What are some causes of red eye?
Acute angle-closure glaucoma
What is the most common cause of red eye?
What helps to defend the eye from infection?
Tear film (lacrimal fluid and mucus via Meibomian glands)
What do tears contain to help defend against infection?
What are symptoms you should ask about in an ophthalmic history?
Pain - grittiness, dryness, headache
Which infection are people with contact lenses particularly prone to?
How is it treated?
amoeba which colonises if you sleep, swim with your contact lenses in
How are the eyes examined?
Front to back
How can you check IOP in an eye examination?
What piece of equipment can also estimate IOP?
Ballot the eyes
like kidneys in GI exam
blows air into the eye
What is blepharitis?
What symptom does blepharitis usually produce?
Dry, gritty eyes
What is the usual causal organism of anterior blepharitis?
What signs does it produce?
Distorted lashes, scaly, inflamed lids
What structure is diseased in posterior blepharitis?
which produce mucus
What does posterior blepharitis look like?
Swollen lump on eyelid
Dried secretions on lashes
What derm problem, common in middle aged women, is posterior blepharitis associated with?
facial flushing, pustules, rhynophyma
How is blepharitis treated?
Proper lid hygiene
Oral antibiotics for Staph e.g doxycycline
What causes conjunctivitis?
What type of conjunctivitis does chlamydia cause?
What else must be screened for?
Does conjunctivitis affect vision?
What are the symptoms of conjunctivitis?
Discharge (watery for viral, pus in bacterial)
Itch in ALLERGIC conjunctivitis
How is conjunctivitis treated?
What indicates chlamydial conjunctivitis over viral or other bacterial causes?
Follicles on posterior eyelids
What indicates viral conjunctivitis over other types?
Enlarged pre-auricular nodes
What indicates allergic conjunctivitis over other causes?
Papillae on posterior eyelids
History of atopy
What is chemosis?
What would you see in a viral conjunctivitis caused by
a) Herpes simplex
b) Herpes zoster?
a) Cold sores (papules)
b) Dermatomal rash
If a patient has vertical scratches on their cornea, where should you examine?
Posterior eyelids for foreign bodies
“ice rink cornea”
What are the layers of the cornea?
What stain can be used to identify corneal lesions?
What is a sign of significant corneal disease?
What microbes can cause corneal ulcers (i.e a keratitis)?
Viral (dendritic ulcers)
Acanthamoeba (contact lenses)
Corneal ulcers are an indicator of poor control of which type of disease?
Are corneal ulcers painful?
What are the symptoms of corneal ulcers?
What are some signs of corneal ulcers?
Loss of corneal light reflex
Abnormal fluorescein staining
What type of corneal ulcer does proptosis e.g in thyroid eye disease cause?
from cornea being too far out into external environment
In which autoimmune disease may profuse dryness cause corneal ulcers?
Which vitamin deficiency can cause corneal ulcers?
Vitamin A deficiency
remember retinol in rhodopsin is a Vitamin A derivative
How are corneal ulcers investigated?
Corneal scrape for culture
How often are bacterial corneal ulcers treated with antibacterials?
Hourly drops in hospital
How is autoimmune keratitis treated?
What is given alongside antivirals in viral keratitis?
To prevent superinfection
What structures are inflamed in uveitis?
Which type of disease is highly associated with anterior uveitis?
e.g Reiter’s syndrome, UC, ANKYLOSING SPONDYLITIS, SARCOIDOSIS
What are the symptoms of anterior uveitis?
How does the cornea look in anterior uveitis?
What is seen in the anterior chamber in uveitis?
cells, protein, inflammatory stuff, debris…
Bacterial keratitis and anterior uveitis both cause a hypopyon.
How do you distinguish between them?
In anterior uveitis, cornea is clear
How is anterior uveitis treated?
In glaucoma, drops are used to constrict the pupil.
What type of drops are used in anterior uveitis?
Mydriatic drops (dilate)
To relax the eye muscles are reduce pain
What is relatively common, self-limiting disease which is associated with gout?
What is a painful disease of the deep sclera?
associated with RA, vasculitis
What does scleritis look like?
Deep injection of sclera
How is scleritis treated?
so steroids, NSAIDs and DMARDs (azathioprine, methotrexate, ciclosporin)
Who tends to get acute angle-closure glaucoma?
MYOPIC, elderly patients
What are the symptoms of acute angle-closure glaucoma?
Sudden loss of peripheral vision
Painful, red eye
What sign can be felt on balloting of the eye in acute angle closure glaucoma?
Stony hard due to raised IOP
How does the pupil look in acute angle-closure glaucoma?
How does the cornea look in acute angle-closure glaucoma?