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Ophthalmology 2023 > Red eyes and red flags part 2 > Flashcards

Red eyes and red flags part 2 Flashcards

1
Q

allergic conjunctivitis Hx

A

intermittent/seasonal, itchiness, redness and watering
rhinitis, atopy
chemosis/conjunctival swelling

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2
Q

management of allergic conjunctivitis

A

lubricating eye drops
oral antihistamines
ophthalmology
PRN (for use my ophthalmologists): topical antihistamines, mast cell stabilisers, steroids

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3
Q

blephoritis

A

common
middle aged to elderly patients
oil glands on the eyelid margins
chronic, bilateral, grittiness, burning, watering, intermittant blurring

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4
Q

glands that make eye oil

A

meibomian glands

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5
Q

examination of blephoritis

A

lid erythema, conjunctival injection, punctate staining
dandruff like flakes on eyelashes, blocked meibomian glands

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6
Q

management of blephorits

A

lid hygiene, warm compress, lubricating eye drops
oral omega-3 fatty acids
ophthalmology PRN: topical antibiotic/steroid, oral doxy/minocycline, thermal pulsation

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7
Q

lid hygiene

A

uses a cotton tip dipped in boiled water to scrub eye lashes every day
either bicarb sod or johnson johnson baby shampoo
use a flannel in a warm shower to massage the eye lid to mechanically push out the blockages
lubricating eye drops

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8
Q

chalazion

A

trapped meibomian gland secretion that has enlarged over time
inflammatory condition

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9
Q

stye

A

staph infection of eyelash follicle

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10
Q

management of chalazion

A

warm compress, fish oil supplements

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11
Q

management of stye

A

remove infected lash
warm compress
topical antibiotic ointment eg. clorsig

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12
Q

what is the difference between scleritis and episcleritis

A

both sectoral redness but scleritis is more painful

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13
Q

scleritis Hx

A

sub acute
sectoral reddness
severe pain boring into their head
among most painful eye conditions
visual disturbance
wakes patient at night

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14
Q

scleritis aetiology

A

idiopathic, collagen vascular / rheumatological conditions
gout
infection (HZO, syphilis)

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15
Q

management of scleritis

A

oral NSAIDs
urgent referral to ophthalmology
may need systemic immunosupression, manage with opthal and rheum

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16
Q

diagnostic test for scleritis

A

drop of phenylephirine
conjunctival vessels constrict causing conjunctival redness to go away
if the eye becomes completely white, it must be either episcleritis or conjunctivitis
if the redness remains, it must be scleritis

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17
Q

pre-septal cellulitis

A

also called periorbital cellulitis
infection or inflammation of contents in front of the orbital septum
can become post-septal
subacute (hours to days)
unilateral
young

18
Q

examination of pre septal cellulitis

A

white eye
peri orbital erythema
normal eye movements
eye isnt proptosed
systemically well

19
Q

management of pre septal cellulitits

A

opthalmology consult
oral ABs
daily follow up
CT head and orbits if unable to examine eye,

20
Q

red tender swelling near the nose
acute in onset

A

dacrocystitis

21
Q

dacrocystitis Hx

A

acute onset
painful red swelling at medial canthus
patient unwell
blocked nasolacrimal sac causing infection
may be discharging - you can swab this
common in kids and >40yo

22
Q

management of dacrocystitis

A

ophthalmology consult
swab for culture
FBC and CT if febrile or severe
start ABs
can become orbital cellulitis
definitive management is often surgury
beware extension to orbital cellulitis
admission

23
Q

red flags for orbital cellulitis

A

displaced eyeball
extra occular muscle involvement
red eye
reduced VA

24
Q

management for orbital cellulitis

A

urgent CT head and orbits
IVABx
opthalmology and ENT consults, admission +/- theatre
FBC, blood cultures, wound swab

25
Q

risks in orbital cellulitis

A

risk of subperiosteal/orbital/intracranial abscess, meningitis

26
Q

hypopion

A

pus fluid level in the anterior chamber
either infective or inflammatory

27
Q

endophthalmitis Hx

A

sub acute
severe pain
recent injection, surgery, contact lens wearer
hypopion
same day opthalmology referral

28
Q

most common cause of endopthalmitis

A

injections into the eyes

28
Q

where to the antibiotics need to go for endopthalmitis

A

injected into the eye

29
Q

endophthalmitis examination

A

reduced VA, severe injection, peri-orbital erythema, hypopyan
cloudy cornea and anterior chamber

30
Q

management of endophthalmitis

A

urgent ophthalmology consult
fast
+/- systemic antibiotics
vitrous tap and injection of ABs
+/- vitrectomy surgery (remove vitreous gel, to remove bacterial load)

31
Q

pterygium

A

chronic growth over years
red eye
discomfort

32
Q

management of pterygiums

A

lubricating eye drops
beware rapid growths (may be SCC)
referral to ophthalmology for surgery

33
Q

when to refer for surgery for pterigiums

A

rapid growth
threatening vision
astigmatism (by exterting traction of the cornea)
discomfort
cosmesis

34
Q

shallow anterior chamber indicates, dated non reactive pupil, elevated IOP

A

acute angle glaucoma

35
Q

normal pressure

A

10-21

36
Q

checking pressure

A

anesthetise the eye
measure intraoccular pressure

37
Q

pressure in acute angle glaucoma

A

50+ or not recordaable

38
Q

management of acute angle closure

A

urgent opthal consult
topical pressure lowering drops, use at least 3 classes
systemic acetazolamide
definitive management = laser peripheral iridotomy (makes a hole through the iris

39
Q

definitive treatment for acute angle closure glaucoma

A

laser peripheral iridotomy
makes a hole in the iris using the laser
creates a bypass, gives immediate relief
have to wait until corneal swelling is reduced
sometimes they do one prophylactically in the other eye

40
Q

classes of pressure lowering drops

A

beta blockers eg. timolol
carbonic anhydrase inhibitors
alpha-2 agonists
prostaglandins

Ophthalmology 2023 (18 decks)

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