Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ophthamology > 5. Red eye and Lid > Flashcards

5. Red eye and Lid Flashcards

(104 cards)

Start Studying
1
Q

To assess a red eye you will need:

A
  • Snellen chart, or the Snellen App
  • Fluorescein drops
  • Local anaesthetic
  • Pen torch, or ophthalmoscope light
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary care red eye

A
  • No pain (mild discomfort, itching, burning)
  • Dryness or tearing
  • Bilateral
  • Vision preserved
  • Bright red
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tertiary care red eye

A
  • Painful
  • Photophobia
  • Unilateral
  • Vision loss
  • Deep red
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are common eyelid causes of red eye in primary care?

A

Blepharitis (inflammation of eyelid margins)

Stye (hordeolum) – a painful, red lump usually due to a blocked gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common conjunctival and corneal causes of red eye?

A

Conjunctivitis (viral, bacterial, allergic)

Foreign body in the eye

Subconjunctival haemorrhage – bright red patch on the white of the eye, usually painless

Pterygium – fleshy triangular growth over the conjunctiva

Pingueculum – yellowish raised spot on the conjunctiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the role of the primary care provider in managing red eye?

A

Start initial treatment and determine if the case is benign or serious. Refer or phone for advice if there is any uncertainty, pain, vision change, or atypical features.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What red flags in red eye require urgent referral?

A

Severe pain

Decreased vision

Photophobia

Corneal opacity or hazy cornea

Irregular pupil

Unresponsive to initial treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is blepharitis?

A

Blepharitis is a chronic inflammation of the eyelid margins, often associated with bacterial overgrowth, seborrhoea, or meibomian gland dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which age group is most commonly affected by blepharitis?

A

Blepharitis commonly affects older patients, but can occur at any age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the typical features of blepharitis?

A

Red, inflamed lid margins

Crusting or flaking at the base of the eyelashes (“dandruff-like” debris)

Irritation, burning, or gritty sensation in the eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is blepharitis managed in primary care?

A

Lid hygiene (warm compresses, gentle cleaning with diluted baby shampoo or lid wipes)

Artificial tears for symptomatic relief

If not resolving add Topical antibiotics (e.g., fusidic acid or erythromycin ointment) if secondary infection is suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is blepharitis a serious condition?

A

No, it’s usually benign but chronic. However, it can cause persistent discomfort and lead to styes, chalazion, or dry eye if not managed properly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What long-term complication can chronic blepharitis cause?

A

Chronic blepharitis can lead to corneal vascularisation, where abnormal blood vessels grow into the normally avascular cornea, potentially affecting vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for chronic, non-resolving blepharitis?

A

Oral doxycycline 100 mg daily can be used for several weeks to reduce inflammation and improve meibomian gland function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In which patients should doxycycline be avoided?

A

Pregnant women

Children under 12 years old
Due to risks of tooth discoloration and bone growth interference.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a stye (hordeolum)?

A

A stye is a painful, red lump at the edge of the eyelid caused by an acute infection of an eyelash follicle or associated gland (usually Staphylococcus aureus).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the first-line treatment for a stye?

A

Warm compresses several times a day to promote drainage

Topical antibiotic ointment (e.g., chloramphenicol/Chloromycetin) applied to the lid margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When should a stye be lanced?

A

If the stye is pointing (coming to a head) and not resolving with conservative treatment, it can be lanced (incised and drained) using aseptic technique.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the main types of infective conjunctivitis?

A

Viral conjunctivitis (most common)

Bacterial conjunctivitis

Chlamydial conjunctivitis (inclusion conjunctivitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the common causes of viral conjunctivitis?

A

Usually caused by adenoviruses, presenting with watery discharge, redness, and often associated with a recent upper respiratory infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does bacterial conjunctivitis typically present?

A

With purulent (pus-like) discharge, eyelid sticking, redness, and sometimes mild discomfort.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is chlamydial conjunctivitis?

A

A chronic, follicular conjunctivitis caused by Chlamydia trachomatis, often sexually transmitted or neonatal infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the types of allergic conjunctivitis?

