Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RB Y2 Ophthamology > The Acute Red Eye > Flashcards

The Acute Red Eye Flashcards

1
Q

how do contact lenses affect infectious presentation

A

delay it - act as a bandage to the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

blepharitis

A
  • lid inflammation
  • the eyes have burning, itchy red margins with scales on the lashes
  • gritty eyes
  • FB sensation
  • mild discharge
  • dry eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which part of the lid is redder in anterior blepharitis

A

lid margin redder than deeper part of lid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

anterior blepharitis: seborrheic dermatitis

A

squamous

there are red lid margins, greasy sclaes on lashes, which are stuck together

dandruff

there is no ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

anterior blepharitis: staphylococcal

A

ulcerative - infection involving lash follicle

there is a red lid margin

eyelashes are distorted, some trichiasis

there is matted hard crusts around lashes, with scarring and hypertrophy if long standing. removal of crusts leaves small ulcers which bleed/ooze

styes are seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

trichiasis

A

in growing of eye lashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

stye

A

red/tender lump caused by an infection of an oil gland of the eyelid - hordeolum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which type of stye is seen in staphylococcal anterior blepharitis

A

hordeolum externum - abscess/infection in the glands of Moll in the lash follicle

points outwards and may cause much inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what effect does trichiasis have on the cornea

A

irritates it - corneal staining and marginal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

posterior blepharitis

A

due to meibomian gland dysfunction

secretions of the gland thicken and block the gland, there is scarring and the glands fill up with secretion

there is insipissated (dried) secretion at the gland openings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the appearance of posterior blepharitis

A

redness in the deeper part of the lid, margins appear quite normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what type of stye is seen in posterior blepharitis

A

hordoleum internum - abscess of tarsal glands, point inwards opening onto conjunctiva and cause less of a local reaction but leave residual swelling called a chalazion/Meibomian cyst when they subside

pic: chalazion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hordeolum internum and externum

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is blepharitis a common cause of

A

secondary infections eg conjunctivitis, keratitis, episcleritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the most common manifestation of ocular rosacea (acne rosacea)

A

anterior and posterior blepharitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

treatment of blepharitis

A

lid hygiene is essential, crusts must be cleaned off lashes

supplementary tear drops

oral doxycycline for 2-3 months

difficult to eradicate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

general symptoms of conjunctivitis

A

red and inflamed conjunctiva

eyes itch burn and lacrimate

pain on eye movement

FB sensation - gritty eye

may be photophobia

often bilateral with eyelids sticking together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is unaffected in conjunctivitis

A

vision (acuity), pupillary responses and corneal lustre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

chemosis

A

odema of conjunctiva

non specific sign of eye irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

allergic conjunctivitis

A

stringy discharge

itch

papillae present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is allergic conjunctivitis treated with

A

anti-histamine drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

3 most common causes of bacterial conjunctivits in neonates

A
  • Staph. aureus
  • Neisseria gonorrhoea
  • Chlamydia trachomatis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3 most common causes of bacterial conjunctivitis

A
  • Staph. aureus
  • Strep, pneumoniae
  • H. influenzae (especially in children)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

bacterial conjunctivitis

A

red sticky eye

purulent discharge

papillae - red, small and circular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

treatment of bacterial conjunctivitis

A

often self limiting, swab eye

topical ABx used, 1. chloramphenicol

    1. Fusidic acid*
    1. Gentamicin*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

treatment of bacterial conjunctivitis in pregnant women

A

fusidic acid - chlormaphenicol can cause grey baby syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

when is chloramphenicol avoided

A
  • history of anaplastic anaemia (can cause bone marrow aplasia - type B reaction!)
  • allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is used to treat Pseudomonas aeruginosa bacterial conjunctivitis

A

not covered by chloramphenicol

covered by Gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

viral conjunctivitis

A

more pink than bacteiral

no pus, more of a thick watery secretion

often have URTI, and enlarged pre-auricular and submandibular lymph nodes

not serious but v contagious

red velvety apperance of conjunctiva and raised follicle (rice grains)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

adenovirus causing viral conjunctivitis

A

often follows URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

HSV causing viral conjunctivitis

  • appearance
  • enquiries
  • treatment
A

ask about ulcers

treat with acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

HZ opthalmicus

  • epidemiology
  • signs
A

Pain and neuralgia in the distribution of CNV1 dermatome precedes a blistering, inflamed rash

often so significant it can track over to the other eye

typically occurs in older adults

Hutchison’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how can HZ opthalmicus present

