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Ophthalmology Week 2 > The Red Eye > Flashcards

The Red Eye Flashcards

1
Q

most common cause of red eye?

A

conjuctivitis

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2
Q

when does subconjuctival haemorrhage most commonly occur?

A

in older patients with friable vessels or patients on warfarin. when they sneeze/cough/strain

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3
Q

how is a subconjuctival haemorrhage managed?

A

-usually left alone, it is self limiting

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4
Q

in what situation is orbital cellulitis often seen?

A

in a child with a sinus infection

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5
Q

what are the things that make the ocular defences?

A
  • lids
  • tears
  • conjuctivae
  • epithelium
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6
Q

what secretion is released from the lids?

A

meibomian

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7
Q

what lid is more important in protecting the eye?

A

the upper lid

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8
Q

what is an achey pain in the eye classic of?

A

intraocular infection

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9
Q

what is an itch in the eye normally caused by?

A

allergy

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10
Q

what type of discharge is associated with a bacterial infection?

A

purulent, sticky discharge

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11
Q

what is mucoid discharge classic of?

A

allergic type reaction

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12
Q

what does redness maximal at the limbus usually indicate?

A

an intra-ocular infection or keratitis

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13
Q

what is the term for inflamed eyelids?

A

blepharitis

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14
Q

what are the 2 different types of blepharitis?

A

anterior and posterior

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15
Q

what can be seen in anterior blepharitis?

A

seborrhoeic (sqamous) scales on the lashes

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16
Q

what pathogen often infects the lash follicle in anterior blepharitis?

A

staphlococcal

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17
Q

where is most of the redness seen in blepharitis?

A

at the lid margin

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18
Q

what is the problem in posterior blepharitis?

A

meibomian gland dysfunction

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19
Q

where is the reddness seen in posterior blepharitis?

A

in deeper part of lid

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20
Q

symptoms of blepharits?

A
  • similar to conjuctivitis
  • gritty eyes
  • foreign body sensation
  • mild discharge
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21
Q

in a seborrhoeic anterior bleparitis, what are the signs?

A
  • lid margin red

- a lot of scales and dandruff on margin

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22
Q

what anterior blepharitis affects the lashes more?

A

a staphylococcal blepharitis

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23
Q

what are the signs in a staphylococcal blepharitis?

A
  • lid margin red
  • lashes distorted, loss of lashes, ingrowing lashes
  • styes, ulcers of lid margin
  • corneal staining, marginal ulcers
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24
Q

what is the correct term for ingrowing lashes?

A

trichiasis

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25
Q

what happens to the meibomian glands in posterior blepharitis?

A

the openings are pouting and swollen

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26
Q

what is around the gland openings in posterior blepharitis?

A

dried secretions

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27
Q

what is the result of dried secretions and swollen gland openings in posterior blephartis?

A

Meibomian Cysts

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28
Q

what is another name for meibomian cysts?

A

chalazia

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29
Q

what is associated (50%) with posterior blepharitis?

A

Acne Rosaecea

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30
Q

how can a meibomian cyst cause a stygmatism?

A

if it gets too big it can press on the eyeball

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31
Q

what is the treatment of blepharitis?

A
  • lid hygiene- daily bathing/warm compresses
  • supplementary tear drops
  • oral doxycycline
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32
Q

how long should doxycycline be given for in blepharitis?

A

2-3 months

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33
Q

what are the infective causes of conjuctivitis?

A

viral, bacterial, chlamydial

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34
Q

what can cause a non-infective conjuctivitis?

A
  • allergy
  • chemicals/drugs
  • skin diseases eg eczema
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35
Q

what is a viral conjuctivitis usually preceeded by?

A

a viral URTI

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36
Q

where is the redness more diffuse in conjuctivitis?

A

towards the fornices

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37
Q

what is the fornices?

A

space between the eyeball and eye socket

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38
Q

what is meant by chemosis?

A

oedema

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39
Q

what lymph glands are typically swollen in a viral conjuctivitis?

A

pre-auricular

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40
Q

how long does an acute bacterial conjuctivitis take to clear up without antibiotics?

A

about 14 days

41
Q

most common organisms causing acute bacterial conjuctivitis?

A
  • staph. aureus
  • strep. pneumonia
  • h.influenzae
42
Q

what are papillae seen in?

A

bacterial conjuctivitis

43
Q

what things can cause a follicular conjuctivitis?

A
  • virus
  • chlamydial infection
  • drugs
44
Q

what drugs can cause a follicular conjuctivitis?

A

propine, trusopt

45
Q

what is the appearance and site of follicular conjuctivitis secondary to chlamydial infection?

A

raised white dots with redness around the base on the inner upper lip surface

46
Q

what are the layers of the cornea from anterior to posterior?

A
  • epithelium
  • stroma
  • endothelium
47
Q

what is keratitis?

A

inflammation of the cornea

48
Q

what are the causes of a central corneal ulcer?

A
  • viral
  • fungal
  • bacterial
  • acanthamoeba
49
Q

what causes peripheral corneal ulcers?

