal nerve

45
Q

Signs of herpes zoster opthalmicus

A

Vesicular or pustular rash seen along the V1 dermatome distribution
- Hutchinson’s sign: involvement of tip of the nose due to involvement of the nasociliary branch of V1 of trigeminal nerve

46
Q

Risk factors of herpes zoster ophthalmicus

A

Advanced age
Stress
Immunocompromised

47
Q

Common organisms for bacterial keratitis

A

Pseudomonas aeruginosa
Staphylococcus aureus
Streptococcus

48
Q

Risk factors of bacterial keratitis

A

Poor contact lens hygiene
Trauma
Contaminated water contact with eye

49
Q

Signs of bacterial keratitis

A
  • Conjunctival injection
  • Corneal ulcer
  • Whitish Cornea opacity (Round white spot); Stain with fluorescein
  • Hypopyon
  • Corneal edema
50
Q

Immediate investigation for bacterial keratitis

A

Cornea scrapings for gram stain and culture

51
Q

Immediate management for bacterial keratitis

A
  • Refer ophthal immediately!
  • Topical Abx Cefazolin + Topical Gentamicin→ applied every hour
  • Topical cycloplegia
52
Q

Complications of bacterial keratitis

A

Corneal perforation
Corneal scar
Blindness
Endophthalmitis

53
Q

Endophthalmitis

A

Bacterial or fungal infection within the eye involving vitreous/aqueous humour

!medical emergency!

54
Q

Causes of endophthalmitis

A
  • Trauma
  • FB
  • Acute post cataract surgery
  • Extension of keratitis
55
Q

Symptoms of endophthalmitis

A

Red and painful eye
Severe vision loss

56
Q

Signs of endophthalmitis

A
  • Diffuse conjunctival injection
  • Hypopyon
  • RAPD
  • Loss of red reflux
  • Presence of vitritis
  • Chemosis
  • Hazy cornea from corneal edema
57
Q

How to differentiate between keratitis and endophthalmitis?

A

B-scan ultrasonography to check for vitreous involvement

58
Q

Investigations for endophthalmitis

A
  • Vitreous tap sent for culture and gram stain
  • Blood culture if septic shock
59
Q

Treatment of endophthalmitis

A
  • Give intravitreal Abx straightaway (Tap and inject)
    Vancomycin
    Ceftazidime
  • Give topical and systemic Abx
  • Vitrectomy
60
Q

Common causative organisms in endophthalmitis

A

Strep (Endocarditis)
Staph (Cutaneous infx)
Bacillus (IVDU)
Candida

61
Q

Treatment for stye

A

Warm compress
Lid hygiene
Epilation of lash a/w the infected follicle
Topical Abx ointment

62
Q

How to differentiate viral and bacterial conjunctivitis?

A

Viral
- watery discharge
- unilateral
- self-limiting

Bacterial
- mucopurulent discharge
- bilateral
- topical abx

63
Q

Distinguishing feature of viral conjunctivitis

A
  • Starts in one eye and rapidly spreads to the other eye
  • Self limiting within a week or so, supportive management is enough
64
Q

Distinguishing sign of HSV keratitis

A

Dendritic corneal ulcers that stain with fluorescein

65
Q

Distinguishing feature of keratitis

A

Whitish corneal opacity

66
Q

Distinguishing feature between preseptal vs orbital cellulitis

A

Orbital cellulitis is distinguished from preseptal cellulitis by pain with ocular movements and vision changes

67
Q

Difference between orbital vs pre-septal cellulitis

A

Preseptal cellulitis
- Disease of infant/toddler (20 months old)
- Presents with redness and edema but NO vision loss or pain on eye movements
- Treat with co-amoxiclav

Orbital cellulitis
- POST SEPTAL cellulitis which tracts from the ethmoidal sinus
- Presents with more systemic and severe effects such as fever, pain with eye movements, ophthalmoplegia and ptosis
- Medical emergency and treat with IV ceftriaxone or vancomycin

68
Q

What type of drugs is contraindicated in keratitis?

A

Corticosteroids
- can cause immunosuppression and worsen the infection

m4 EYE (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions