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Ophtalmology > Red Eye > Flashcards

Red Eye Flashcards

0
Q

Conjunctival injection?

A

Engorgement of large & superficial bulbar conjunctival vessel

Move with conjunctiva

Constrict with tropical vasoconstrictor: phenylephrine

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1
Q

Definition of red eye?

Conjunctival injection?

Conjunctival congestion?

A

Red eye: discoloration of the eye due to sclera/conjunctiva hyperaemia

injection:
Redness and swelling caused by dilation of blood vessel secondary to inflammatiry or infectious process

Congestion: abnormal accumulation of fluid usually blood in body part, organ or area

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2
Q

Ciliary injection?

Indicating?

A

Injection of deep conjunctival and episcleral vessel surrounding cornea

Involve ranch of anterior ciliary arteries

Indicate: inflammation of cornea, iris or ciliary body

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3
Q

Acute viral conjunctivitis

Sign and symptoms?

A

Due to adenovirus

Sx and sign:

  1. Conjunctival chemosis
  2. Eyelid edema and follicles
  3. Tender and palpable preauricular LN
  4. Pseudomembrane formation
  5. Keratoconjunctivitis (keratitis)
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4
Q

Treatment viral conjunctivitis

A
  1. Spontaneous resolution within 2-3week + tropical eye drop

2. Pseudomembrane and keratitis - tropical steroid under supervision ophtalmologist

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5
Q

Bacterial conjunctivitis

Causes?
Sx and sign?
Treatment

A

Cause: s. Pneumonia, s. Aureus, H. Influenza, moraxella catarrhalis

Sx: mucopurulent, eyelid edema, red eye

Ix: swab c&s, pcr
Tx: topical antibiotic: chloramphenicol, gentamicin, ciprifloxacin

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6
Q

Allergic conjunctivitis

A

Acute allergic

Sx: papillary hypertrophy at superior tarsal conjunctival, limbitis, keratitis

Itchiness, watery or mucus discharge and chemosis

A/w allergic rhinitis

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7
Q

Treatment allergic conjunctivitis

A
  1. Avoidance allergen
  2. Topical anti histamine: levocabastine
  3. Mast cell stabilizer: olapatadim
  4. Ophtalmology referal
    - tropical steroid: flurometalone
    - suptarsal steroid injection: triamcinolone
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8
Q

Bacterial keratitis

Causes?
Risk factor?

A

Causes: pseudomonas aeruginosa, staphylococcus aureus, streptococci sp.

Risk factor: prolong contact lens, trauma, steroid usage, DM

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9
Q

Sx of bacterial keratitis and investigation

A

Sx:

  1. Corneal opacity
  2. Mucopurulent discharge
  3. Hypopyon

Ix:
1. Corneal scraping for gram stain and C&S

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10
Q

Treatment bacterial keratitis

A
  1. Topical antibiotic: forfitied gentamicin
  2. Tropical steroid:
    - to resuce scaring
    - may cause corneal perforation, then can use cyanoacrylate glue
  3. Corneal transplant - penetrating keratoplasty
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11
Q

Fungal keratitis

Causes and risk factor?

A

Yeast - candida
Filamentous - fusarium and aspergillus

Risk factor

  1. Vegetative material exposure
  2. Immunocompromised
  3. Prolong tropical steroid usage
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12
Q

Symptoms and investigation for fungal keratitis

A

Sx:

  1. Cornel infiltrate
    - suppurative (candida)
    - feathery & satellite lesion (filamentous)
    - endothelial pluque

Ix:
Corneal scraping - gram & giemsa stain
Culture on sabouraud dextroseagar

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13
Q

Treatment for fungal keratitis

A
  1. Topical antifungal: amphotericin
  2. Systemic antifungal: fluconazole, voriconazole
  3. Corneal transplant
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14
Q

Acanthamoeba keratitis

A

Protozoa

Risk factor: swimming with contact lens

Sx:

  1. severe eye pain,
  2. ring infiltrate
  3. Perineural infiltrate
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15
Q

Investigation and treatment of acanthamoeba keratitis

A

Ix:
I. corneal scraping C&S
II. Non-nutrient agar

Tx:
Corneal debridment
Topical amoebicide: polyhexamethylene biguainide, chlorhexidine, propaminide

16
Q

Viral keratitis

Causes?
Sx?

A

Herpes simplex keratitis - HSV type 1

Sx:
I. epithelial - dendritic ulcer
II. Necrotizing stromal and disciform (endotheliasis)
III. Disciform keratitis - central stroma edema with surrounding (wessely) immune ring
IV. Descement membrane fold
V. Keratic precipitate
VI. Elevated IOP, decrease corneal sensation

17
Q

4 Treatment of HSV keratitis

A
  1. Tropical antiviral: ointment aciclovir
  2. Systemic antiviral: oral aciclovir
  3. Topical steroid**: disciform keratitis
    * *contraindicated in dendritic ulcer
  4. Corneal transplant
18
Q

Corneal abrasion?

A

Corneal Epithelial defect d/t trauma, contact lens

Sx

  1. Painful
  2. Redness
  3. Tearing
  4. Foreign body sensation
19
Q

Diagnosis of corneal abrasion?

Treatment?

A

Dx: de-epithelialized stained with fluorescein

Tx:

  1. Eye pad
  2. Prophylaxis
  3. Vitamin c
  4. Pain relief
20
Q

Orbital cellulitis?

A

Bacterial cause usually sinus related especially ethmoid sinus

Sx: fever, unilateral periorbital & lid edema, proptosis, painful ophtalmoplegia, ON dysfunction

21
Q

Investigation and treatment for orbital swelling?

A

Ix:
CR scan orbit & paranasal sinus
MRI
Septic workout

Tx:
IV antibiotics: ceftazidime, ceftriaxone, vancomycin, metronidazole
Surgical drainage

22
Q

Endophythalamitis?

A

Intraocular infection/inflammation

Exogenous vs endogenous
Causes: bac/fungal

Sx: reduce vision, RAPD +ve, eyelid swelling, chemosis, hypopyon, vitritis, choriorenititis

23
Q

Investigation and treatment for endothalmitis

A

Ix: B scan ultrasound, vitreous tap for c&s

Tx:
Intravitreal antibiotics: ceftazidime, vancomycin, amphotericin B
Topical/systemic antibody
Mydriatics
Pars planar vitrectomy

Ophtalmology (9 decks)

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