Acute red eye Flashcards Preview

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Flashcards in Acute red eye Deck (54):
1

hat coniditons can cause a red eye?

Conjunctivitis
Keratits
Anterior uveitis
Acleritis/Episcleritis
Acute close angle glaucoma
Subconjunctival haemorrhage
Orbital disease (e.g. cellulitis)

2

What is the most common cause of a red eye?

Conjunctivitis

3

What is secreted from the lids in defence?

Mebomian

4

What is blepharitis?

Inflamed eyelids

5

What is a sty?

Staph infection involving the lash follicle

6

How do differentiate between anterior & posterior blepharitis?

Anterior - seborrhoeic scales on the lashed, lid margin redder than deeper part of lid

Posterior - redness is in deeper part of lid, lid margin often quite normal looking

7

What causes posterior blepharitis?

Meibomian gland dysfunction

8

Symptoms of blepharitis

Similar to conjunctivitis
Gritty eyes
Foreign body sensation
Mild discharge

9

What other causes of red eye is blepharitis associated with?

Conjunctivitis
Keratitis
Episcleritis

10

Signs of seborrhoeic anterior blepharitis

Lid margin red
Scales ++
Dandruff +
(No ulceration, lashes unaffected)

11

Sign of staphylococcal anterior blepharitis

Lid margin red
Lashes distorted, loss of lashes, ingrowing lashes
Styes ulcer of lid margin
Corneal staining
Marginal ulcers (due to axotoxin)

12

Signs of posterior blepharitis

Lid margin skin and lashes unaffected
MG openingspouting & swollen
Inspissated (dried) secretion at gland openings
Meibomian cysts (chalazia)

13

What is posterior blepharitis associated with?

Acne Rosacea (50%) `

14

Management of Blepharitis

Lid hygiene - daily bathing/warm compresses
Supplementary tear drops
Oral doxycyine for 2-3 mnths

15

Infective causes of conjunctivitis

Viral
Bacterial
Chylamydial

16

Non-infective causes of conjunctivitis

Allergic
Chemical/drugs
Skin diseases - eczema

17

Symptoms of conjunctivitis

Red eye
Foreign body sensation (gritty eye)
Discharge - sticky eye
Itch = allergy
VISION UNAFFECTED

18

Signs of conjunctivitis

Red eye
Discharge
Papillae or follicles
Sub conjunctival haemorrhage
Chemosis

19

Which glands may be enlarged in viral conjunctivitis?

Pre-auricular glands

20

How long does acute bacterial conjunctivitis take to clear up without treatment?

14 days

21

What are the most common causative organism of acute bacterial conjunctivitis?

Staph. aureus
Strep. pneumoniae
H. influenzae

22

What causes follicular conjunctivitis?

Viral (adeno, HS, HZ)
Chlamydial
Drugs (e.g. propine, trusopt)

23

Causes of chronic conjunctivitis

Blepharitis
Chlamydial infection
Keratoconjunctivitis sicca
Lacrimal disease (chronic dacryocysitis)
Sensitivity to topical glaucoma medication
Sub-tarsal foreign body

24

How long does conjunctivitis have to last for to be termed chronic?

4 weeks

25

What are the 3 layers of the cornea?

Epithelium
Stroma
Endothelium

26

Causes of central cornea ulcers?

Viral
Fungal
Bacterial
Acanthamoeba

27

Causes of peripheral corneal ulcers

RA
Hypersensitivity e.g. marginal ulcers)

28

Symptoms of corneal ulcer

Pain +
Photophobia
Profuse lacrimation
Vision may be reduced
Circumcorneal red eye

29

Signs of corneal ulcer?

Redness
Corneal reflex (reflection abnormal)
Corneal opacity
Staining with luroscein
Hypopyon

30

Causes of exposure keratitis

Thyroid
VII palsy

31

In what condition does keratoconjunctivitis sicca occur?

Sjogren's

32

What can cause neutrophic keratitis?

Herpes zoster V1

33

Deficiency of which vitamin can causes corneal ulcers?

Vitamin A

34

Investigation for corneal ulcers?

'Corneal scrape'[ for gram stain & culture

35

Treatment of bacterial infected corneal ulcer?

Antimicrobial (e.g.ofloxacin hourly)

36

Treatment of herpetic corneal ulcer

Aciclovir ointment 5 x day

37

Autoimmune causes of anterior uveitis

Reiter's
UC
Ankylosing spondylitis
Sarcoidosis

38

Infective causes of anterior uveitis

TB
Syphylis
Herpes Simplex
Herpes Zoster

39

Malignant cause of anterior uveitis

Leukemia

40

Symptoms of anterior uveitis

Achy pain (+ referred pain)
Vision may be reduced
Photophobia
Red eye (circumcorneal)

41

Signs of anterior uveitis

Ciliary injection
Cells & flare in anterior chamber
Keratic precipitates
Hypopyn
Synechia (small or irregular pupil)

42

Management of anterior uveitis

Topical steroids (pred forte 1% hourly tapering over 4-8 weeks)
Mydriatics
Investigate for systemic associations

43

What is episcleritis associated with?

Gout

44

Management of episcleritis

Self limiting
Lubricants/topical NSAIDs/ mild steroids

45

Which is more serious scleritis or episcleritis?

Scleritis

46

What is scleritis associated with?

Serious systemic vasculitides (e.g. RA, Wegners)

47

Presentation of scleritis

PAINFUL +
Injection of deep vascular plexus - violaceous hue

48

What other eye condition is scleritis commonly associated with?

Uveitis

49

What test can be used to confirm scleritis?

Phenylephrine test

50

Treatment of scleritis

Oral NSAIDs
Oral Steroids
Steroid sparing agents

51

WHat is acute closed angle galucoma?

IOP rises acutely due to drainage angle being closed

52

Features of glaucoma

Circumcorneal injection
Cornea cloudy
Pupil middilated
Eye stony hard
Severe pain + nausea

53

Which individuals are particularly predisposed to acute closed angle galucoma?

Elderly
Hypermetropic

54

What wrrants an urgent referral in a red eye?

Vision affected
Marked photophobia