7: Red eye Flashcards

(58 cards)

1
Q

What are some causes of red eye?

A

Eye infections

Haemorrhage

Acute angle-closure glaucoma

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2
Q

What is the most common cause of red eye?

A

Conjunctivitis

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3
Q

What helps to defend the eye from infection?

A

Structures

Tear film (lacrimal fluid and mucus via Meibomian glands)

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4
Q

What do tears contain to help defend against infection?

A

Lysozymes

Immunoglobulins

Complement

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5
Q

What are symptoms you should ask about in an ophthalmic history?

A

Pain - grittiness, dryness, headache

Itch

Discharge

Photophobia

Visual loss

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6
Q

Which infection are people with contact lenses particularly prone to?

How is it treated?

A

Acanthaemoba

amoeba which colonises if you sleep, swim with your contact lenses in

Chlorhexidine

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7
Q

How are the eyes examined?

A

Front to back

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8
Q

How can you check IOP in an eye examination?

What piece of equipment can also estimate IOP?

A

Ballot the eyes

like kidneys in GI exam

Tonometer

blows air into the eye

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9
Q

What is blepharitis?

A

Inflamed eyelids

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10
Q

What symptom does blepharitis usually produce?

A

Dry, gritty eyes

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11
Q

What is the usual causal organism of anterior blepharitis?

What signs does it produce?

A

Staph. aureus

Distorted lashes, scaly, inflamed lids

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12
Q

What structure is diseased in posterior blepharitis?

A

Meibomian glands

which produce mucus

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13
Q

What does posterior blepharitis look like?

A

Swollen lump on eyelid

Dried secretions on lashes

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14
Q

What derm problem, common in middle aged women, is posterior blepharitis associated with?

A

Acne rosacea

facial flushing, pustules, rhynophyma

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15
Q

How is blepharitis treated?

A

Proper lid hygiene

Tear drops

Oral antibiotics for Staph e.g doxycycline

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16
Q

What causes conjunctivitis?

A

Bacteria

Viruses

Allergy

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17
Q

What type of conjunctivitis does chlamydia cause?

What else must be screened for?

A

Trachoma

STIs

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18
Q

Does conjunctivitis affect vision?

A

No

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19
Q

What are the symptoms of conjunctivitis?

A

Red eye

Gritty

Discharge (watery for viral, pus in bacterial)

Itch in ALLERGIC conjunctivitis

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20
Q

How is conjunctivitis treated?

A

Antibiotics

Antivirals

Anti-inflammatories

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21
Q

What indicates chlamydial conjunctivitis over viral or other bacterial causes?

A

Follicles on posterior eyelids

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22
Q

What indicates viral conjunctivitis over other types?

A

Pink eye

Watery discharge

Enlarged pre-auricular nodes

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23
Q

What indicates allergic conjunctivitis over other causes?

A

Itchy eye

Papillae on posterior eyelids

Chemosis

History of atopy

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24
Q

What is chemosis?

A

Conjunctival oedema

25
What would you see in a viral conjunctivitis caused by a) Herpes simplex b) Herpes zoster?
**a) Cold sores** (papules) ## Footnote **b) Dermatomal rash**
26
If a patient has **vertical scratches** on their cornea, where should you examine?
**Posterior eyelids for foreign bodies** "ice rink cornea"
27
What are the layers of the cornea?
**Epithelium** (hydrophobic) **Stroma** (hydrophilic) **Endothelium** (hydrophobic)
28
What stain can be used to identify corneal lesions?
**Fluorescein**
29
What is a sign of significant corneal disease?
**Vascularisation**
30
What microbes can cause **corneal ulcers** (i.e a keratitis)?
**Viral** (dendritic ulcers) **Fungal** (rare) **Bacterial** (hypopyon) **Acanthamoeba** (contact lenses)
31
Corneal ulcers are an indicator of poor control of which type of disease?
**Autoimmune disease** e.g RA
32
Are corneal ulcers **painful**?
**Yes**
33
What are the symptoms of corneal ulcers?
**Pain** **Photophobia** **Profuse lacrimation**
34
What are some **signs** of corneal ulcers?
**Redness** **Loss of corneal light reflex** **Abnormal fluorescein staining** **Hypopion**
35
What type of corneal ulcer does **proptosis** e.g in thyroid eye disease cause?
**Exposure keratitis** from cornea being too far out into external environment
36
In which autoimmune disease may **profuse dryness** cause corneal ulcers?
**Sjogren's syndrome**
37
Which vitamin deficiency can cause corneal ulcers?
**Vitamin A deficiency** remember retinol in rhodopsin is a Vitamin A derivative
38
How are corneal ulcers investigated?
**Corneal scrape** for culture
39
How often are **bacterial corneal ulcers** treated with antibacterials?
**Hourly drops in hospital**
40
How is autoimmune keratitis treated?
**Anti-inflammatories**
41
What is given alongside antivirals in viral keratitis?
**Antibiotics** To prevent superinfection
42
What structures are inflamed in **uveitis**?
**Iris** **Cilary bodies** **Choroid**
43
Which type of disease is highly associated with anterior uveitis?
**Autoimmune disease** e.g Reiter's syndrome, UC, ANKYLOSING SPONDYLITIS, SARCOIDOSIS
44
What are the symptoms of **anterior uveitis**?
**Pain** **Reduced vision** **Photophobia** **Red eye**
45
How does the cornea look in anterior uveitis?
**Clear**
46
What is seen in the anterior chamber in uveitis?
**Flare** cells, protein, inflammatory stuff, debris...
47
**Bacterial keratitis** and **anterior uveitis** both cause a hypopyon. How do you distinguish between them?
**In anterior uveitis, cornea is clear**
48
How is **anterior uveitis** treated?
**Topical steroids**
49
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
50
What is relatively common, self-limiting disease which is associated with gout?
**Episcleritis**
51
What is a **painful disease** of the deep sclera?
**Scleritis** associated with RA, vasculitis
52
What does **scleritis** look like?
**Deep injection of sclera** "violaceous hue"
53
How is **scleritis** treated?
**Oral anti-inflammatories** so steroids, NSAIDs and DMARDs (azathioprine, methotrexate, ciclosporin)
54
Who tends to get **acute angle-closure glaucoma**?
**MYOPIC, elderly patients**
55
What are the symptoms of acute angle-closure glaucoma?
**Sudden loss of peripheral vision** **Painful, red eye** **Headache** **Nausea** **Vomiting**
56
What sign can be felt on balloting of the eye in acute angle closure glaucoma?
**Stony hard** due to **raised IOP**
57
How does the pupil look in acute angle-closure glaucoma?
**Mid-dilated**
58
How does the cornea look in acute angle-closure glaucoma?
**Cloudy**