A

Seasonal allergic conjunctivitis (common, linked to pollen)

Perennial allergic conjunctivitis (year-round, due to dust mites, pet dander)

Acute allergic conjunctivitis (sudden onset)

Vernal conjunctivitis (severe, chronic, usually in children)

Atopic conjunctivitis (associated with atopic dermatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are follicles in the context of viral conjunctivitis?

A

Follicles are small, round, pale lumps seen on the conjunctiva, representing clusters of lymphoid cells reacting to infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do follicles appear in viral conjunctivitis?
Follicles are paler in the center because the blood vessels are displaced to the periphery of each follicle, giving them a characteristic appearance.
26
Where are follicles typically found in viral conjunctivitis?
Follicles are often seen on the lower tarsal conjunctiva (inside of the eyelid) and sometimes the bulbar conjunctiva.
27
How can follicles help differentiate viral conjunctivitis from bacterial conjunctivitis?
Follicles are characteristic of viral or chlamydial conjunctivitis, while bacterial conjunctivitis usually shows more diffuse redness and pus without follicles.
28
What lymph nodes are commonly enlarged in viral conjunctivitis?
Pre-auricular lymph nodes (in front of the ears) are often tender and enlarged.
29
What is a common preceding history in viral conjunctivitis?
A recent or concurrent upper respiratory tract infection (URTI) is common.
30
How does viral conjunctivitis typically start and progress?
It often starts unilateral (one eye) but usually spreads to involve both eyes (bilateral) within a few days.
31
What are other key clinical features that support a diagnosis of viral conjunctivitis?
Watery discharge Follicles on the conjunctiva Mild irritation or gritty sensation No purulent discharge (unlike bacterial conjunctivitis)
32
Treatment of viral conjunctivitis
Highly contagious, so advise to stay at home Symptomatic treatment eg. lubricants
33
Characteristics of bacterial conjuctivitis
Characterised by a purulent discharge
34
Treatment of bacterial conjunctivitis
Chloramphenicol drops or ointment x 5 days  Refer if no improvement after a course of antibiotics, or if worsening of symptoms
35
What is the first step in managing gonococcal conjunctivitis?
Copious irrigation of the eye with sterile water or normal saline to remove discharge and reduce bacterial load.
36
Why is gonococcal conjunctivitis a medical emergency?
It can rapidly destroy the cornea and cause permanent blindness if not treated urgently.
37
What systemic antibiotic is used in gonococcal conjunctivitis?
A single intramuscular injection (IMI) of ceftriaxone 125 mg stat.
38
What other treatments are part of managing gonococcal conjunctivitis?
Urgent ophthalmology referral for full exam and work-up Use of fortified topical antibiotics Contact tracing and treatment of sexual partners
39
What are common signs of gonococcal conjunctivitis?
Profuse purulent discharge Marked eyelid swelling Conjunctival injection Risk of corneal ulceration
40
What is the typical presentation of chlamydial conjunctivitis?
It presents as a chronic follicular conjunctivitis, often with minimal discharge and persistent redness.
41
How is chlamydial conjunctivitis diagnosed?
Diagnosis is confirmed via immunofluorescence testing of a conjunctival swab to detect Chlamydia trachomatis.
42
What is the most common mode of transmission for chlamydial conjunctivitis in adults?
It is sexually transmitted and may be associated with genital chlamydia infection.
43
What is the treatment for chlamydial conjunctivitis?
Systemic tetracyclines (e.g., doxycycline 100 mg twice daily for 7–10 days) are the treatment of choice.
44
Why is it important to treat both the patient and their sexual partners in chlamydial conjunctivitis?
To prevent reinfection and control the spread of sexually transmitted infections (STIs).
45
What are papillae in the context of allergic conjunctivitis?
Papillae are raised, red, cobblestone-like structures on the underside of the eyelid due to inflammation
46
How do papillae differ from follicles in appearance?
Papillae are more diffusely red with central blood vessels, while follicles are paler centrally with peripheral vessels.