A

Autoimmune conditions

  • RA
  • hypersensitivity
  • rarely, GPA
50
Q

In the UK, what kind of patients get a fungal corneal ulcer?

A

immunosuppressed patients

51
Q

what is the pain like in a corneal ulcer?

A

severe- needle like pain

52
Q

what virus can affect the corneal sensation?

A

herpes viruses

53
Q

what are the symptoms of a corneal ulcer?

A
  • pain
  • photophobia
  • profuse lacrimation
  • may be reduced vision
  • red eye
54
Q

signs of corneal ulcers?

A
  • redness
  • corneal reflex abnormal
  • corneal opacity
  • hypopyon may be present
55
Q

where is the redness seen in corneal ulcers?

A

circumcorneal - around the cornea

56
Q

what is a hypopyon?

A

fluid level of white blood cells - inflammatory exudate

57
Q

what kind of ulcer does H.simplex virus cause?

A

dendritic ulcer

58
Q

what can happen to the edge of limbus in an auto-immune ulcer?

A

becomes obscured

59
Q

in what conditions does a corneal ulcer form due to exposure keratitis?

A
  • thyroid disease eg in proctosus in Graves

- VII palsy

60
Q

what does keratoconjuctivitis sicca mean?

A

dry eye

61
Q

how does Sjorgens manifest in the eyes?

A

dry eyes

62
Q

what conditions can cause neurotrophic keratitis leading to a corneal ulcer?

A

H zoster in ophthalmic division of trigeminal

63
Q

what vitimin defiency can cause a corneal ulcer?

A

vit A

64
Q

how is the cause identified in a corneal ulcer?

A

‘corneal scrape’ for gram stain and culture

65
Q

what is the treatment for a bacterial corneal ulcer?

A

ofloxacin hourly

66
Q

what is the treatment fora herpetic corneal ulcer?

A

aciclovir ointment 5 times a day

67
Q

what is given to treat autoimmune corneal ulcers?

A

oral/topical steroids

68
Q

what are the autoimmune causes of anterior uveitis?

A

-reiter’s, UC, Ank Spon, Sarcoidosis

69
Q

malignant causes of anterior uveitis?

A

leukemia

70
Q

infective causes of anterior uveitis?

A

-TB, syphylis, herpes simplex, herpes zoster

71
Q

what is anterior uveitis often mistreated as?

A

conjuctivitis

72
Q

symtoms of anterior uveitis?

A
  • pain
  • vision may be reduced
  • photophobia
  • red eye
73
Q

where is the redness most obvious in anterior uveitis?

A

circumcorneal - at the limbus

74
Q

signs of anterior uveitis?

A
  • ciliary injection
  • cells and flare in anterior chamber
  • keratic precipitates
  • hypopyon
  • small or irregular pupil
75
Q

what is the term for an irregular pupil?

A

synechiae

76
Q

where can the keratic precipitates be seen in anterior uveitus?

A

in inferior 1/3rd of cornea

77
Q

treatment of anterior uveitis?

A
  • topical steroids

- mydriatics

78
Q

what topical steroid is given to treat anterior uveitis?

A

Pred Forte 1%

79
Q

what mydriatic is used in anterior uveitis and how often is it given?

A

cyclopentolate 1% BD

80
Q

what systemic disease is episcleritis associated with?

A

gout

81
Q

what usually iniates episcleritis?

A

a late night, lack of sleep

82
Q

how is episclertits managed?

A

it is self-limiting, no serious associations

83
Q

what can occur in recurrent episcleritis?

A

nodules

84
Q

how can you differentiate between episcleritis and scleritis?

A
  • scleritis is painful

- apply vasoconstrictor drop to eye and the vessels will blaunche in episcleritis but they wont in scleritis

85
Q

what is scleritits associated with?

A

serious systemic vasculitis eg RA, GPA

86
Q

what is meant by the sign ‘violaceous hue’ in scleritis?

A

injection of deep vascular plexus

87
Q

what would you expect in the phenylephrine test in scleritis?

A

vessels will not blaunche

88
Q

what other feature in the eye often accompanies scleritis?

A

uveitis

89
Q

treatment for scleritits?

A

oral NSAIDS, oral steroids, steroid sparing agents

90
Q

what supportive treatment can be given in episcleritis?

A

lubricants, topical NSAIDS, possibly mild steroids

91
Q

are hypermetropes or myotropes more likely to get acute closed angle glaucoma?

A

hypermetropes

92
Q

where is the maximal redness in acute closed angle glaucoma?

A

at the limbus

93
Q

why does IOP rise actutely in ACAG?

A

drainage angle is closed

94
Q

what is the main symptom of ACAG?

A

severe pain, can make patient sick

95
Q

where is the injected blood vessels most predominant in ACAG?

A

around cornea -limbus

96
Q

what is the appearance of the cornea in ACAG?

A

cloudy (oedematous)

97
Q

what state is the pupil in in ACAG?

A

mid dilated

98
Q

how does the eye feel in ACAG?

A

stony hard

Ophthalmology Week 2 (6 decks)

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