The Red Eye

Question 1

Can orbital cellulitis cause red eye?

Answer 1

Yes

Question 2

What are the occular defences?

Answer 2

Lids
Tears
Conjunctivae - mucous
Epithelium - corneal/conjunctiva

Question 3

What can cause a corneal ulcer?

Answer 3

Lid disease

Question 4

What immunoglobulins are in tears?

Answer 4

IgA

IgG

Question 5

What enzyme is in tears?

Answer 5

Lysozyme

Question 6

What is blepharitis?

Answer 6

Inflamed eyelids

Question 7

What can cause posterior eye lid inflammation?

Answer 7

Meibomian gland dysfunction

Question 8

What does the lid margin look like in posterior eye inflammation?

Answer 8

Can be normal

Question 9

What are symptoms of blepharitis?

Answer 9

Gritty eyes
Foreign body sensation
mild discharge

Question 10

What are signs of seborrhoeic blepharitis?

Answer 10

red lid margin
scales ++
dandruff
no ulceration nor lashes problems

Question 11

What are signs of Staphylococcal blephratis?

Answer 11

red lid margin
lashes distorted
ulcers of lid margins
corneal staining

Question 12

What is eyelash ingrowing?

Answer 12

Trichiasis

Question 13

What is posterior blepharitis associated with?

Answer 13

Acne rosacea (50%)

Question 14

How do you treat Blepharitis?

Answer 14

Lid hygeine - daily bathing + warm compresses
Supplementary tear drops
Oral doxycycline for 2-3 months

Question 15

What are symptoms of conjunctivitis?

Answer 15

Red eye
foreign body - gritty eye
discharge - sticky eye
itch - allergy

Question 16

What are signs of conjunctivitis?

Answer 16

Red eye
Discharge
Papillae or follicular
oedema (chemosis)

Question 17

Is vision affected in conjunctivitis?

Answer 17

No

Question 18

What are the more common organisms to cause conjunctivitis?

Answer 18

Staph aureus
Strep pneumoniae
H. influenzae

Question 19

What can cause viral follicular conjunctivitis?

Answer 19

Adeno
HS
HZ

Question 20

What drugs can cause follicular conjunctivitis?

Answer 20

Propine

Trusopt

Question 21

What autoimmune disorders can cause corneal ulcers?

Answer 21

Rheumatoid arthiritis
Wagener’s granulomatosis
Polyartheritis

Question 22

What are symptoms of corneal ulcers?

Answer 22

pain
photophobia
perfuse lacrimation

Question 23

What are signs of a corneal ulcer?

Answer 23

redness
corneal reflex
corneal opacity
staining
hypopyon

Question 24

How do treat corneal ulcers?

Answer 24

Gram stain and culture to find cause
aciclovir if herpetic
Ofloxacin hourly if bacterial
oral/topical steroids if autoimmune

Question 25

What are autoimmune causes of anterior uveitis?

Answer 25

Reiter’s
UC
Ank spondylitis
Sarcoidosis

Question 26

What are infective causes of anterior uveitis?

Answer 26

TB
Syphilis
Herpes simplex
Herpes zoster

Question 27

What are symptoms of anterior uveitis?

Answer 27

pain
reduced vision
photophobia
red eye

Question 28

Can cancer cause anterior uveitis?

Answer 28

yes, e.g. leukaemia

Question 29

What are signs of anterior uveitis?

Answer 29

ciliary injection
cells & flare in anterior chamber
Keratic precipitates
Hypopyon
Synechiae - small or irregular pupil

Question 30

How do you manage anterior uveitis?

Answer 30

Topical steroids - Pred forte 1% hourly tapering over 4-8 weeks
Mydriatics - Cyclopentolate 1% BD

Question 31

What is episcleritis associated with?

Answer 31

Gout

Question 32

What is scleritis?

Answer 32

A serious disease

painful

Question 33

What is scleritis assoc with?

Answer 33

Vasculitides,
Rh arthritis
Wegener’s
and Uveitis

Question 34

What test is done for scleritis?

Answer 34

Phenylephrine

Question 35

What are treatments for episcleritis?

Answer 35

lubricants
topical NSAIDs
mild sclerosis

Question 36

What are treatments for scleritis?

Answer 36

Oral NSAIDs
Oral steroids
steroid sparing agents