Red Eye

Question 1

<p>What protection do the lids provide?</p>

Answer 1

<p>Blinking

| Secrete meibum </p>

Question 2

<p>What protection do the tears provide?</p>

Answer 2

<p>IgA
Drainage
Complement
Lyzozyme</p>

Question 3

<p>What different types of pain may a patient complain of in the eye?</p>

Answer 3

<p>Foreign body
Grittines
Dry
Ache</p>

Question 4

<p>What types of discharge might a patient have? </p>

Answer 4

<p>Watery

| Purulent</p>

Question 5

<p>What are the symptoms of blephritis?</p>

Answer 5

<p>Gritty sensation

| