Red eyes

Question 1

sight threatening causes of a red eye

Answer 1

acute angle closure glaucoma
corneal ulcer/abscess
penetrating eye injury

require immediate ophthalmologist attention

Question 2

questions to ask in the history of someone with a red eye

Answer 2

does the patient wear contact lenses
any allergies
been sexually active recently 
in contact with people with red eyes
had an URTI recently

Question 3

signs and symptoms of conjunctivitis

Answer 3

reactive pupils
normal VA
conjunctival injection (blood shot eyes)
mucoid discharge 
discomfort or itch

Question 4

investigations in suspected conjunctivitis

Answer 4

bacterial, viral and chlamydial swabs

Question 5

treatment and management of conjunctivitis

Answer 5

advise:
remove excess discharge
don’t use contact lenses for at least 48 hours after complete resolution of symptoms, shouldn’t be used whilst topical antibiotic treatment continues
wash hands regularly, avoid sharing towels to stop spread
warn to seek attention in the event of deterioration

chloramphenicol eye drops 4 times a day for a week

topical antibiotics if bacterial

Question 6

common pathogens causing bacterial conjunctivitis

Answer 6

S.pneumoniae, S.aureus, H.influenza, Moraxella

Question 7

always stain with fluorescein drops to see what pathology

Answer 7

show you if there is any corneal pathology
dendritic ulcer
corneal abrasion
microbial keratitis

Question 8

treatment for dendritic ulcer

Answer 8

topical acyclovir ointment for the eye and /or cream for skin lesions

Question 9

signs and symptoms of anterior uveitis or iritis

Answer 9

red eye
no discharge
eye aches and hurts when looking in a. bright light - photophobia 
slight blurring of vision or floaters 
reduced VA 

warrants attention by an ophthalmologist

Question 10

bacterial keratitis

Answer 10

contact lens increase the risk of bacterial infection
marginal ulcer +/- hypopyon
requires urgent attention
oral AB, steroid eye drops and wearing contact lenses are all contraindicated

treatment: frequent topical broad spectrum AB
if treatment is delayed bacteria continue to replicate and condition can progress rapidly

Question 11

don’t prescribe steroids initially for

Answer 11

dendritic ulcers
conjunctivitis
bacterial keratitis

Question 12

management of uveitis

Answer 12

refer to ophthalmologist

reducing regime of topical steroid and a cycloplegic and dilating drop for pain relief

can’t drive when using steroid eye drops