47
In which condition are subtarsal papillae typically seen?
They are commonly seen in allergic conjunctivitis, especially in vernal or atopic forms.
48
What is the first step in managing allergic conjunctivitis?
Remove the allergen by irrigating the eye with sterile water or saline.
49
What symptom is most characteristic of allergic conjunctivitis?
An acutely itchy eye is the hallmark symptom.
50
What medications are used to relieve symptoms in allergic conjunctivitis?
Topical or systemic antihistamines can be used to reduce itching and inflammation.
51
What types of allergic conjunctivitis are recognised based on timing and severity?
Seasonal, perennial, and atopic conjunctivitis.
52
What is the first-line treatment for mild seasonal or perennial conjunctivitis?
Topical antihistamines or lubricants to relieve itching and irritation
53
What is used as prophylaxis in chronic allergic conjunctivitis?
Sodium chromoglycate eye drops (a mast cell stabiliser) given four times daily (qid).
54
When should a patient with allergic conjunctivitis be referred to a specialist?
If the condition is severe and requires topical steroid treatment.
55
What is a pterygium and how does it present?
A pterygium is a wing-shaped fibrovascular growth that gradually invades the cornea from the conjunctiva, often nasally.
56
What is a pingueculum and how does it differ from a pterygium?
A pingueculum is a common, yellowish elevated lesion that lies under the conjunctiva and does not invade the cornea.
57
What are shared risk factors for both pterygium and pingueculum?
UV light exposure Living in dry or dusty environments Hereditary predisposition
58
How can pterygium and pingueculum be prevented?
UV protection with sunglasses and wide-brimmed hats Avoiding midday sun Environmental protection (dust, wind)
59
What is the symptomatic treatment for pterygium or pingueculum?
Artificial tears for dryness or irritation Topical NSAIDs (e.g. ketorolac) for short courses if inflamed
60
When should a pterygium be considered for surgical removal?
If it is invading the visual axis, causing recurrent inflammation, or for cosmetic reasons.
61
What is a subconjunctival haemorrhage?
A bleed under the conjunctiva that presents as a bright red patch on the white of the eye.
62
What are common causes of subconjunctival haemorrhage?
Post-traumatic Spontaneous due to hypertension, Valsalva, coughing, or straining
63
How is a subconjunctival haemorrhage managed in primary care?
Reassure the patient—it is self-limiting Offer lubricants for comfort
64
When should you refer a patient with a subconjunctival haemorrhage?
If there are signs of systemic bleeding or frequent recurrence, refer to haematology.
65
What serious conditions can cause a red eye requiring tertiary care?
Keratitis (corneal pathology) Uveitis (intraocular inflammation) Endophthalmitis (post-op or traumatic infection) Acute angle-closure glaucoma
66
What is keratitis and why is it a tertiary red eye?
Keratitis is corneal inflammation, often due to infection, trauma, or contact lenses. It can threaten vision and needs urgent specialist care.
67
What is uveitis and how does it present?
Uveitis is inflammation of the uveal tract (iris, ciliary body, choroid), presenting with pain, photophobia, blurred vision, and a red eye.
68
What is endophthalmitis and what causes it?
Endophthalmitis is a serious intraocular infection, often occurring post-operatively or after trauma. It’s an emergency requiring urgent referral.
69
Why is acute angle-closure glaucoma a tertiary red eye emergency?
It causes sudden painful vision loss, with high intraocular pressure. Urgent treatment is needed to prevent permanent blindness.
70
What is the appropriate referral timeline for tertiary care red eye conditions?
Refer within 24 hours to an ophthalmologist—these are vision-threatening emergencies.
71
Causes of keratitis
Viral Bacterial Fungal Immune-response
72
What is a key clinical feature of herpes simplex keratitis?
It is usually unilateral and often recurrent, causing redness, pain, photophobia, and blurred vision.
73
What diagnostic test helps confirm herpes simplex keratitis?
Use fluorescein staining to reveal a classic dendritic (branching) ulcer pattern on the cornea.
74
