Red Eye

Question 1

How do we diagnose the cause of Acute Red Eye?

Answer 1

We base it on pain, redness, discharge & vision

Question 2

What are the causes of acute red eye?

Answer 2

• Uveitis
• Conjunctivitis (Bacterial, viral, allergic)
• Scleritis
• Acute (closed angle) Glaucoma
• Keratitis/Corneal Ulcer
• Orbital Cellulitis

Question 3

What is conjunctivitis?

Answer 3

Inflammation of the thin vascular membrane covering the inner surface of the eyelid and the sclera

Question 4

What are the types of conjunctivitis?

Answer 4

Bulbar - affects conjunctiva over the sclera

Palpebral - affects conjunctiva on inside of lids

(Can be both)

Question 5

What is the presentation of Conjunctivitis?

Answer 5

• No pain
• Peripheral & diffuse redness
• Vision unaffected
• Discharge
  Bacterial = Pus
  Viral = Watery
  Allergic = Mucous

Question 6

What is uveitis?

Answer 6

Inflammation of the middle vascular layer of the eye (ciliary body, iris & choroid)

Question 7

How does uveitis present?

Answer 7

• None/mild irritation
• Pericorneal Redness
• No Discharge
• Blurred Vision

Question 8

What are the types of Uveitis?

Answer 8

Ant - Iris
Intermediate - Ciliary Body
Post - Choroid
Panuveitis

Question 9

What are the specific signs of anterior & intermediate uveitis?

Answer 9

Anterior

• Inflammatory cells leak from iris into Aqueous humor
• > Hazy cell filled Ant chamber and Hypopyon (cells settled inferiorly in ant chamber)

Intermediate

• Inflammatory cells leak from ciliary body in Vitreous Humour
• > Patient has hazy vision or “floaters”

Question 10

Causes of Uveitis?

Answer 10

• Idiopathic
• Systemic Disease, often autoimmune (SLE/Sarcoid)
• Infection (TB, CMV, Herpes Simplex, Syphilis)
• Masquerade
  Not actually uveitis e.g. intraocular lymphoma or leukaemia

Question 11

Treatment of uveitis?

Answer 11

Depends on cause

• Systemic Steroids
• Systemic Immunosuppresants
• Infection treatment
• Topical Anti-inflammatories

Question 12

How does scleritis present?

Answer 12

• Severe Boring type pain
• Diffuse redness
• Normal vision
• No discharge

Question 13

How does Acute angle closure glaucoma present?

Answer 13

• Severe pain & headache
• Vomiting
• Fixed mid-dilated pupil
• Pericorneal Redness
• Vision loss
• Possible discharge

Question 14

What causes acute angle-closure glaucoma?

Answer 14

Some event triggers closure of the angle in a predisposed eye leading to a back up of aqueous humor –> Raised IOP

Question 15

How does a corneal abrasion or ulcer present?

Answer 15

• Severe pain on eye closing
• Pericorneal redness
• Possible discharge
• Visual loss

Question 16

What are the types of eye cellulitis?

Answer 16

Preseptal

Orbital

Question 17

What causes both types of cellulitis?

Answer 17

Preseptal cellulitis:
- Lid cyst or insect bite

Orbital Cellulitis
- Sinusitis & Dental Infection

Question 18

How do the types of cellulitis present?

Answer 18

Severe Pain
Redness
Lid Swelling

Orbital Cellulitis also causes diplopia, blurred vision, limited extra ocular eye movements and Exophthalmos (outward bulging of the eye)