The Red Eye Flashcards
What do the meibomian glands secrete?
Meibum, an oily substance that prevents evaporation of the eye’s tear film.
What do tears do/contain?
Help with blinking, trap mucous. Lysozyme, IgA, IgG, complement
What is found on the lashes in anterior seborrhoeic blepharitis?
Seborrhoeic (squamous) scales
What distinct bacteria can often cause anterior blepharitis due to an infection involving the lash follicle?
Staphylococcal
In anterior blepharitis how does the lid margin compare to the deeper part of the lid?
It will be redder
What is posterior blepharitis due to?
Meibomian gland dysfunction (MGD)
In posterior blepharitis how does the lid margin compare to the deeper part of the lid?
Margin is normal, redness in deeper part of lid
What are the symptoms of blepharitis?
Similar to conjunctivitis, gritty eyes, foreign body sensation, mild discharge
What is blepharitis associated with?
Conjunctivitis, keratitis (Marginal, SPK), episcleritis
What are the signs in seborrhoeic anterior blepharitis?
Lid margin red, scales, dandruff, (no ulceration, lashes unaffected)
What are the signs in staphylococcal anterior blepharitis?
Lid margin red, lashes distorted, loss of lashes, ingrowing lashes (trichiasis), styes, ulcers of lid margin, corneal staining, marginal ulcers (due to exotoxin)
What are the clinical features in posterior blepharitis?
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%)
What is the treatment for blepharitis?
Lid hygiene-daily bathing/warm compresses. Supplementary tear drops, oral doxycycline for 2-3 months
What can cause conjunctivitis?
Infective-viral, bacterial, chlamydial. Allergic, chemical/drugs, skin diseases-eczema
What are the symptoms of conjunctivitis?
Red eye, foreign body sensation-gritty eye, discharge, itch=allergy. Vision unaffected
What are the signs of conjunctivitis?
Red eye-diffuse more towards the fornices. Discharge-serous or mucopurulent. Papillae or follicles, sub conj. haemorrhage, chemosis, pre-auricular glands swollen
What are key features of acute bacterial conjunctivitis?
Red sticky eye, papillae, self limiting-2wks (topical antibiotics clear faster)
What organisms most commonly cause acute bacterial conjunctivitis?
Staph aureus, Strep pneumoniae, H influenzae
What causes follicular conjunctivitis?
Viral-adenovirus, HSV, HZV. Chlamydial. Drugs - propine, trusopt
What can often lead to chronic conjunctivitis?
Blepharitis, chlamydial infection, keratoconjunctivitis sicca, lacrimal disease (chr. dacryocystitis), sensitivity to topical glaucoma medication, sub-tarsal foreign body
What can cause central corneal ulcers?
Viral, fungal, baterial, acanthamoeba
What can cause peripheral (AI) corneal ulcers?
RA, hypersensitivity e.g. marginal ulcers. (Rarely wegener;s, polyarteritis etc)
What is examined in keratitis examination?
Anaesthetics if photophobic. Corneal reflex, use of fluorescein, vascularisation, opacity, oedema
What are the symptoms of corneal ulcers?
Pain-needle like severe (herpes virus affects sensation), photophobia, profuse lacrimation, vision may be reduced, red eye-circumcorneal
