Eye Conditions Flashcards
Bacterial Conjunctivitis
Starts unilateral becomes bilateral Purulent yellow sticky discharge Lasts 10-14 days Generalized redness towards corners Gritty feeling + discomfort Chloramphenicol + neomycin for 5-7 days
Contact dermatitis
Can affect both eyes Thin watery discharge Sudden onset Swelling of eyelid, perioirbital rash Treatment- avoiding the allergen. Cool compresses provide some relief. An oral antihistamine for severe itching may be needed.
Viral conjunctivitis
Bilateral but one first Watery discharge URTI symptoms- nasal congestion present Duration: 5-14 days Generalized redness Gritty, discomfort, not painful Treatment: Artificial tears and cool compresses may provide symptomatic comfort. If the condition is severe antiviral agent such as aciclovir should be used.
Allergic conjunctivitis
Bilateral
Watery discharge
Rhinitis present
Seasonal onset
Redness generalized but greatest in corners
Itching
Treatment: Avoiding allergens is the best treatment and antibiotic treatment is not appropriate. Topical mast cell stabilizers such as 4% sodium cromoglicate, 4 times a day and in some cases oral antihistamines, are sufficient treatment.
Episcleritis
Unilateral No discharge Acute onset Discomfort or tenderness reported Duration: 2/3 weeks- 6/8 weeks Redness in part of the eye Dull ache, no pain Treatment: Artificial tears are useful for patients with mild-to-moderate symptoms. Patients with severe or prolonged episodes may require artificial tears and/or topical corticosteroids. Topical ophthalmic 0.5% prednisolone, 0.1% dexamethasone, or 0.1% betamethasone daily may be used. Systemic anti-inflammatory agents may be useful.
Scleritis
Bilateral in patients with rheumatic disease
No discharge
Gradual onset
Blurred vision
Whole eye or localized redness
Severe pain
Treatment: Oral NSAIDs are commonly used for 1-2 weeks to treat this. If there is no adequate response, corticosteroids such as prednisolone may be needed.
PACG
Unilateral Quick onset in the evening Vomiting and headache on the same side present Red and cloudy eye Severe pain Laser surgery can be used for treatment
POAG
Bilateral
Caused by raised IOP
Drainage of the aqueous humour through the trabecular meshwork is restricted, and the angle between the iris and the cornea is normal.
Initially, this condition tends to be asymptomatic, however, as glaucoma progresses, patients may present with irreversible sight loss or visual field defects. Patients with ocular hypertension (an intra-ocular pressure greater than 21 mmHg) are at high risk of developing chronic open-angle glaucoma.
A topical prostaglandin analogue, such as latanoprost, tafluprost, travoprost, or bimatoprost (a synthetic prostamide), is recommended as first-line treatment in patients with an intra-ocular pressure of 24 mmHg.
Keratitis
Unilateral
Watery discharge
Photophobia , loss of visual acuity , small pupil
Limbal redness
Very severe pain
Viral- Acyclovir ointment , Ganciclovir gel
Bacterial- broad spectrum antibiotics, fluoroquinolone eye drops during the day and ointment at bedtime.
Subconjunctival haemorrhage
Unilateral No discharge Sudden onset No visual disturbance, visual acuity unaffected Bright red eye No pain
Uveitis
Unilateral
Photophobia, pupil irregular, constricted or fixed
Redness in limbal area
Pain present
Blepharitis
Bilateral
Excessive tearing
Worse in morning
Irritation, itching, burning of lid margins, skin debris
Treatment mainly reliant on appropriate lid hygiene; eyelid margins must be scrubbed with a baby shampoo or similar product twice a day, and warm compresses applied to alleviate the symptoms. Antibiotic topical or systemic (doxycycline) may be also used. Treatment is ongoing as condition is rarely completely eradicated. Frequent use of artificial tears helps with dry eyes.
Hordeola (styes)
Unilateral No discharge Onset over a few days Redness and swelling present Local pain of eyelids Warm compresses can comfort the patient and speed pointing. If the offending lash is then removed with the aid of a good light, some magnification and a pair of tweezers or forceps, the condition will subside rapidly. Antibiotics are unnecessary, unless complications occur.
Chalazion
a common condition in which a small lump or cyst develops in your eyelid due to a blocked oil gland. The condition can occur due to inflammation around the opening of the oil glands just behind your eyelashes. This is called blepharitis
Self-limitting
Discomfort but painless
Warm compresses at 15 minute intervals along with oral antibiotics (flucloxacillin or cephalexin for 5 days) can be used to treat the condition
Dry eye disease
Bilateral Worsening throughout the day Sensation of sand or gravel in eyes. Worsened by dry air, wind, dust and smoke Not red unless irritated Pain present Artificial tears, ciclosporin 0.1% drops
