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2 Ophthalmology > The Red Eye > Flashcards

The Red Eye Flashcards

1
Q

common causes of a red eye

A 
Conjunctivitis 
Keratitis 
Anterior uveitis 
Scleritis/epscleritis 
Acute angle closure glaucoma 
Subconjunctival haemorrhage 
Orbital disease
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2
Q

what is a subconjunctival haemorrhage

A

look v dramatic but just a blood blister

blood vessel bleeds under conjunctiva - has little or no consequence

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3
Q

what is orbital cellulitis

A

inflammation of the tissues behind the orbital septum

most commonly caused by infection from the sinuses

causes permanent vision loss and can spread to the brain

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4
Q

what immune defences does the eye have

A

eye lids
tears
conjunctivae (mucous)
epithelium (conjunctiva/corneal)

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5
Q

where are tears produced

A

lacrimal glands

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6
Q

what does an ache in the eye usually suggest

A

an intraocular problem

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7
Q

what does an itch in the eye usually suggest

A

allergy

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8
Q

what does dryness/grittiness/foreign body sensation suggest

A

problem with the surface of the eye

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9
Q

what examination can you do to quickly determine if there is raised IOP

A

Bllotting- eye feels ‘stony hard’

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10
Q

what is blepharitis

A

inflamed eyelids

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11
Q

what are the two types of anterior blepharitis

A

seborrhoeic (oily skin flakes causing irritation)

staphylococcal (infection involving lash follicle)

both give a v red lid margin

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12
Q

what is anterior blepharitis

A

Meibomian gland dysfunction

the redness is in the deeper part of the lid and the lid margin looks normal

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13
Q

symptoms of blepharitis

A

gritty eyes
foreign body sensation
mild discharge

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14
Q

signs of seborrhoeic blepharitis

A

red lid margin
scales ++
Dandruff +
(no ulceration, lashes unaffected)

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15
Q

signs of 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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16
Q

signs of posterior blepharitis

A

lid margin skin and lashes unaffected

meibomian glad openings pouting and swollen

dried secretion at gland

meibomian cysts

associated with acne rosacea

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17
Q

treatment for blepharitis

A

lid hygiene - daily bathing/warm compress
Supplementary tear drops
Oral doxycycline for 2-3 months

v difficult to irradiate

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18
Q

what are the types of infective conjunctivitis

A

viral
bacterial
chlamydial

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19
Q

what are the non-infective types of conjunctivitis

A

allergic
chemical/drugs
skin diseases - eczema

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20
Q

symptoms of conjunctivitis

A

red eye
foreign body sensation - gritty eye
discharge- sticky eye
itch (allergy)

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21
Q

signs of conjunctivitis

A 
red eye (redness is diffuse more towards fornices (top and bottom))
discharge 
papillae or follicles 
sub conjunctival haemorrhage 
chemises (oedema) 
pre-auricular glands (if viral)
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22
Q

how long does it take for acute bacterial conjunctivitis to clear on its own

A

14 days

23
Q

what are the most common causative organisms for bacterial conjunctivitis

A

staph azures
strep pneumoniae
h.influenza

24
Q

what causes follicular conjunctivitis

A

chlamydia

25
Q

what viruses can cause conjunctivitis

A

adenovirus
herpes simplex
herpes zoster

26
Q

what is chemosis

A

conjunctival oedema

27
Q

what are the layers of the cornea

A

epithelium
stroma
endothelium

28
Q

where on the cornea do infective ulcers lie

A

centrally

29
Q

what causes infective corneal ulcers

A

viral
fungal
bacterial
ancanthamoeba

30
Q

where on the cornea do autoimmune ulcers lie

A

peripherally

31
Q

causes of autoimmune corneal ulcers

A

rheumatoid arthritis

hypersensitivity eg. marginal ulcers

32
Q

symptoms of corneal ulcers

A 
pain (needle like and severe)
photophobia 
produce lacrimation 
reduced vision 
circumcorneal redness
33
Q

when might not you feel the pain of a corneal ulcer

A

if it is the herpes virus (this affects the corneal nerves)

34
Q

signs of a corneal ulcer

A 
Circumcorneal redness
Abnormal corneal reflex 
Corneal opacity 
Staining with fluorescein 
Hypopyon
35
Q

what can cause exposure keratitis

A

thyroid eye disease
VII palsy

(can’t close lid, this can lead to a corneal ulcer)

36
Q

what can cause keratoconjunctivitis sicc

A

sjogrens

can lead to a corneal ulcer

37
Q

what causes neurotrophic keratitis

A

Herpes zoster

38
Q

what vitamin deficiency can cause a corneal ulcer

A

vitamin A

39
Q

how do you treat a corneal ulcer

A

Corneal scrape for gram stain and culture to determine cause

antimicrobial if antibiotic (eg, hourly ofloxacin)

antiviral if herpetic (aciclovir ointment 5x day)

anti-inflammatory if autoimmune
(oral/topical steroids)

40
Q

what can cause anterior uveitis

A

autoimmune disease
infections
malignancy (leukaemia)
other (idiopathic, trauma act)

41
Q

what are some autoimmune causes of anterior uveitis

A

Reiter’s
Ulcerative Colitis
Ankylosing spondylitis
Sarcoidosis

42
Q

what are some infective causes of anterior uveitis

A

TB
Syphylis
Herpes simplex
Herpes zoster

43
Q

symptoms of anterior uveitis

A

pain
reduced vision
photophobia
red eye (circumcorneal)

44
Q

signs of anterior uveitis

A 
ciliary injection 
cells and flared in anterior chamber 
keratin precipitates 
hypopyon 
small or irregular pupil (synechiae)
45
Q

treatment for anterior uveitis

A

topical steroids
mydriatics
investigate for systemic associations

46
Q

what is episcleritis

A

superficial inflammation of the sclera - self limiting but recurrent

47
Q

what is episcleritis commonly associated with

A

gout

48
Q

what is scleritis

A

serious disease deeper in the sclera

49
Q

symptoms/signs of scleritis

A

v painful
association with vasculitis (Rh arthritis, Wegners)
Injected deep vascular vessels
associated with uveitis

50
Q

what is the phenylephrine test used for

A

to differentiate between episcleritis and scleritis

51
Q

how do you treat episcleritis

A

it is self limiting

lubricant
topical NSAIDS
mild steroids

52
Q

How do you treat scleritis

A

oral NSAIDS
oral steroids
Steroid sparing agents

53
Q

signs/symptoms of acute closed angle glaucoma

A 
severe pain 
acute onset nausea and vomiting 
Circumcorneal injection 
Cornea cloudy 
Pupil mid dilated 
Eye stony hard

2 Ophthalmology (16 decks)

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