Eye-tis 101

Question 1

Anterior uveitis symptoms, investigations, management

Answer 1

Pain
Photophobia
Blurred/double vision
Pupillary changes / haziness
HYPOPYON

Investigations: fundoscopy will show an irregular and small pupil and HYPOPYON (pus)

Mx - refer and give steroids

Question 2

What makes up the uvea

Answer 2

Choroid
Ciliary bodies
Iris

Question 3

Anterior uveitis can be associated with?

Answer 3

IBD
Ank spond (think 6 As)
Arthritis

Question 4

What are the 6 As of ankylosing spondylitis

Answer 4

AV block
Aortic regurgitation
Anterior uveitis
Apical lung fibrosis
Achilles tendonitis
Amyloidosis

Question 5

What are the three types of block

Answer 5

AV block Type 1 - PR intervals are prolonged more than 300 seconds
Type 2 (Mobitz)
-Mobitz 1= progressively prolonging PR intervals until it is dropped
-Mobitz 2 = fixed PR for a few beats, then it is dropped in a fixed ratio (e.g. 3:1)
Type 3 - complete block

Question 6

What is conjunctivitis? How do you differentiate between the causes based on symptoms?

Answer 6

Discharge
Discomfort
“Conjunctival injection”

Due to reaction to something on the outside - infection or allergen

Bilateral - allergen
Unilateral sticky discharge - bacterial
Unilateral watery discharge - viral

Question 7

Which viruses commonly cause conjunctivitis?

Answer 7

Adenovirus

Question 8

Which bacteria commonly cause conjunctivitis?

Answer 8

Staph
Strep
HiB

Question 9

Management of conjunctivitis

Answer 9

If bacterial - chloramphenicol drops
If viral - nothing
If allergic - antihistamine drops
If contact wearer - same day opthal review to rule out microbial keratitis

Question 10

What is keratitis

Answer 10

Inflammation of the cornea - can be an ulcer

Question 11

Symptoms of keratitis

Answer 11

Pain
Photophobia
Blurred vision
Grittiness/defect
White corneal opacity

Question 12

Causes of keratitis

Answer 12

Bacteria - S. aureus, P. aeruginosa form contact lenses
Fungi
Amoeba - acanthamoeba keratitis
Viral - herpes simplex keratitis

Question 13

Investigations of keratitis and management

Answer 13

Slit lamp fluorescein staining

Mx - refer for swabs and topic abx/aciclovir drops, mydriasis

Question 14

What is a corneal abrasion

Answer 14

When there is an epithelial breach without keratitis; pain, photophobia, blurred vision, visible defect

Question 15

Investigations for corneal abrasion

Answer 15

Slit lamp fluorescein staining
Mx - infection prophylaxis with chloramphenicol

Question 16

Classic symptoms of scleritis

Answer 16

SEVERE PAIN WORSE ON EYE MOVEMENT

Question 17

What is scleritis associated with?

Answer 17

GPA
RhA
SLE
Vasculitis

Question 18

Key complication of scleritis

Answer 18

Scleromalacia and perforation of the globe

Question 19

Investigations and management of scleritis

Answer 19

Fundoscopy for severe conjunctival oedema worse than episcleritis

Question 20

How to differentiate between scleritis and episcleritis

Answer 20

Symptomatically - episcleritis is not painful, but scleritis is

Phenyephrine drops - scleritis stays red, episcleritis goes white

Question 21

Management of scleritis

Answer 21

Refer urgently within 24 hours - corticosteroids, immunosuppressants, phenylephrine

Question 22

Acute Glaucoma symptoms

Answer 22

Pain (severe)
Haloes around lights
N and V
Reduced acuity

Question 23

Signs of glaucoma/investigations

Answer 23

Fundoscopy showing cloudy cornea + fixed, dilated pupil

Tonometry - Increased IOP
Gonioscopy with slit lamp (measures iridocorneal angle) (gold-standard)