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Opthalmology > The Red Eye and Adnexal Oncology > Flashcards

The Red Eye and Adnexal Oncology Flashcards

1
Q

Presentation of acute closed angle glaucoma

A 
Extreme, deep, dull pain 
Red eye
Sudden onset 
Visual loss - visual field changes 
Fixed dilated pupil 
Systemically very unwell and vomiting
Hard eye 
Cloudy / steamy cornea
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2
Q

Possible symptoms along with a red eye

A 
Blurred vision / affected vision 
Pain 
Itching
Discharge
Watery / excess tear production
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3
Q

Who is at a higher risk of closed angle glaucoma?

A

Inuits

Older age

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4
Q

Which of a constricted or dilated pupil would result in a smaller angle and therefore lead to CAG?

A

A dilated pupil

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5
Q

What should be done if an older patient presents with vomiting?

A

Check the eyes

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6
Q

Who is rubiotic glaucoma seen in?

A

DM

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7
Q

What is glaucoma?

A

Damage to the optic nerve due to with or without raised IOP

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8
Q

What does IOP stand for?

A

Intraocular pressure

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9
Q

How is normal IOP maintained? What would increased IOP do to this?

A

Pump in the cornea is on the endothelium of the eye
Pumps water out and maintains arrangement of collagen / proteins
Raised IOP would displace them and cause hazy vision

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10
Q

What prodromal symptoms are seen in someone with threatening glaucoma?

A

Halos and lights in the evening

Intermittent evening headaches

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11
Q

What is the conjunctiva?

A

A translucent membrane that carries blood vessels

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12
Q

How can conjunctivitis be passed onto a baby from mum?

A

Vaginally

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13
Q

Why is it important to diagnose congenital conjunctivis?

A

Can penetrate through the cornea and can result in bilateral blindness

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14
Q

Types of conjunctivis

A

Viral
Bacterial
Allergic

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15
Q

How can someone get conjunctivitis?

A

Direct contact
Newborns; vaginally
Chlamydia infection
Flies

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16
Q

What causative organism causes newborn conjunctivis?

A

Gonococcus bacteria

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17
Q

What presentation would indicate conjunctivitis caused by chlamydia?

A

UNILATERAL conjunctivitis > 2 weeks

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18
Q

What virus usually causes conjunctivitis?

A

Adenovirus

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19
Q

How long does a corneal abrasion take to heal?

A

48 hours

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20
Q

Pathology of a corneal abrasion

A

Removal of corneal epithelium
Has not gone through to stroma
NO infiltrates

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21
Q

Presentation of corneal abrasion

A

Very painful - stingy pain

Feeling of something in eye

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22
Q

What should always be checked for in a corneal abrasion?

A

Under the eyelid for a foreign body

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23
Q

Causes of corneal ulcer / keratitis

A 
Autoimmune
Bacterial 
Viral 
Fungal 
Amoeba 
Irritant
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24
Q

Pathology of keratitis / corneal ulcer

A

Penetration of stroma

White infiltrates

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25
Q

Causative organisms of viral corneal ulcers

A

HSV

HZV

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26
Q

Who gets fungal corneal ulcers?

A

Immunosuppressed

Hot tropical countries

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27
Q

Pathology of irritant corneal ulcers

A

Oil not being produced so bacteria build up and production of by products by them causing the irritation

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28
Q

Is there infiltrates in corneal ulcers?

A

Yes, white infiltrates

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29
Q

What is a lesion near the outside of the cornea called?

A

Near the limbus

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30
Q

What is the lesion near the middle of the cornea called?

A

Visual access

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31
Q

In shingles what comes first, the pain or the rash?

A

Pain

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32
Q

What happens if have shingles in V1?

A

Usually starts on the scalp then moves to the eye, so check them then look at the cornea for microdendrites

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33
Q

What is a feature of a viral corneal ulcer?

A

Dendrites

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34
Q

Where is the blood supply to the deeper part of the eye found?

A

Limbus

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35
Q

What do floaters indicate?

A

The back of the eye

36
Q

Are all blephritis red eyes?

A

No, it is a spectrum

37
Q

What is blephritis?

A

Inflammation of the ridges of the eyelids

38
Q

What does the uvea consist of?

A

Iris
Ciliary body
Choroid

39
Q

Presentation of iritis / anterior uveitis

A

Acute
Red eye ; centrally around cornea at limbus
Deeper pain
Small and irregular pupil; lens and iris getting stuck as iris gets stuck when inflamed
Hazy vision / floaters
Photosensitivity / photophobia
Accommodative pain e.g. looking up close, at light etc

40
Q

What may patients get with a corneal problem?

A

Light sensitivities

41
Q

Presentation of a subconjunctival haemorrhage

A

Red eye
Stingy
A lot of coughing
Can look very serious

42
Q

How long does a subconjunctival haemorrhage take to resolve? Does it need treatment?

