SPM- Acute Red Eye Flashcards
What is blepharitis?
Chronic inflammation of the eye lid margins
What causes blepharitis?
Blockage of the meibomian glands with infection (usually staph aureus or epidermis)
What are the symptoms of blepharitis?
Sore eyes
Gritty sensation in the eyes
Dry eyes
What are some complications of blepharitis?
Marginal keratitis
Secondary conjunctivitis
Meibomian cyst
What is a stye?
Infected hair follicle on the eye lid- always self limiting
What is the treatment for blepharitis?
Lid hygiene Warm compress Anti-biotic ointment- reduce bacterial load Lubricants- relive abrasion and dry eyes Low dose tetracycline (e.g. doxycycline)
What is an entropion?
In turning of the eye lid
What is an ectropion?
Eversion of the lower eye lid
What are the causative organisms of bacterial conjunctivitis?
Staph
Strep
Haemophilus species
What are the symptoms of bacterial conjunctivitis?
Slight discomfort
Red sticky eye
Visual acuity only affected due to discharge on the surface
What is the treatment for bacterial conjunctivitis?
Frequent ABx if bacterial- will go on it’s own anyway
Want to prevent spread to others- don’t share towels, wash hands regularly
Which is the most common cause of conjunctivitis?
Viral- often adenovirus (preceding URTI)
What are the symptoms of viral conjunctivitis?
Red eye
Watery eyes (not sticky yellow like bacterial)
Gritty and uncomfortable feeling
What are some examination findings for viral conjunctivitis?
Conjunctival injection
Associated URTI
Enlarged pre-auricular lymph node- suggests adenovirus cause
What is the treatment for viral conjunctivitis?
None
Anti-biotic drops to prevent secondary bacterial infection
Highly contagious so prevent spread e.g. don’t share towel
Which STI can cause a red eye?
Chlamydia- indicator is that it does not respond to normal measures for conjunctivitis. Instead requires systemic Abx.
What sensitivity reaction can cause a red eye?
Allergic conjunctivitis can occur with type 1 hyper-sensitivity reactions
What is keratitis?
Inflammation of the cornea
What are the features of microbial keratitis?
Hypopyon Red eye Photophobia Painful eye Reduced visual acuity
What is a complication of microbial keratitis?
Endopthalmitis
Corneal perforation
Loss of eye
Which virus causes viral keratitis?
Often HSV
What is a unique feature of viral keratitis due to HSV on examination?
Branching dendritic ulcer
How does the corneal sensation change with viral keratitis?
Typically corneal sensation is reduced- so there is a reduced reflex when a tissue is pressed against the cornea (note this is strictly the clear part and not the white of the eye which is the sclera)
What is the management for viral keratitis?
Topical aciclovir
Dilate the pupil for comfort- photophobia is due to iris inflammation
How can you differentiate scleritis from episcleritis?
Scleritis is extremely painful, episcleritis is less painful
What are some causes of scleritis?
Majority are idiopathic
25% are associated with a connective tissue or vasculitic disease (most often RA)
Infections- VZV, Bacterial endotoxins
Is scleritis diffuse or localised?
Scleritis may be diffuse or localised
Why might scleritis cause the sclera to appear blue/blackish?
There is thinning of the sclera with necrotising scleritis
What is the treatment for scleritis?
Mild- Oral NSAIDs
Topical Steroids
Systemic immunosuppression- steroids, methotrexate, mycophenolate
What are some complications of scleritis?
Visual loss
Thinning of the sclera
Globe perforation
What is the uvea?
Iris, ciliary body and choroid
