The "red eye" Flashcards
1
Q
Chemical burn
A
- true ocular emergency
- Alkali more serious than acid (goes deeper and causes more scarring)
- requires immediate irrigation (even before reaching the office)
- after irrigation tx with cyclopeglic, topical abx, possible patching, referral
- want to dilate eye to decrease pain and inflammation
2
Q
Non traumatic red eye
A
- conjunctivitis
- iritis (uveitis)
- corneal inflammation / infection
- subconjunctival hemorrhage vs. hyphema
- ectropion vs. entropion
- episcleritis vs. scleritis
3
Q
Conjunctivitis
A
- allergic, viral, or bacterial
- description of symptoms (red, itching, watery is allergic)
- hx of contact lens use
4
Q
Allergic conjunctivitis
A
- acute vs. chronic
- sx: red, watery eyes, itching, little to no discharge
- clinic signs: mild to moderate injection, mild chemosis, papillae
- tx: lubricants, antihistamines, more severe steroids
- vernal: severe form of allergic, most common in young males, have to have steroids as it can cause permeate scarring
5
Q
Viral conjuctivitis
A
- “pink eye”
- most commonly associated w/ the adneo virus
- highly contagious (epidemic keratoconjunctivitis)
- moderate to severe redness, sensitivity to light, watery to yellow discharge (matting shut), follicles
- tx: lubricants, antihistamines, NSAID, steroids
- if they need steroids they need to see an eye doctor for them (need to monitor IOP)
6
Q
Bacterial conjunctivitis
A
- moderate to severe redness, moderate to severe papillae, mucus discharge (green and goopy)
- can be caused by STD (gonorrhea, chlamdyia)
- tx: abx drops and ointments. In severe cases oral abx
7
Q
Giant Papillary Conjunctivitis (GPC)
A
- large papillae
- multiple bumps on inner upper eyelid
- associated with contact lens use
- when they take contacts out they feel like there are boulders in their eyes
- tx: change in contact lens material or discontinue. Topical steroids
8
Q
Iritis or Uveitis
A
- inflammation of anterior chamber
- painful red eye, possible reduced vision, sensitivity to light
- causes: recent trauma, idiopathic, autoimmune
- can cause permanent vision (scarring)
- Can become chronic, must treat underlying inflammation
- can increase risk of glaucoma and cataracts (b/c we tx with steroids)
- tx: cyclopegic, topical steroid
- careful monitoring for recurrence
9
Q
Hemorrhage
A
- subconjunctival: blood in sclera, self limiting, NO PAIN, NO CHANGE IN VISION, commonly associated w/ use of blood thinners (heals on its own) - redness in one area
- hyphema: blood anterior chamber. associated w/ recent trauma, can AFFECT VISION AND CAN BE PAINFUL ( will not heal on its own) - redness all around
10
Q
Subconjunctival hemorrhage tx
A
- self limiting: will resolve in a week to 10 days
- if on blood thinners more like 14 days
- monitor for changes in vision
11
Q
Hyphema tx
A
- can loss vision
- cyclopelgics, topical steroids,
- bedrest at 30 degree angle w/ shield
- must monitor for increased IOP
- monitored every 24 hours for first 5 days
- may need surgical intervention
12
Q
Ectropion vs. Entropion
A
- Ectropion: loss of lid laxity (or trauma) lower eyelid ROLLS OUT. Constant watering.
- Entropion: loss of lid laxity (trauma or congenital), lower eyelid ROLLS INWARD, constant FB sensation
- both cause red irriated eyes. In severe cases can cause corneal scarring and reduce vision - will require surgical intervention
13
Q
Episcleritis
A
- inflammation of tissue between conjunctiva and sclera (superficial)
- generalized localized redness, mild soreness, no discharge
- can be associated with systemic inflammatory conditions
- tx with topical steroids
14
Q
Scleritis
A
- inflammation of sclera (deeper tissue)
- more diffuse redness, photophobia, deep boring pain
- almost always associated with a systemic inflammatory condition
- acute: tx with systemic steroids, but need to tx underlying condition (rheumotology)
15
Q
Episcleritis vs Scleritis
A
- Episcleritis: focalized area of redness, can move eye, little pain
- Scleritis: diffuse redness, not able to move eye, very painful
