The Red Eye Flashcards
Where does the infection in orbital cellulitis tend to spread from?
ethmoidal or frontal sinuses
What does an itchy eye indicate?
allergy
What infection typicallu affects contact lens wearers?
acanthomoeba
What drugs can cause dry eye?
oral anti-histamines; antipsychotics; beta blockers
What is redness at the limbus called?
ciliary flush
What does ciliary flush indicate?
inflammation of the cornea or iris
What is blepharitis?
inflamed eyelids
What are the 2 types of anterior blepharitis?
seborrhoeic (squamous) and staphylococcal
Where is the redness in anterior blepharitis?
lid margin
Where is the redness in posterior blepharitis?
deeper part of the lid
What causes of posterior blepharitis?
meibomian gland dysfunction
What is staphylocccal blepharitis?
infection involving the lash follicle
What are the symptoms of blepharitis?
gritty eyes; foreign body sensation; mild discharge
What other conditions is blepharitis associated with?
conjunctivitis; keratitis; episcleritis
What are the signs of seborrheic blepharitis?
lid margin red; scales and dandruff
What are the signs of staphylococcal blepharitis?
lid margin red; lashes distorted, loss of lashes and ingrowing lashes- trichiasis; styes corneal staining and marginal ulcers
what causes the corneal staining and marginal ulcers in anterior blepharitis?
exotoxin
What is the fucntion of the meibomian gland?
produces lipid serum
What are the signs of posterior blepharitis?
MG openings pouting and swollen; dried secretion at gland openings; meibomian cysts; redness deeper part of lid
What condition is posterior blepharitis associated with?
acne rosacea
What is the treatment for blepharitis?
lid hygiene- daily bathing/warm compresses; supplementary tear drops; doxycycline for 2-3 months
What is a stye?
an acute abscess of eye lash follicle
What are the infective causes of conjunctivits?
viral; bacterial and chlamydial
What are the other non-infective causes of conjunctivits?
allergic; chemical/drugs; skin disease-eczema
What is the pattern of red eye in conjunctivits?
diffuse, more towards fornices (gutter at bottom)
What are the symptoms of conjunctivitis?
red eye; rofeign body sensation-gritty eye; discharge; chemosis; papillae/follicles
What type of discharge do you get with viral conjunctivitis?
watery
what type of discharge do you get with bacterial conjunctivits?
sticky
What type of discharge do you get with allergic conjunctivits?
stringy
Is vision affected in conjunctivitis?
no, vision is not affected, if it is-not conjunctiviits
What is the difference between folllicles and papillae?
follicles are bigger and like grains of rice, papillae have a central red spot
What can cause pre-auricular glands?
viral and chlamydial
what are follicles associated with?
viral conjunctivitis (and chlamydia)
What are papillae associated with?
bacterial conjunctiviits
What usually precedes viral conjunctivitis?
URTI
What is chemosis?
oedema of the conjunctiva
What is the disease progression of acute bacterial conjunctivitis?
self limiting- 14 days
What organisms typically cause bacterial conjunctivitis?
staph. aureus; s. pneumoniae; H. influenzae
What viruses cause conjunctivitis?
adenovirus; herpes simplex; herpes zoster
What is herpes simplex conjunctivitis?
child with primary infection
What is V1 shingles called?
herpes zoster ophthalmicus
What are the 3 layers of the cornea?
epithelium; stroma; endothelium
What is Hutchison’s sign?
when the tip of the nose is affected by herpes zoster infection
What causes central corneal ulcers?
infective
What causes peripheral corneal?
autoimmune conditions
What is the most common cause of central corneal ulcer in non-contact lens wearers?
viral (herpetic)
What is the most common cause of cnetral corneal ulcer in contact lens wearers?
bacterial
Who gets acanthamoeba central ulcers?
contact lens wearers
Why do herpetic ulcers not cause pain?
infect the nerves
What causes marginal ulcers?
hypersensitivity
What is the pain like in corneal ulcers?
needle like severe pain
What are the symptoms of corneal ulcers?
pain; photophobia; profuse lacrimation; circumcorneal redness; abnormal corneal refelx; corneal opacity; hypopyon
What causes hypopyon in a corneal ulcer?
reactive accumulation of WBCs in anterior chamber
Where do autoimmune ulcers form?
at the limbus
What happens in an autoimmune corneal ulcer?
immune complexes at peripheral cornea release enzymes and can melt cornea
What is the treatment for bacterial corneal ulcer?
ofloxacin hourly
What is the treatment for herpetic corneal ulcer?
aciclovir
what is the treatment for AI corneal uclers?
steroids
What AI disease typically causes of anterior uveitis?
ankylosing spondylitis
What are the main causes of infective anterior uveitis?
herpes simpelx and zoster
What sinister condiition can cause anterior uvieitis?
leukaemia
Where can anterior uveitis pain be referred?
to brow
What type of pain is seen with anterior uveitis?
dull ache
What is synechiae?
small or irregular pupil
What are the signs of anterior uveitis?
pain; photophobia; decreased acuity; lacrimation (no sticky discharge); cirumcorneal redness; hypopyon
What causes synechiae?
initially iris spasm; later may be irrefular or filate irregularly due to adhnesions between lens and iris
What are the complications of anterior uveitis?
disruption flow of aqueous–glaucoma +/- adhesions bewteen iris and lens
What can be seen in the anterior chamber?
white cells- keratic precipitates (inflam cells on corneal endothelium)
What is the treatment for anterior uveitis?
topical steroids; mydriatics- prefent adgesions between lens and iris
What is episcelritis associated with?
association with gout
What is scleritis?
serious systemic vasculitides eg RA; Wegeners
What are the signs of scleritis?
very painful- injection of deep vacular plexus
What is often seen with episcleritis?
inflammatory nodule
What vessels are injected in scleritis?
deep vascular plexus
What test differentiates between scleritis and episcleritis?
phenylephrine test- episcleritis vessels blanch whereas in scleritis the vessels dont
What is the treatment for episcleritis?
lubricants; topical NSAIDs
What is the treatment for scleritis?
oral NSAIDs and steroids
What can be associated with scleritis?
uveitis
What type of glaucoma can cause red eye?
acute closed angle
What are the symptoms of acute closed angle glaucoma?
red eye-circumcorneal injection; severe apin and nausea; cornea cloudly; pupil mid dilated; eye stony hard
When should a red eye be referred?
if it affects vision or causes marked photophobia
