RedEye

Question 0

CHRONIC itch, burn, scratch
Flux in vision
Poor tear film—> surface problem

Answer 0

Dx- Dry Eye (via Blepharitis)

Tx- Artificial tears/ ointment
TOPICAL cyclosporin
Punctal plug

Question 1

Eyelid inflamed/ NO vision decrease/ Meibomion gland dysfunction ,Chalazion or Seborrheic/ worse in AM

Answer 1

Dx- Blepharitis

Tx- Warm compress/ antibx or steroid/ baby shampoo

Question 2

Periorbital tissue infection
Red and swollen all around orbit
Presptal starts with stye
Orbital—> think systemic

Answer 2

Dx- Cellulitis

Tx- SYSTEMIC
Refer to ophth.

Question 3

Acute, bilateral
watery
Pre-auricular adenopathy
Injection, itch, burn
No vision loss

Answer 3

Dx- VIRAL conjunct.

Tx- tears, compress, time

Question 4

Acute, unilateral 
Mucopurulent
Sticky lids
Injection
No vision loss

Answer 4

Dx- BACTERIAL conj.

Tx- topical antibx +- systemic antibx
Test- gram stain

Question 5

Chronic bilateral
Stringy, mucoid
Chemosis (swollen eye) 
Injection, itch
No vision loss

Answer 5

Dx- ALLERGIC conj.

Tx- Topical antihistamine
Artificial tears
MAST cell stabilizers

Test- Patch skin test

Question 6

Blood in conjunctiva
Acute, from trauma
Red patch
No vision prob.

Answer 6

Dx- Subconjunctival Hemorrhage

Tx- chill out. Reassure. Don’t get punched in the eye again.

Question 7

Epithelial defect
Flouracin stain shows effect
Acute pain, foreign body sensation
+- vision loss

Answer 7

Dx- Corneal abrasion

Tx- NO TOPICAL ANESTHETICS
Lubricant
Antibx

Question 8

Inflamed sclera
Subacute foreign body sensation
Pain
No vision loss
Blue hue, focal injection

Answer 8

Dx- Episcleritis/ scleritis

Tx- top./ sys. Antibx
Refer to ophth

Question 9

Chemical burn
Acute pain and burn
Red, pink, white with corneal abrasion (white worst)
Vision loss

Answer 9

Dx- Chemical injury

Tx- Irrigate fast and a lot
Topical lubricant/ antibx

Question 10

Speck on eye
Acute onset
No vision prob

Answer 10

Dx- foreign body

Tx- remove
Lubricant/ antibx

Question 11

Corneal infection
Lens abuse 
Mucous, vision loss
Acute pain
White infiltrate

Answer 11

Dx- Keratitis; cornea ulcer

Tx- topical antibx

Question 12

HSV infection (dendritic w/ flouracin)
Acute mucosal

Answer 12

Dx-Keratitis; herpes simplex (usually type 1)

Tx- refer ophth ASAP

Question 13

Inflamed uvea
Photophobia
Ciliary flush, maybe hypopyon (pus in ant. Chamber)
Idiopathic

Answer 13

Dx- Iritis/ Uveitis

Tx- steroid
Cycloplegics (paralyze ciliary muscle)
Dilate

Question 14

Iris trauma
Blood in ant. Chamber
Photophobia

Answer 14

Dx- Hyphema

Tx- eyeshield, refer ASAP to
Control IOP

Question 15

IOP acute
Obstructed outflow 
Halos 
Sudden vision loss 
Circumlimbal injection (edge of cornea)
Ciliary flush (congestion of ciliary vessels) 
Steamy cornea (cloudy)

Answer 15

Dx- Acute angle glaucoma

Tx- refer ASAP to ophth for surgery
Beta-block/ alpha-2 antagonist