Uncommon but serious ophthalmology

Question 1

STUFF ON

Answer 1

THYROID EYE DISEASE 
HERPES SIMPLEX 
CORNEAL ULCERS 
MORE 
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Question 2

What are some urgent referrals for suspected serious causes of red eye?

Answer 2

Acute glaucoma

Corneal ulcer, contact lens-related red eye and corneal foreign body (refer anyone with contacts with red eye)

Anterior uveitis

Scleritis

Trauma, such as penetrating eye injury or high-velocity foreign body

Chemical injuries

Neonatal conjunctivitis -discuss with paediatrics or ophthalmology depending on clinical judgement

Question 3

What are some red flag signs and symptoms when assessing a red eye?

Answer 3

Reduced visual acuity

Deep pain within the eye

Unilateral red eye

Contact lens use

Photophobia - can be a symptom of acute uveitis, corneal ulcer, contact lens-related red eye or corneal foreign body, systemic causes e.g. meningitis

All high-velocity injuries (for example injuries occurring while hammering or chiseling), or injuries involving glass

Chemical eye injury

Ciliary injection - seen in corneal ulcer, contact lens related red eye, corneal foreign body and anterior uveitis

Fluorescein staining - can indicate corneal ulcer or abrasion

Unequal or misshapen pupils, or abnormal pupillary reactions - seen in acute glaucoma and anterior uveitis

Pain on pupillary constriction - can be elicited on testing the direct light reaction, consensual light reaction or finger-to-nose convergence test

Conjunctivitis in an infant in the first 28 days of life