What part of the eye is most likely to be affected if the patient describes a scratchy/gritty discomfort?
External or surface problem such as conjuntivitis or a foreign body (examine the lids, conjuntiva and cornea)
What part of the eye is likely to be affected if the patient describes a severe deep aching pain?
Intra ocular or orbital problem such as irits, scleritis or angle closure glaucoma
If there is circumcorneal injection what does this mean?
Redness is greatest around the cornea indicating the problem is most likely to be intra ocular
If the redness is greater in the fornices then what is this likely to indicate?
Surface infection or lid disease
What does fluorescein dye and blue light show up?
Epithelial defect wil fluoresce
List 8 potential causes of a red eye
Infection 1. Conjunctivitis 2. Corneal Ulcers Trauma 3. Corneal Foreign body 4. Chemical injury Inflammatory 5. Episcleritis 6. Scleritis 7. Iritis Pressure 8. Acute angle closure glaucoma
What do you use to treat bacterial conjunctivitis?
What do you do to treat viral conjunctivitis?
Supportive treatment: Cool compresses/lubricants
What is the treatment for a bacterial corneal ulcer?
Topical ofloxacin hourly
How do you treat a dendritic ulcer?
Topical aciclovir for 7 - 10 days
What virus causes a dendritic ulcer?
Is episcleritis or scleritis more likely to be associated with connective tissue disease?
What is the treatment for scleritis?
Immunosupression may be needed if there is necrosis
How can you tell the diffeence between episcleritis and scleritis?
- Pain is worse with scleritis
2. Scleritis does not blanch with topical phenylephrine but episcleritis does.
What kind of conditions is anterior uveitis associated with?
HLA B27 linked conditions such as ankylosing spondylitis/IBD/Psoriatic arthtisis
What are the symptoms of anterior uveitis?
What are the signs you see in a patient with anterior uveitis?
Cells in anterior chamber
What is the treatment for anterior uveitis?
Topical steroids hourly with tapering down
Pupil dilating agent (mydratic) such as cyclopentolate
Give three topical mydratics and the difference between them?
- Tropicomide (quick half life)
- Cyclopentolate (Medium half life)
- Atropine (long half life)
Unilateral painful red eye with severe loss of vision, a hazy cornea and a fixed, mid dilated pupil.
Acute angle closure glaucoma
What is the immediate treatment for acute closed angle glaucoma?
IV Diamox (Acetazolamide)
Topical beta blockers
Pilocarpine (Once IOP is less than 50mmHg)
Give a surgical option for acute angle closure glaucoma?
YAG laser peripheral iridotomy which creates a alternative flow pathway for aqueous and reduces risk of recurrence