The Red Eye, Cataracts and Corneal Transplantation Flashcards
less serious ddx of red eye
- corneal abrasion or erosion
- dry eye
- chalazion
- subconjunctival hemorrhage
- nasolacrimal duct obstruction
- pterygium
- conjunctivitis
more serious ddx of red eye
- Preseptal Cellulitis
- Orbital Cellulitis
- Narrow angle glaucoma
- Uveitis
- Scleritis
- Bacterial keratitis
Corneal abrasion or erosion
- Very painful due to extensive innervation in the cornea.
2. Pts have history of trauma or contact lens wear.
Dry eye
- Pts present with photophobia and sensation of a foreign body in the eye.
- May be diagnosed with Fluorescein staining.
Chalazion
- Localized swelling and tenderness of eyelid
- due to infection/inflammation of meibomian glands
(sebaceous glands of the eyelid)
Subconjuctival hemorrhage
Common, benign problem in which blood vessels within the conjunctiva rupture after sneezing, coughing, eye rubbing, etc.
Naso-lacrimal duct obstruction
Leads to excess tearing and ocular discharge.
Pterygium
- UV-induced benign fibrovascular tumor resulting in elastoid degeneration and a wrinkle that forms over the cornea.
- May lead to pronounced astigmatism.
types of Conjunctivitis
- bacterial
- viral
- neonatal
- chronic
- allergic
Bacterial conjunctivitis:
presents with redness and distinct mucopurulent discharge.
Viral conjunctivitis
(most common) presents with photophobia, redness, watery discharge, and swollen pre-auricular lymph nodes.
Neonatal conjunctivitis
(viral or bacterial) is rare, but serious.
Chronic conjunctivitis
(>2 wks.)
often caused by chlamydiae or toxic causes such as neomycin or vasoconstrictors.
Allergic conjunctivitis
presents bilaterally with itchy eyes, redness, chemosis and mucopurulent discharge.
Preseptal Cellulitis
- Inflammation of lids with elevated temp and WBC.
- Common in children.
- Treated with abx unless pt. is a neonate…then hospitalize.
Orbital Cellulitis
- Inflammation of tissues around the eye resulting in decreased vision, proptosis, abnl papillary response and optic disc swelling.
- More serious than preseptal cellulitis.
- Common in children.
narrow angle glaucoma
- A true ocular emergency!
- Narrow angle between iris and cornea prevents fluid drainage leading to rapid increase in intraocular pressure.
- Anatomic predisposition.
narrow angle glaucoma signs
- severe pain
- HA
- n/v
- halo around lights.
uveitis
Inflammation of anterior chamber of eye associated with collagen vascular or autoimmune diseases.
uveitis signs
- photophobia
- floaters
- pain
- decreased vision.
scerlitis
- Very painful
- associated with decreased vision.
- Often associated. with collagen vascular diseases.
Bacterial keratitis
- Ocular emergency!
2. History of trauma or contact lens wear.
Bacterial keratitis signs
- pain
- photophobia
- decreased vision
- White spot on cornea corresponding to infection and accumulation of WBCs.