The Acute Red Eye Flashcards
What are the two types of haemorrhage?
Subconjunctival
Retrobulbar
What is the difference between subconjunctival and retrobulbar haemorrhage?
GOOGLE IMAGES
Subconjunctival - posterior edge of blood patch is visible
Retrobulbar - posterior edge is not visible. Proptosis, restricted eye movements, raised pressure, pupil reaction
What are the causes of localised red eye?
Episcleritis
Phlyctenular
Conjunctivitis
What are the caused of generalised red eye?
Conjunctivitis
Keratitis
Uveitis
Acute Glaucoma
Where is the redness in conjunctival congestion?
superficial vessels
bright red in colour
blanch with topical vasoconstrictions
move with conjunctival folds
centripetal blood flow
Where is the redness in ciliary or circumcorneal congestion?
Predominantly around the cornea
- deeper vessels
- dusky red in colour
- do not blanch with topical vasoconstrictors
- do not move with conjunctival folds
- centrifugal blood flow
What are the symptoms of viral conjunctivitis?
Gritty eyes Sore eye Watery discharge Follicles Lymph nodes
What are the symptoms of bacterial conjunctivitis?
Gritty eyes Purulent discharge Lymph nodes Crusting and matting of the eyelashes V sore eye
What are the symptoms of allergic conjunctivitis?
Itchy eyes
Stringy/watery discharge
Papillae
No lymph nodes
How is allergic conjunctivitis treated?
Self limiting
If needed - Opticrom, Lodoxamide,
Steroids
How is viral conjunctivitis treated?
Self limiting
If needed - antibiotics, antiviral, steroid
How is bacterial conjunctivitis treated?
Needs treatment
Antibiotics topical and systematic
What is a ciliary injection?
indicates inflammation of the cornea, iris or ciliary body WHEREAS conjunctival injection mainly affects posterior conjunctival blood vessels
In what circumstances is there corneal involvement (ciliary injection) ?
Foreign body
Trauma
Keratitis
What is uveitis?
Presentation?
- Inflammation of the iris and ciliary body
- impaired vision
- keratic precipitates
- constricted pupil
- synechiae
- unknown etiology
How does acute angle closure glaucoma present?
- headache, nausea, vomiting
- reduced vision, halos
- red eye
- corneal haze
- fixed mid-dilated pupil
How does keratitis present?
- impaired vision
- ciliary redness
- pupil constricted
- discharge
- moderate to severe pain
What is the treatment for keratitis?
Referal
Culture
Intensive topical fortified antibiotics
Atropine
What causes keratitis?
Viral - dots and dendrites
Bacterial - necrosis
Fungal - organic trauma
Amoebic - contact lens
Summarise how to review a red eye?
1) haemorrhage or congestion
2) congestion: conjunctival or ciliary?
3)
conjunctival - conjunctivitis - consider treating
ciliary - keratitis, uveitis, acute glaucoma
All potentially sight threatening - REFER