A

2 - 3 weeks

Not usually requiring Tx

43
Q

Is a subconjunctival haemorrhage serious?

A

No it is fine but can look very serious

44
Q

What is a retrobulbar haemorrhage?

A

Haemorrhage at the back of the eye in the retrobulbar space which tracks forward
Can lead to compartment syndrome at back of eye

45
Q

Causes of retrobulbar haemorrhage

A

Anticoagulation e.g. warfarin
Trauma
Complication of eye / orbital surgery
AV malformations

46
Q

Presentation / pathology of retrobulbar haemorrhage

A 
Increased IOP -> damage to optic nerve 
Diplopia
- muscles dying
- optic nerve dying 
- no room for the eyeball to move
47
Q

Function of the sclera

A

Attachment to muscles

Structural

48
Q

Pathology of scleritis

A

Sclera melts

Loss of structure of the eye

49
Q

Is scleritis serious?

A

Yes

50
Q

What condition is scleritis associated with?

A

RA

51
Q

Does scleritis always have a red eye?

A

Not if happens at the back of the eye

52
Q

Presentation of scleritis

A 
Extreme pain, wakes up from sleep 
Deep pain 
Pain on movement 
Redness - purple/funny coloured
Vision fine
53
Q

What colour would a very bad case of scleritis be at what would this be at risk of?

A

Black

Perforation

54
Q

Where does episcleritis effect?

A

Top of sclera

55
Q

Is episcleritis serious?

A

No

56
Q

Presentation of episcleritis

A

Sectorial red - bright red
Mild pain / no pain
Comes and goes

57
Q

What does phenylafferen do?

A

Constricts blood vessels

58
Q

Treatment of a chemical in the eye

A

Wash out very quickly

59
Q

If there is dust in the eye, what also needs to be done?

A

Wash on and under eyelid

60
Q

If an eye is burnt by a chemical, can It heal? Why?

A

No

As dont have the limbus rehealing pattern

61
Q

What is a hiphemia?

A

Layers of blood in the anterior chamber

62
Q

Types of trauma to the eye

A

Blunt force

Penetrating

63
Q

What is endoptholmitis?

A

An infected eye - inflammation of the intraocular fluids due to infection

64
Q

Causes of endoptholmitis?

A

Recent operations eg. glaucoma surgery, cataracts

65
Q

Presentation of endoptholmitis

A

Red eye
White pussy layer
Hipopiem

66
Q

Pathology of orbital cellulitis

A

Pus collecting and pushing forward

67
Q

Presentation of orbital cellulitis

A

Diplopia
Red eye
Systematically unwell
Meningitis

68
Q

What can occur secondary to the pus in orbital cellulitis?

A

Compartment syndrome

69
Q

What is looked at with optic disc changes?

A
  1. Visual acuity
  2. Pupils - RAPD
  3. Colour vision
  4. Visual fields
  5. Look at the disc
70
Q

What should the optic disc look like?

A

Pink / orange colour

Donut shaped - thick outer layer

71
Q

What does cupping of the optic disc indicate?

A

Glaucoma

72
Q

Over time what can chronic glaucoma cause damage to?

A

Optic nerve

73
Q

What visual defect can glaucoma lead to?

A

Arcing defects in visual fields

- tunnel vision

74
Q

Where is your blind spot?

A

On the optic nerve

75
Q

What is the normal pressure of the eye?

A

10 - 21 mmHg

76
Q

Most common cause of conjunctivitis? What does this often have a relevant history of?

A

Viral

Goes along often with URTI or sore throat

77
Q

Presentation of bacterial conjunctivitis

A

Thick profuse green discharge

Eye stuck together in morning

78
Q

Causes / associations of uveitis

A 
Syphillis
Lyme
Sarcoidosis
HLA - B27 conditions 
Connective tissue diseases
79
Q

What can happen to uveitis in someone with JIA? What is done due to this?

A

May have a very white eye

Screening is carried out as may have chronic uveitis

80
Q

In uveitis, what is found on the corneal epithelium?

A

Inflammatory cells

81
Q

Presentation of a dendritic ulcer

A

Pain
Red eye
Watery eye
Vision may be affected

82
Q

Cause of dendritic ulcer in the eye

A

HSV

83
Q

What is Hutchisons sign? What does it mean?

A

The tip of the nose is involved in shingles, then there is an increased chance the cornea is involved as they have a common innervation

84
Q

What is Marcus gunns pupil?

A

Relative afferent pupillary defect due to lesion before the optic chiasm

85
Q

How is Marcus gunns pupil diagnosed?

A

Swinging light test

86
Q

Findings of Marcus gunns pupil

A

Affected and normal eye appears to dilate when the light is shown on the affected eye

87
Q

Causes of Marcus gunns pupil

A

Retinal detachment

Optic neuritis

Opthalmology (8 decks)

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