What is the most common cause of red eye?
Name some common causes of red eye?
Conjunctivitis Scleritis Keratitis Uveitis Acute Closed Angle Glaucoma
What are two rarer (but very important) causes of red eye?
Subconjunctival Haemorrhage Orbital Disease (Eg: Cellulitis)
What is conjunctivitis?
Inflammation of the conjunctiva
What is keratitis?
Inflammation of the cornea
What is uveitis?
Inflammation of the uvea Uvea is composed of iris, ciliary body and choroid
Describe subconjunctival haemorrhage? Symptoms? Pain? Who does this affect? Treatment?
This is bleeding under the conjunctiva Asymptomatic Painless Usually in elderly patients (weaker vessels) who sneeze/cough/strain Goes away by itself
Describe orbital cellulitis? How does this occur? Signs and symptoms? Who does this affect? Treatment?
Inflammation of the soft tissues around the eye Often following sinus infection Causes swelling, redness, proptosis of eye Loss of vision Common in children Can be sight threatening Needs IV antibiotics and admission
What are the ocular defences?
Lids (Blink to close eyes) Tears Conjunctiva
Which eyelid is more important?
Describe what can happen when lid disease causes the bottom eyelid to be pulled down constantly?
Causes dry and exposed eye Can lead to corneal ulcer
Describe the function/importance of tears?
Flows across eye to keep it lubricated Contains mucous to trap bugs Contains lysozyme which is antibacterial Contains immunoglobulin - IgG, IgA Complement is present
Where are tears produced?
Describe the examination of the front of the eye?
Facial Appearance Lids Conjunctiva Cornea Iris Pupil
What is Blepharitis? Types?
This is inflammation of the eyelids and eyelashes Divided into anterior and posterior (Anterior = Eyelashes, Posterior = Glands on eyelid)
Describe Anterior Blepharitis? Signs?
This can be sebhorreic (scales on the eyelashes) or staphylococcal (staph infection on the lash follicle) Causes a very red lid margin Staphylococcal may cause a sty
What is a sty?
Acute infection of a follicle Causes a yellow head, filled with pus Goes away after a few days
Describe posterior blepharitis? Signs?
This is caused by Meibomian gland dysfunction Lid and lashes are unaffected Dried secretion at meibomian gland opening called a Chalazion
What is a chalazion?
This is a small bump (cyst) caused by blocked meibomian gland May be painful or annoying but rarely serious
Which group of people are commonly affected by posterior blepharitis?
Those with acne rosacea
Treatment for blepharitis?
Hygiene - Bathing and hot compress Supplementary Tear Drops Oral Doxycycline
What are the two types of conjunctivitis?
Describe infective conjunctivitis?
Can be viral, bacterial or chlamydial
Describe viral conjunctivitis?
Most likely caused by adenovirus Usually follows a preceding upper respiratory tract infection
Describe chlamydial conjunctivitis?
This is conjunctivitis caused by chlaymdia trachomatis Commonly seen in the young Can come from genital infection
If you see chronic conjunctivitis in a young, sexually active person, what should you suspect?
Describe acute bacterial conjunctivitis? Signs? Treatment? Organisms?
This is very common Causes a red sticky eye (due to discharge) Is self limiting and will clear up in 14 days without antibiotics Chloramphenicol drops can be used Organisms: - Staph Aureus - Strep Pneumoniae - Haemophilus Influenzae
Describe the signs and symptoms of conjunctivitis?
Red Eye Discharge Foreign Body Sensation Papillae or Follicles Subconjunctival Haemorrhage Oedema (Chemosis) Pre-aurical glands tender (in viral)
What is chemosis?
This is oedema of the conjunctiva
Describe papillae and follicles? - When are they seen (Which type of conjunctivitis) - Appearance
Papillae - seen in allergic and bacterial conjunctivitis Follicles - Seen in viral and chlamydial Papillae - Cone shaped elevations, red in the middle Follicles - Grains of rice