Approach to the Red Eye Flashcards
How does enophthalmitis present?
Severe pain and loss of vision
Typically with hx of surgery or penetrating injury
What are the types of conjunctivitis? How do you tell the difference?
Bacterial - mucoprurulent discharge, more likely bilateral, may follow acute otitis media
Viral - mild watery discharge, more likely unilateral
Vernal (allergic) - discharge rare, bilateral, pruritis
What is a pterygium? What causes it? How is it managed?
Elevated, external, superficial conjunctival mass that form over the conjunctiva
Elastotic degeration of collagen and fibrovascular proliferation
Surgical removal if it causes significant pain, visual disturbance or altered cosmesis
What is Blepharitis? What causes it? How is it Mx?
Inflammation of the eyelids
Bacterial colonisation of the eyelid
Daily hygiene regimen and topical abx for refractory cases
How do you manage a chemical injury to the eye?
Copious amount of irrigation until the pH is normalised
Flip the eyelip for examination of the posterior surface
IV abx and local steroids
What is a chalazion? What causes them? How are they managed?
An inflammatory lesion of the eyelid that is generally hard and painless (as opposed to a hordeolum which is painful)
Granulomatous inflammation around lipid breakdown products usually from bacterial enzymes or retained sabeous gland secretions
Conservative, massage, heat, incision and drainage
What is scleritis? What causes it? How is it managed?
Inflammation of the sclera
Inflammatory conditions like
- RA, Wegener’s, relapsing polychrondritis, polyarteritis nodosa, SLE (rare)
Urgent ophthal refer
How does iritis present (Hx and Ex)?
Painful red eye with blurred vision and photophobia
Synechiae (iris adhering to the cornea) and pigment deposits on lens boarder
Dilation of ciliary vessel
What is episcleritis? What causes it? How is it managed?
Inflammation between the sclera and conjunctiva
Often idiopathic, but is associated with some connective tissue disorder or vasculitis
Usually self resolving - may require ocular lubricants or topicals NSAIDs
If the patient has dry eyes and other dry membranes, what should you think of? ow do you investigate for it?
Rheumatoid factor, ANA
What is periorbital cellulitis? How is it mx?
Infection of the skin and subcutaneous tissue of the eyelid but anterior to the orbital septum (thin fibrous tissue that originates in the orbital periosteum and inserts in the palpabrae tissue along the tarsal plates
Oral Abx - Augmentin duofort
What signs on examination point of acute closed angle glaucoma?
Shallow anterior chamber
How do you examine a eye for ?foreign body?
Exam eye under blue light
Why might a patient complain of dry but watery eyes?
Reflex tears are produced in response to ocular surface irritation
What are the aetiological agents of keratitis?
Bacterial - Staph aureas, Strep pneumo, pseudo
Viral - HSV
Protozoan - amoeba