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Ophthalmology > The Red Eye > Flashcards

The Red Eye Flashcards

1
Q

What are the main causes of red eye?

A
  1. Conjunctivitis
  2. Keratitis
  3. Anterior uveitis
  4. Scleritis/episcleritis
  5. Acute angle closure glaucoma
  6. Subconjunctival haemorrhage
  7. Orbital disease such as cellulitis
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2
Q

What is the most common cause of red eye?

A

Conjunctivitis

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3
Q

Damage to which glands will lead to eye film disruption?

A

Meibomian

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4
Q

In which two ways are lacrimal glands most commonly damaged?

A
  1. Sjogrens syndrome
  2. Radiotherapy
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5
Q

Where is deep pain within the eye sometimes referred?

A
  1. Head
  2. Brow
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6
Q

Mucoid stringy discharge from the eye is associated with which cause?

A

Allergic cause

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7
Q

The use of contact lenses predisposes the wearer to which type of infection at a much higher rate than non-wearers?

A

Acanthomeba

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8
Q

How can an acanthamoeba infection within the eye be treated?

A

Chlorhexidine ophthalmic drops (antiseptic)

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9
Q

Acanthamoeba causes which condition within the eye?

A

Keratitis

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10
Q

When balloting the upper conjunctival fornix how will it feel if the patient has glaucoma?

A

Stony hard

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11
Q

What is blepharitis?

A

Inflamed eyelids

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12
Q

What is the difference between anterior and posterior blepharitis?

A

Anterior - lid margin is redder then the deeper part of the lid

Posterior - Lid margin often looks quite normal yet the deep aspect is inflamed

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13
Q

What causes anterior blepharitis?

A
  1. Staphylococcal infection involving the lash follicle
  2. Seborrheic scales on the eyelashes
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14
Q

What causes posterior blepharitis?

A

Meibomian gland dysfunction

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15
Q

How does blepharitis often feel to the patient?

A
  1. Dry, gritty eyes
  2. Foreign body sensation
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16
Q

What are the signs for seborrheic blepharitis?

A
  1. Lid margin red
  2. Scales
  3. Dandruff
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17
Q

Why is dandruff a sign for seborrheic blepharitis?

A

There is an association with seborrheic dermatitis which causes oily flaky skin

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18
Q

What is the term given to eyelashes which are ingrowing?

A

Trichiasis

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19
Q

What are the main signs for a staphylococcal blepharitis?

A
  1. Lid margin red
  2. Distorted lashes and trichiasis
  3. Styes, ulcers of lid margin
  4. Corneal staining, margin ulcers (exotoxin induced)
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20
Q

Posterior blepharitis, or meibomian gland disease, has a strong association with which other condition?

A

Rosacea

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21
Q

How is meibomian gland disease generally treated?

A

Long term, low dose tetracycline

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22
Q

What happens if a meibomian cyst does not resolve itself after 3 months?

A

Incision and drainage

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23
Q

What are the causes for infective conjunctivitis?

A
  1. Viral
  2. Bacterial
  3. Chlamydial
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24
Q

If conjunctivitis is associated with an itch it is most likely to be due to what?

A

Allergy

25
Q

Rice grain follicles are associated with which cause of conjunctivitis?

A

Chlamydial/viral

26
Q

Small circular papillae which are red in the centre and found on the inside of the eyelids are associated with which cause of conjunctivitis?

A

Bacterial

27
Q

What are the most common organisms to cause bacterial conjunctivitis in adults?

A
  1. S. aureus
  2. S. pneumoniae
  3. H. influenzae
28
Q

A red sticky eye is most associated with which cause for conjunctivitis?

A

Bacterial

29
Q

What often preceeds a viral conjunctivitis?

A

URTI

30
Q

What can induce a follicular conjunctivitis?

A
  1. Viral causes
  2. Chlamydial
  3. Drugs (propine, trusopt)
31
Q

Why should patients be encouraged not to rub their eyes with a viral conjunctivitis?

A

Corneal abraision is likely

Increases chances of dendritic ulcer formation

32
Q

What can lead to chemosis?

A
  1. Allergy
  2. Aggressive viral conjunctivitis
33
Q

If a cornea has an “ice rink” appearance, where is it important to look?

A

Underneath the eyelids for a foreign body

34
Q

Where in the world are fungal corneal ulcers most common?

A
  1. Sub-Saharan Africa
  2. South-east asia
35
Q

Why do many autoimmune reactions involve corneal inflammation?

A

Immune complexes can easily become trapped in the extracellula rmatric of the peripheral cornea causing an immune reaction

36
Q

Which type of red eye is associated with corneal ulcers amongst other conditions?

A

Ciliary flush

37
Q

How can a dendritic ulcer produced by herpes simplex be differentiated by one produced by herpes zoster?

A

Terminal bulbs are found at the end of branches for H.simplex

38
Q

Which infective causes can cause corneal ulcers?

A
  1. Viral
  2. Bacterial
  3. Fungal
  4. Acanthomeba
39
Q

Which other non-infective causes are there for corneal ulcers?

A
  1. Exposure keratitis
  2. Keratoconjunctivitis sicca
  3. Neurotrophic keratitis
  4. Vitamin A deficiency
40
Q

A vitamin A deficiency may eventually lead to what?

A

Corneal perforation

41
Q

Where in the world is vitamin A deficiency most common?

A

South east Asia

(high rice intake which has low vit A)

42
Q

What are two major causes for exposure keratitis?

A
  1. Proptosis associated with thyroid eye disease
  2. Bell’s palsy (CN VII palsy, may causes eyes to remain open)
43
Q

How is H. simplex keratitis treated?

A

Aciclovir

(5x daily, 7-10 days)

44
Q

Which autoimmune conditions are associated with anterior uveitis, and which has the highest association?

A
  1. Ankylosing spondylitis (most common)
  2. Reiter’s
  3. Ulcerative colitis
  4. Sarcoidosis
45
Q

What are four key causes for infective anterior uveitis?

A
  1. Tb
  2. Syphilis
  3. Herpes simplex
  4. Herpes zoster
46
Q

Which type of pain is associated with anterior uveitis?

A

Dull ache

47
Q

What are the main clinical signs for anterior uveitis?

A
  1. Ciliary injection
  2. Cells and flare
  3. Keratic precipitates
  4. Hypopyon
  5. Synechiae (small/irregular pupil)
48
Q

How can anterior uveitis be treated?

A

Topical steroids

49
Q

Episcleritis is associated with which other condition?

A

Gout

50
Q

Which condition is more serious, episcleritis or scleritis?

A

Scleritis

51
Q

Episcleritis is painful

True or false?

A

Not usually painful

52
Q

Scleritis has associations with which other conditions?

A

Rheumatoid arthritis

Granulomatosis with polyangiitis

Anterior uveitis

53
Q

Scleritis has which unique clinical sign?

A

Eyes have blueish/purple tinge best seen in daylight

(due to injection of deep vascular plexus)

54
Q

How can episcleritis and scleritis quickly be differentiated?

A

Episcleritis will blanch, scleritis will not

55
Q

How can episcleritis be treated?

A
  1. Topical NSAIDs
  2. Lubricants
  3. Mild steroids
56
Q

How can scleritis be treated?

A

Oral NSAIDs

Oral steroids

Steroid sparing agents e.g. DMARDs

57
Q

What precipitates acute closed angle glaucoma?

A

Pupil dilatation

58
Q

How do patients with acute closed angle glaucoma present?

A
  1. Nausea
  2. Vomiting
  3. Eye stony hard
  4. Severe pain

Ophthalmology (15 decks)

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