Red Eyes Flashcards by Falak Jabeen

‘Itis’

A disease indicating an inflammatory disease

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State some sx a patient presenting with a red eye could have .

Pain / Irritation 
Discomfort 
Itching 
Redness 
Bilateral 
Discharge ( may feed mag to view this )

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How would you differentiate between scleral and conjunctival redness?

Conjunctiva is overlying the sclera and is very vascular
Hardly any in sclera
Conjunctiva is a loose layer of connective tissue - you could use your thumb to push lids , the overlying conjunctiva vessels will move around abit

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State others ways to describe ‘ redness’?

Injection

Hyperaemia

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Why do the vessels in the eye look red ?

Vessels are dilated

Increased permeability

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What could inflammatory cells in the eye cause?

Leaking- proteins , inflammatory cells

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What could you use to assess the redness of an anterior eye?

Grading scales - Effron

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Define ‘ chemosis’

Severe oedema ( swelling ) of conjunctiva

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What causes chemosis?

Vessels in eye leak rich proteins which get stuck in the conjunctiva
May also be associated with allergens

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State the types of discharge.

Mucous
Purulent
Watery
Mucopurulent

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Define the mucous discharge type

Aka mucoid , stringy

Associated with acute infection of mucous membrane

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Name a eye condition which presents mucous type discharge

Vernal conjunctivitis

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Define purulent type discharge

milky look and texture
Indicates presence of dying neutrophils and infective organisms as well as mucous
Often describes as pus

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Define watery discharge

Clear fluid discharge , resembles epiphora

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Define muco-purulent discharge

Combination of excess mucous and pus discharge

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What is the name of conjunctivitis that can occur in neonates?

Ophthalmia neonatorum

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State the different types of conjunctivitis

Bacterial
Viral
Allergic
Others

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What is conjunctivitis ?

Inflammation of the conjunctiva

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What would you see in a slit lamp on a patient presenting with bacterial conjunctivitis

Red 
Vessels move in blinking 
Cornea is clear - unaffected 
Papillae - lumps under lids 
Purulent or muco purulent discharge

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State some sx that can occur with viral conjunctivitis

All ages 
Mono/bino
Burning sensation max of 1/52
VA may be slightly affected due to watery eyes 
Hx of systemic illness

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What would you see in a slit lamp on a patient presenting with viral conjunctivitis

Short TBUT
Watery discharge
Follicles
Enlarged preaurticular nodes

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State some sx of allergic conjunctivitis

Acute onset ( hours / mins ) 
Mono/Bino*
Hx of allergy 
Itchy 
Fluctuating VA 
Seasonal

What would you see in a slit lamp on a patient presenting with allergic conjunctivitis ?

Chemosis 
Swollen lids 
Watery discharge 
Increase in mucous 
Papillae

What is papillae ?

Small round bumps 
Mainly upper lid - upper tarsal conjunctiva 
Associated with chronic inflammation 
Can be big 
Central blood vessel

What are follicles ?

Round collections of lymphocytes Both lids may be affected Smaller , paler Associated with acute inflammation

What is the episclera?

Thin layer between sclera and conjunctiva | Less vascular that conj - more vascular that sclera

What is episcleritis?

``` Common condition affecting the episclera Mild pain / painless May be sectoral Photophobia Tearing No affect in VA Self limiting - no tx ```

What is scleritis ?

``` Sclera is swollen , red , tender , painful Deep boring pain All layers injected Tearing Photophobia Gradual onset Graduation reduction in VAn ```

What is Keratitis .

Cornea is swollen due to ulceration Pain Reduced VA Photophobia **

What is Acute angle closure of glaucoma ?

``` Shallow anterior chamber Raised IOP Circumlimbal injection Sever pain Fixed pupil - mid dilated Nausea ```

What is anterior uveitis ?

``` Affects the inside of the front of eye ( between cornea and iris ) and ciliary body Circumlimbal injection Photophobia Miotic pupil Mild VA reduction May be chronic Ache, pain ```

What should you always ask a patient if they present with a red eye ?

Trauma

State some questions to ask patients who present with a red eye ?

Do you wear CLs? Do you have any allergies ? Have you had any recent illness? Have you had a family member with red eye ?

What is the two types of eyelash demodex mites?

D folliculorum- affects eyelashes , feed on dead skin cells around lashes and lids D brevis - likely to affect sebaceous glands

What could be given/ prescribed to a patient suffering from bacterial conjunctivitis ?

Chloramphenicol (P)

What could be given/ prescribed to a patient suffering from allergic conjunctivitis ?

Antihistamine drops - otrivine-antistin | Opticrom

What is adenovirus ?

Highly contagious Mild burning Watery discharge

What is important to remember if you suspect a patient has adenovirus ?

HYGIENE | hand washing , equipment hygiene

How do you examine the preaurticular nodes?

Palpate the area in front of the ear against against the jaw Record finding PAN +ve , PAN -ve

What is the likely management for viral conjunctivitis ?

Self limiting | See GP if continues

What is the likely management for bacterial conjunctivitis ?

Antimicrobial (IP,P,GP)

What is the most likely management plan for allergic conjunctivitis ?

Avoid allergen | Antihistamine

Briefly explain what bacterial conjunctivitis is ?

Causes by bacteria - spread through poor hygiene Last about two weeks Contagious

What sx can a patient with bacterial conjunctivitis present with ?

Eyes stuck together in morning Milk irritation 2-3 days Sticky discharge Normal VA

What signs as an optometrist would indicate patient has bacterial conjunctivitis ?

``` Mucopurulent , purulent discharge Cornea clear Redness around fornices Papillae Vessels move on blink ```

What tx plan is ideal for a patient who is suffering from bacterial conjunctivitis ?

Antibx eye drops - chloramphenicol | Antimicrobial - stop growth and kill microorganism

Briefly explain what viral conjunctivitis is ?

Contagious Last about two weeks Causes by adenovirus Follows cold or sore throat

What sx would a pt suffering from viral conjunctivitis present with ?

Burning sensation 3-7 days VA mildly affected Watery discharge

What is keratitis ?

Inflammation of the cornea

State the types of keratitis

Infectious and non infectious

Explain the sub categories in infectious keratitis

Bacterial Fungal Viral Parasitic

What increase the risk of keratitis ?

CL wear , swimming in them , improper disinfection Dry eye Eye lid disorders Not wearin eye protection

Explain the non infectious keratitis group

Injury Eyelid disorders that prevent closure Dry eye Photokeratiis

What sx are associated with keratitis ?

``` Eye pain Eye redness Tearing / discharge Blurred vision Photophobia Irritation Feeling something in eye ```