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BVetMed4 - Optho > The Red Eye > Flashcards

The Red Eye Flashcards

1
Q

How should you approach a patient with a red eye?

A

Where?
Where is the redness

What?
What structures can be found in this location

How?
Hoe can this structure become red

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2
Q

What can ocular redness be divided into?

A

Ocular coats/ adnexa
Iris hyperaemia
Intraocular bleed

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3
Q

What structures can become red?

A 
Eyelids
Conjunctiva
Third eyelid 
Cornea 
Anterior chamber 
Interior uvea
Posterior uvea/retina 
Retrobulbar area
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4
Q

What is the anterior uvea?

A

Iris and ciliary body

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5
Q

What is the posterior uvea?

A

Choroid

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6
Q

Describe your approach to red eyelids and what you might note?

A

Where: red periocular tissue
What: skin, Meibomian glands, conjunctiva
How : Hyperaemia, swelling, ulcers, crusts, hairloss

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7
Q

What are key differentials for eyelid redness?

A

Periocular dermatitis

Meibomian gland infection/inflammation/neoplasia

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8
Q

What other stuctures can be affected by eyelid irritation?

A

Cornea and tear film production, abnormal contact to ocular surface (hair, mass lesions etc)

Irratation of sclera - conjunctival hyperaemia

Corneal irritation - corneal neovascularisation and ulceration

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9
Q

What would you consider for third eyelid redness? What might you note?

A

Where: red ocular coats
What: Cartilage, lymphoid tissue, accessory lacrimal gland
How:
T-shape cartilage - can can curl and cause outward fold
Lymphoid tissue: large amount - prominent in young, allergies, some cat infections
AL gland - can prolapse + inflammation

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10
Q

What DDx should be considered for TEL hyperaemia and swelling?

A

Ocular surface disease

Orbital disease

TEL neoplasia

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11
Q

There are multiple small lumps on the inner side of the TEL. What is your main DDx ? What patients would you expect this in?

What other CS may accompany this ?

A

TEL Follicular proliferation

Young, allergies, some cat infections

Hyperaemia may be present

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12
Q

What is the colloquial term for a prolapsed nicitants gland?

A

Cherry eye

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13
Q

What presents very similarly to cherry eye?

how can you differentiate between the two?

A

Scrolled cartilage

Manipulate under topical anaesthesia

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14
Q

What would you consider for conjunctival redness? What might you note?

A

Where: red ocular coats

What: mm lining eyelids, third eyeling and sclera
- epithelium, goblet cells, lymphoid tissue
- BVs
How : hyperaemia, swelling, ulcers, lymphoid follicles

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15
Q

What can conjunctival hyperaemia be a sign of?

A

Ocular surface disease

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16
Q

What would you consider for episcleral/scleral redness? What might you note?

A

Where: red ocular coats

What: fibrous tunic of globe

  • collagen
  • BVs

How: hyperaemia and swelling

17
Q

What might scleral/episcleral hyperaemia indicate?

A

Deeper ocular tissue disease including intraocular

18
Q

How can you differentiate between conjunctival and episcleral hyperaemia?

A

Conjunctival - tortuous branching bright red Thinner most evident at FORNICES
- MOVE with conjunctiva

Episcleral - straight deep red thick
- STATIONARY
Most evident at limbus

19
Q

What are the four layers of the cornea?

A

Epithelium
Stroma
Descemet’s membrane
Endothelium

20
Q

When might you see conjunctival hyperaemia due to superficial corneal neovascularisation?

A

Ulcerative keratitis

Keratoconjunctivitis sicca (dry eye)

21
Q

What STT reading would you expect for dry eye?

A

LOW

22
Q

Compare the appearances of superficial and deep corneal neovascularisation

A

Superficial - long and branching like a tree

Deep - short, straight, usually stay close to the limbus - like a bush

23
Q

When might you see deep corneal neovascularisation?

A

Uveitis

Gaucoma

24
Q

What clinical signs are associated with uveitis?

A

Episcleral hyperaemia
Deep corneal neovascularisation
MIOSIS

LOW IOP

25
Q

What clinical signs are associated with glaucoma?

A

Episcleral hyperaemia
Deep corneal neovascularisation
MYDRIASIS

HIGH IOP

26
Q

What are the anatomical limits of the anterior chamber?

A

Cornea
Iris
Iridocorneal angle

27
Q

What causes iris hyperaemia?

A 
Uveal bleed 
Uveal tumour
Engorgement of normal vascularisation 
- usually 2ry to uveitis 
Iridal neovascularisation
28
Q

How would you investigate a red eye?

A

Complete op tho exam

  • Hands off
  • Hands on - outside to inside, diagnostics
  • BOTH eyes
29
Q

What diagnostics be used for red eye work up?

A

STT
Fluorescein
IOP measurement

30
Q

When are some diagnostics contraindicated?

A

Corneal or scleral rupture - FRAGILE EYE

BVetMed4 - Optho (8 decks)

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