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Chlamydial Conjunctivitis

A

suspected in unresponsive, chronic conjunctivitis (may last for months)

most common in newborns and young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

classical Chlamydial Conjunctivitis presentation

A

unresponsive, chronic unilateral conjunctivitis in young adults

symptoms of urethritis and vaginitis

follicular conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

chronic follicular Conjunctivitis

A

subtarsal scarring, the scarring abrades the cornea on blinking. the cornea eventually becomes opaque

commonly cause by Chlamydial Conjunctivitis and trachoma

37
Q

treatment of Chlamydial Conjunctivitis

A

topical oxytetracycline

may need oral azithromycin for a genital infection

38
Q

trachoma

A
  • caused by repetitive infection with Chlamydia Trachomatis and most commonly seen in hot climates, spread by flies
  • there is lacrimation, redness and rupturing of conjunctival follicles and replacement with scar tissue
  • scar tissue distorts the lids and may lead to entropion
  • eye lashes scratch cornea - may ulcerate
  • can lead to blindness
39
Q

treatment of trachoma

A

Treatment is with Tetracycline and oral Azithromycin. Lid surgery may be required.

40
Q

what medication can patients typically become sensitised to

A

preservatives

eg Benzalkonium

41
Q

drug sensitivity

A

typically causes peri-orbital oedema

once drug is stopped skin will subside in 2-3 weeks

42
Q

keratitis

A

corneal inflammation, indicated by a hypopyon

moderate to intense pain, impaired eyesight, photophobia, red eye and a gritty sensation

43
Q

examination of keratitis

A
  • Use of anaesthetics (eg 1% tetracaine) if photophobic
  • Corneal reflex
  • Use of fluorescein and bright blue light to examine the cornea and identify area of epithelial loss
  • Vascularisation
  • Opacity
  • Oedema
44
Q

layers of the cornea

A
45
Q

central vs peripheral ulcers

A

central tend to be infective (eg bacterial, viral, fungal)

peripheral tend to be autoimmune (eg RA, hypersensitivity)

46
Q

name 4 autoimmune causes of a corneal ulcer

A

rheumatoid arthritis - 30%

SLE

IBD

ANCA vasculitis

47
Q
A

peripheral corneal ulcer

48
Q

symptoms of corneal ulcer

A

pain - needle like and severe, due to nerve exposure due to epithelium disruption - NOTE

photophobia

profuse lacrimation

reduced vision

red eye - circumcorneal

49
Q

signs of a corneal ulcer

A

circumcorneal redness

corneal reflex (reflection abnormal)

corneal opacity

hypopyon

50
Q

hypopyon

A

collection of inflammatory cells seen in the anterior chamber - also called sterile pus

51
Q

bacterial keratitis

A

round hypopyon

usually only found with other corneal pathology (eg corneal ulcer) or contact lense wearer

52
Q

which pathogen may progress rapidly

A

Pseudomonas

53
Q

treatment of bacterial keratitis

A

hourly drops

4-quinolone (Ofloxacin) (doesn’t treat Strep. Pneumoniae)

or Gentamicin or Cefuroxime

54
Q

HSV keratitis

A
  • classic dendritic ulcer
  • very painful and may relapse and recur, eventually resulting in reduced corneal sensation (as infection is in the nerves)
  • gritty red eyes
  • slight photophobia and reduced vision
55
Q

classical history of HSV keratitis

A

very fatigued patient, recent cold sore

56
Q

treatment of HSV keratitis

  • investigation
  • what to avoid
A

can be viewed with fluroscein and bright blue light

avoid steroids!! can cause corneal melt and perforation

acyclovir - topical if on the epithelium, otherwise need oral

57
Q

adenoviral keratitis

A

bilateral and usually follows UTI

contagious

small white flecks (subepithelial infiltrates) seen

may affect vision

58
Q

treatment of adenoviral keratitis

A

topical ABx to prevent 2y infection

steroids can speed recovery in chronic cases

59
Q

fungal keratitis

A
  • usually seen in contact lense wearers
  • Acanthamoeba or Pseudomonas aeruginosa usually
  • chronic, slow progessing history where the signs are more significant than the symptoms
  • deep severe ulcer
  • often history from trauma/vegetation
60
Q