How is herpes simplex keratitis treated?
Urgent referral is needed. Treat with topical or systemic acyclovir as prescribed by a specialist.
75
What treatment is contraindicated in herpes simplex keratitis and why?
Never prescribe topical steroids—they can worsen the infection and cause corneal perforation.
76
Herpes Keratitis Complications
Scarring and vascularisation from recurrent attacks Geographic ulcer (and sometimes melting or perforation), from inadvertent steroid use
77
What are the typical clinical features of bacterial keratitis?
A round, white corneal opacity or abscess, often with a hypopyon. May stain with fluorescein.
78
What are the complications of untreated bacterial keratitis?
Corneal perforation Endophthalmitis Permanent blindness
79
What is the urgency of referral for bacterial keratitis?
Urgent ophthalmology referral within 24 hours is essential.
80
What should be done for bacterial keratitis in rural areas before referral?
Start ciprofloxacin or ofloxacin drops ½ hourly during transfer to tertiary care.
81
What are the clinical features of a fungal corneal abscess?
Corneal opacity that is fluffy, grey, often with satellite lesions around the main lesion.
82
What is a common cause of fungal corneal abscess?
Injury with organic material such as wood or plant matter.
83
How urgent is the referral for fungal corneal abscess?
Urgent referral to ophthalmology is required to prevent complications.
84
What causes marginal keratitis?
It is an immune-mediated response caused by staphylococcal hypersensitivity
85
How urgent is the referral for marginal keratitis?
Urgent referral to ophthalmology is recommended.
86
What is the underlying mechanism of marginal keratitis?
It results from a hypersensitivity reaction to staphylococcal exotoxins, causing inflammation near the corneal margin.
87
What systemic diseases are associated with immune-related peripheral corneal melt?
Look for systemic vasculitides such as: Systemic lupus erythematosus (SLE) Rheumatoid arthritis Wegener’s granulomatosis (Granulomatosis with polyangiitis)
88
What is immune-related peripheral corneal melt?
It is a severe inflammatory condition causing corneal thinning and melting at the periphery due to systemic autoimmune vasculitis.
89
What is the urgency of referral for immune-related peripheral corneal melt?
Urgent referral to ophthalmology and rheumatology is required to prevent severe vision loss.
90
What is anterior uveitis?
Inflammation of the anterior uveal tract, primarily the iris.
91
What are the main symptoms of anterior uveitis?
Pain Photophobia Blurred vision
92
What pupil abnormality is seen in anterior uveitis?
An irregularly-shaped pupil caused by posterior synechiae—adhesions between the iris and lens.
93
What is a sterile hypopyon and when does it occur?
A hypopyon without infection, seen in severe anterior uveitis.
94
What systemic diseases should you consider in anterior uveitis?
Underlying sarcoidosis and other systemic rheumatological diseases.
95
What is the urgency of referral for anterior uveitis?
Urgent referral to ophthalmology is required.
96
What is endophthalmitis?
A severe intraocular infection that occurs after eye surgery, eye trauma, or can be associated with septicaemia.
97
What is the clinical significance of endophthalmitis?
It causes rapid blindness if not treated promptly.
98
How urgent is referral for suspected endophthalmitis?
Urgent referral within hours to ophthalmology is critical.
99
What causes an inflamed lid lump like a chalazion?
It is caused by obstruction of the meibomian gland orifice, often associated with underlying blepharitis.
100
What is the initial treatment for an inflamed lid lump?
Conservative treatment with lid hygiene and warm compresses.
101
When should you refer an inflamed lid lump for surgical treatment?
Refer for incision and curettage if it does not resolve within 3 months.
102
What causes a phlycten?
It is caused by tuberculosis or staphylococcal hypersensitivity.
103
Where do phlyctens usually occur?
Usually on the limbal conjunctiva, but can also occur on the cornea.
104
What is the management approach for phlycten?
Identify and treat the underlying cause, and refer for specialized eye management.

Ophthamology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions