The Red Eye, Cataracts and Corneal Transplantation

Question 1

less serious ddx of red eye

Answer 1

1. corneal abrasion or erosion
2. dry eye
3. chalazion
4. subconjunctival hemorrhage
5. nasolacrimal duct obstruction
6. pterygium
7. conjunctivitis

Question 2

more serious ddx of red eye

Answer 2

1. Preseptal Cellulitis
2. Orbital Cellulitis
3. Narrow angle glaucoma
4. Uveitis
5. Scleritis
6. Bacterial keratitis

Question 3

Corneal abrasion or erosion

Answer 3

1. Very painful due to extensive innervation in the cornea.

2. Pts have history of trauma or contact lens wear.

Question 4

Dry eye

Answer 4

1. Pts present with photophobia and sensation of a foreign body in the eye.
2. May be diagnosed with Fluorescein staining.

Question 5

Chalazion

Answer 5

1. Localized swelling and tenderness of eyelid
2. due to infection/inflammation of meibomian glands
   (sebaceous glands of the eyelid)

Question 6

Subconjuctival hemorrhage

Answer 6

Common, benign problem in which blood vessels within the conjunctiva rupture after sneezing, coughing, eye rubbing, etc.

Question 7

Naso-lacrimal duct obstruction

Answer 7

Leads to excess tearing and ocular discharge.

Question 8

Pterygium

Answer 8

1. UV-induced benign fibrovascular tumor resulting in elastoid degeneration and a wrinkle that forms over the cornea.
2. May lead to pronounced astigmatism.

Question 9

types of Conjunctivitis

Answer 9

1. bacterial
2. viral
3. neonatal
4. chronic
5. allergic

Question 10

Bacterial conjunctivitis:

Answer 10

presents with redness and distinct mucopurulent discharge.

Question 11

Viral conjunctivitis

Answer 11

(most common) presents with photophobia, redness, watery discharge, and swollen pre-auricular lymph nodes.

Question 12

Neonatal conjunctivitis

Answer 12

(viral or bacterial) is rare, but serious.

Question 13

Chronic conjunctivitis

Answer 13

(>2 wks.)

often caused by chlamydiae or toxic causes such as neomycin or vasoconstrictors.

Question 14

Allergic conjunctivitis

Answer 14

presents bilaterally with itchy eyes, redness, chemosis and mucopurulent discharge.

Question 15

Preseptal Cellulitis

Answer 15

1. Inflammation of lids with elevated temp and WBC.
2. Common in children.
3. Treated with abx unless pt. is a neonate…then hospitalize.

Question 16

Orbital Cellulitis

Answer 16

1. Inflammation of tissues around the eye resulting in decreased vision, proptosis, abnl papillary response and optic disc swelling.
2. More serious than preseptal cellulitis.
3. Common in children.

Question 17

narrow angle glaucoma

Answer 17

1. A true ocular emergency!
2. Narrow angle between iris and cornea prevents fluid drainage leading to rapid increase in intraocular pressure.
3. Anatomic predisposition.

Question 18

narrow angle glaucoma signs

Answer 18

1. severe pain
2. HA
3. n/v
4. halo around lights.

Question 19

uveitis

Answer 19

Inflammation of anterior chamber of eye associated with collagen vascular or autoimmune diseases.

Question 20

uveitis signs

Answer 20

1. photophobia
2. floaters
3. pain
4. decreased vision.

Question 21

scerlitis

Answer 21

1. Very painful
2. associated with decreased vision.
3. Often associated. with collagen vascular diseases.

Question 22

Bacterial keratitis

Answer 22

1. Ocular emergency!

2. History of trauma or contact lens wear.

Question 23

Bacterial keratitis signs

Answer 23

1. pain
2. photophobia
3. decreased vision
4. White spot on cornea corresponding to infection and accumulation of WBCs.