Causes of a red eye Flashcards
(15 cards)
what is blepharitis?
What causes it?
How do you manage it?
Blepharitis is inflammation of the eyelid margins. It causes a gritty, itchy, dry sensation in the eyes. It can be associated with dysfunction of the Meibomian glands, which are responsible for secreting oil onto the surface of the eye. It can lead to styes and chalazions.
Manage with a hot compress and lubricating eye drops (relief of symptoms)
What is a stye ?
How are they managed?
this is infection of the glands of the eye. Pus may be visible
Two types:
1. Hordeolum externum is an infection of the glands of Zeis or glands of Moll. The glands of Moll are sweat glands at the base of the eyelashes. The glands of Zeis are sebaceous glands at the base of the eyelashes
2. Hordeolum internum is infection of the Meibomian glands. They are deeper, tend to be more painful and may point inwards towards the eyeball underneath the eyelid.
Treat with hot compress and analgaesia
May require topical antibiotics
What is a Chalazion and how does it present
A chalazion occurs when a Meibomian gland becomes blocked and swells up. It is often called a Meibomian cyst. It presents with a swelling in the eyelid that is typically not tender. It can be tender and red.
Treat with a hot compress and analgaesia. topical antibiotics can be used where the chalazion is acutely inflamed
what is an entropion
How do you manage this
this is where the eyelid turns inwards with the eyelashes against the eyeball. This causes pain and can result in corneal damage and ulceration
Tape the eyelid down in the short term but surgical management will be required
describe an ectropion and the danger this can cause
How is it managed
An ectropion is where the eyelid begins to turn outwards, with the inner aspect of the eyelid exposed.
May result in exposure keratopathy
Mild cases will only require lubricating eye drops but more severe cases will require surgery
what is trichiasis ?
What causes it?
How is it treated?
Trichiasis is inward growth of the eyelashes. Can result in corneal damage and ulceration. Causes: - eye infection - inflammation of the eyelid - AI conditions - trauma
Requires specialist care to remove
which features would differentiate orbital cellultis from periorbital cellulitis
pain on eye movement, reduced eye movements, changes in vision, abnormal pupil reactions and forward movement of the eyeball (proptosis).
what would you include in your differential for a painless red eye?
- Conjunctivitis
- Episcleritis
- Subconjunctival haemorrhage
what would you include in your differential for a painful red eye?
- Glaucoma
- Anterior uveitis
- Scleritis
- Corneal abrasion or ulceration
- Keratitis
- Foreign body
- Traumatic or chemical injury
what is episcleritis and how does it usually present?
Management
This is benign and self-limiting inflammation of the episclera. It is usually associated with inflammatory disorders e.g. RA and IBD
Presentation
- acute onset, unilateral
- segmental redness rather than diffuse
- not usually painful
- Foreign body sensation
- Dilated episcleral vessels
- Watering of eye
Conservative unless severe
- eye drops, compress, analgesia
Severe - systemic NSAIDs/topical steroid drops
what is sclertitis and how may it be differentiated from episcleritis?
Name the different types
This is inflammation of the full thickness of the sclera. It is not usually caused by infection.
It is severely painful (contrast), is bilateral in 50% of cases (contrast)
There is pain with eye movements, photophobia, watering of the eye, reduced VA, with an abnormal pupil reaction to light.
Diffuse, Nodular, necrotising
Needs to be treated as an emergency with same day referral - sight-threatening
how would you diagnose a corneal abrasion?
What would you have to include in your DDx?
use of fluorescein stain.
Can use a slit lamp to look for more significant abrasions.
Same day referral.
Where there are contact lenses involves there may be an infection - consider need for Abx
Herpes keratitis.
how does herpes keratitis present?
How would you investigate if you suspected the condition?
- Painful red eye
- Photophobia
- Vesicles around the eye
- Foreign body sensation
- Watering eye
- Reduced visual acuity. This can vary from subtle to significant
- Staining with fluorescein – shows a dendritic corneal ulcer (different to a corneal abrasion)
- Slit lamp
o Essential for diagnosing keratitis - Corneal swabs or scrapings
o Can be used to isolate the virus using a viral culture or PCR
Name some complications of contact lens wear
corneal de-epithelialisation
corneal distortion
sterile infiltrates
Microbial keratitis
describe how an eye may appear in anterior uveitis
o Dull, aching, painful red eye
o Ciliary flush (a ring of red spreading from the cornea outwards)
o Reduced visual acuity
o Floaters and flashes
o Sphincter muscle contraction causing miosis (constricted pupil)
o Photophobia due to ciliary muscle spasm
o Pain on movement
o Excessive tear production (lacrimation)
o Abnormally shaped pupil due to posterior synechiae (adhesions) pulling the iris into abnormal shapes
