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Ophthalmology > The Red Eye > Flashcards

The Red Eye Flashcards

1
Q

What do the meibomian glands secrete?

A

Meibum, an oily substance that prevents evaporation of the eye’s tear film.

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2
Q

What do tears do/contain?

A

Help with blinking, trap mucous. Lysozyme, IgA, IgG, complement

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3
Q

What is found on the lashes in anterior seborrhoeic blepharitis?

A

Seborrhoeic (squamous) scales

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4
Q

What distinct bacteria can often cause anterior blepharitis due to an infection involving the lash follicle?

A

Staphylococcal

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5
Q

In anterior blepharitis how does the lid margin compare to the deeper part of the lid?

A

It will be redder

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6
Q

What is posterior blepharitis due to?

A

Meibomian gland dysfunction (MGD)

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7
Q

In posterior blepharitis how does the lid margin compare to the deeper part of the lid?

A

Margin is normal, redness in deeper part of lid

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8
Q

What are the symptoms of blepharitis?

A

Similar to conjunctivitis, gritty eyes, foreign body sensation, mild discharge

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9
Q

What is blepharitis associated with?

A

Conjunctivitis, keratitis (Marginal, SPK), episcleritis

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10
Q

What are the signs in seborrhoeic anterior blepharitis?

A

Lid margin red, scales, dandruff, (no ulceration, lashes unaffected)

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11
Q

What are the signs in staphylococcal anterior blepharitis?

A

Lid margin red, lashes distorted, loss of lashes, ingrowing lashes (trichiasis), styes, ulcers of lid margin, corneal staining, marginal ulcers (due to exotoxin)

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12
Q

What are the clinical features in posterior blepharitis?

A

Lid margin skin and lashes unaffected. MG openings pouting and swollen, inspissated (dried) secretion at gland openings, meibomian cysts (chalazia), associated with acne rosacea (50%)

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13
Q

What is the treatment for blepharitis?

A

Lid hygiene-daily bathing/warm compresses. Supplementary tear drops, oral doxycycline for 2-3 months

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14
Q

What can cause conjunctivitis?

A

Infective-viral, bacterial, chlamydial. Allergic, chemical/drugs, skin diseases-eczema

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15
Q

What are the symptoms of conjunctivitis?

A

Red eye, foreign body sensation-gritty eye, discharge, itch=allergy. Vision unaffected

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16
Q

What are the signs of conjunctivitis?

A

Red eye-diffuse more towards the fornices. Discharge-serous or mucopurulent. Papillae or follicles, sub conj. haemorrhage, chemosis, pre-auricular glands swollen

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17
Q

What are key features of acute bacterial conjunctivitis?

A

Red sticky eye, papillae, self limiting-2wks (topical antibiotics clear faster)

18
Q

What organisms most commonly cause acute bacterial conjunctivitis?

A

Staph aureus, Strep pneumoniae, H influenzae

19
Q

What causes follicular conjunctivitis?

A

Viral-adenovirus, HSV, HZV. Chlamydial. Drugs - propine, trusopt

20
Q

What can often lead to chronic conjunctivitis?

A

Blepharitis, chlamydial infection, keratoconjunctivitis sicca, lacrimal disease (chr. dacryocystitis), sensitivity to topical glaucoma medication, sub-tarsal foreign body

21
Q

What can cause central corneal ulcers?

A

Viral, fungal, baterial, acanthamoeba

22
Q

What can cause peripheral (AI) corneal ulcers?

A

RA, hypersensitivity e.g. marginal ulcers. (Rarely wegener;s, polyarteritis etc)

23
Q

What is examined in keratitis examination?

A

Anaesthetics if photophobic. Corneal reflex, use of fluorescein, vascularisation, opacity, oedema

24
Q

What are the symptoms of corneal ulcers?

A

Pain-needle like severe (herpes virus affects sensation), photophobia, profuse lacrimation, vision may be reduced, red eye-circumcorneal

25
Q

What are the signs of corneal ulcers?

A

Redness-circumcorneal, corneal reflex (reflection abnormal), corneal opacity, staining with fluorescein, hypopyon

26
Q

What are the special groups of corneal ulcers?

A

Exposure keratitis e.g. thyroid, CNVII palsy. Keratoconjunctivitis Sicca e.g. Sjogrens. Neurotrophic keratitis e.g. H Zoster or CNV1. Vitamin Deficiency e.g. A

27
Q

What is the management for corneal ulcers?

A

Identify cause-corneal scrape for gram stain and culture. Antimicrobial if bacterial (e.g. ofloxacin hourly), antiviral is herpetic (aciclovir ointment 5x day), anti-inflammatory if AI (oral/topical steroids)

28
Q

What are the AI causes of anterior uveitis?

A

Reiter’s, UC, AS, Sarcoidosis

29
Q

What are the malignant causes of anterior uveitis?

A

Leukaemia, others

30
Q

What are the infective causes of anterior uveitis?

A

TB Syphylis, HSV, HZV

31
Q

What are the non AI/malignant/infective causes of anterior uveitis?

A

Idiopathic, trauma, 2’ to other eye disorders

32
Q

What are the symptoms of anterior uveitis?

A

Pain (+referred pain), vision may be reduced, photophobia, red dye (circumcorneal)

33
Q

What are the signs of anterior uveitis?

A

Ciliary injection (i.e. circumcorneal), cells &flare in anterior chamber, keratic precipitates, hypopyon, synechiae (small/irregular pupil)

34
Q

What is the management of anterior uveitis?

A

Topical steroids-Prednisolone Forte 1% hourly over 4-8 wks tapering, Mydriatics e.g. Cyclopentolate 1% BD, investigate for associations

35
Q

What are the key features of episcleritis?

A

Common, associated with gout. Recurrent, self limiting. Nodules may occur

36
Q

What is associated with Scleritis?

A

Systemic vasculitides e.g. RA, Wegener’s. Uveitis common

37
Q

What are the key features of scleritis?

A

Very painful, injection of deep vascular plexus (violaceous hue)

38
Q

How is scleritis identified?

A

Phenylephrine test

39
Q

How is episcleritis treated?

A

Self limiting, lubricants/topical NSAIDs, mild steroids

40
Q

How is scleritis treated?

A

Oral NSAIDs, Oral Steroids, steroid sparing agents

41
Q

Why does IOP rise acutely in closed angle glaucoma?

A

Drainage angle being closed (pupil dilatation precipates it)

42
Q

How will acute closed angle glaucoma present?

A

Severe pain and nausea. Circumcorneal injection, cornea cloudy (oedematous), pupil mid dilated, eye stony hard

Ophthalmology (11 decks)

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