acanthamoeba

A
  • causes a fungal keratitis almost exclusive to contact lense wearers (often from pools)
  • very difficult to eradicate
  • prevention: dont over wear/sleep/swim in contacts
61
Q

diagnosis of keratitis

A

corneal scrapes for Gram stain and culture

62
Q

typical causes of anterior uveitis

A
63
Q

clinical features of anterior uveitis

A

pain

reduced acuity

significant photophobia

lacrimation

circumcorneal redness

64
Q

describe the pain in anterior uveitis

A

dull ache, boring pain

may refer to eyebrow

65
Q

signs of anterior uveitis

A

ciliary (circumcorneal) injection

synechiae - smal/irregular pupil (iris inflammation)

hypopyon

cells/flare in anterior chamber

66
Q

treatment of anterior uveitis

A

the aim of treatment is to prevent damage from prolonged inflammation leading to disruption of aqueous flow, and glaucoma and iris and lens adhesions

topical steroids eg Prednisolone forte 1%

mydriatrics eg tropicamide, cyclopentolate 1%

67
Q

episclera

A

layer between sclera and conjunctiva

68
Q

episcleritis

A

inflammation of episclera

relatively common and has no serious associations, often recurrent and self-limiting. bilateral in 30%

often seen with inflammatory nodule

Sclera may look blue below a focal, cone shaped wedge (thin and towards pupil) of engorged vessels that can be moved around, unlike in scleritis where they are deeper. Eye aches dully and is tender (especially over inflamed area).

69
Q

what is associated with gout

A

episcleritis

70
Q

treatment of episcleritis

A

self-limiting

lubricants/topical NSAIDs/sometimes steroids

71
Q

scleritis

A

significant, deep boring pain. has been known to wake patients up from sleep

erythema - can be limited to area of eye

photophobia

generalized inflammation and chemosis, scleral thinning

injection of deep vascular plexus causes violaceous hue

72
Q

what is often assoicated with scleritis

A

anterior uveitis

73
Q

how can one distinguish between episcleritis and scleritis

A

phenyephrine test (vasoconstrictor)

  • the episcleral vessels will blanch with it, scleritis will not
74
Q

treatment of scleritis

A

oral NSAID

oral steroids

steroid sparing agents

75
Q

orbital cellulitis

A

Divided into pre and post septal. Pre-septal cellulitis is not that severe.

Post-septal cellulitis is inflammation of eye tissues behind orbital septum, it is sight-threatening

76
Q

where does infection typically spread from to cause orbital cellulitis

A

adjacent sinuses (paranasal) or through the blood

can also be an extension of a focal orbital infection or post-operative

77
Q

if left untreated, what can orbital cellulitis cause

A

it can lead to the development of orbital abscesses or can spread posteriorly to cavernous sinus

78
Q

classical presentation of orbital cellulitis

A

child with lid swelling, fever, orbital inflammation, decreased eye mobility (pain on eye movement)

as it is often associated with paranasal sinusitis there is often mucous coming out of the nose - check the ears and pupils

79
Q

orbital cellulitis - uni or bi lateral

A

inflammatory causes tend to be unilateral, whereas allergic causes tend to be bilateral

80
Q

investigation and treatment of orbital cellulitis

A

CT scan to identify and drain orbital abscesses

broad spectrum ABx and close monitoring

abscess may require drainage

81
Q

ABx treatment of orbital cellulitis

A
  • ceftriaxone
  • flucloxacillin
  • metronidazole
82
Q

Endophthalmitis

A

devastating infection of the inside of the eye

very painful and associated with decreased vision - can be sight threatening

very red eye

83
Q

what is the most common causative organism of Endophthalmitis

A

Staph. Epidermidis

84
Q

treatment of Endophthalmitis

A

Intravitreal amikacin/ceftazidime/vancomycin and topical antibiotics

85
Q

what classically causes chorioretinitis in AIDS

A

CMV

86
Q

toxoplasma gondii causing chorioretinitis

A

it is a protozoan infection, typically from cats and raw meat

creates a mild flu like illness that rarely causes any further problems and is fairly common

however, it can be sight threatening if it affects the macula

can reactivate

87
Q

toxocara canis casuing chorioretinitis

A

parasitic nematode (round worm)

affects cats and dogs. is unable to replicate in humans so remains in an immature form of worm, this means it is often self limiting

can form granulomas which can lead to irreversible vision loss

88
Q

what is a common contaminant of contaminated bottles

A

Psuedomonas

RB Y2 Ophthamology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions