Red Eye

Question 1

Explain systematic approach for lids

Answer 1

blepharitis symptoms (crusting,blocked oil glands,conjuctival injection), lid hygiene, rx

Question 2

Explain systematic approach for conjunctiva

Answer 2

Subconjunctival haemorrhage: no discharge, exclude trauma, FMH

Conjunctivitis (Viral, Bacterial, Allergic, Chlamydial) and other conjunctival lesions (yellow-white pinguecula, pink triangle pterygium)

Question 3

Explain systematic approach for the episclera and sclera

Answer 3

redness pattern of episcleral layer (more severe ~ scleritis where 50% px have systemic disease ~ treated with NSAID/steroids)

sclera: bilateral, severe pain, purple hue (deep episcleral vessels)

Question 4

Explain the systematic approach for the cornea

Answer 4

abrasions (foreign bodies), corneal ulcers:

bacterial keratitis: AC inflammation, pain, reduced VA, photophobia
marginal keratitis
viral keratitis: herpes simplex, recurrent, watery discharge
amoebic keratitis: patchy stroma

CL wear history, photophobia, pain

Question 5

Explain systematic approach for uvea

Answer 5

Uveitis: uveal tract inflammation (iris, choroid, ciliary body)
hyperaemia, keratic precipitates, posterior synechiae

Anterior: photophobia, pain (worse with accom.), lower vision, lacrimation (look for injection, aq cells/flare in AC)

treated with steroids/dilation

Question 6

Explain acute angle glaucoma

Answer 6

hyperaemia (circumcorneal injection), corneal epithelial oedema

pupil dilated/oval, absent/reduced pupil reflex
HIGH IOPs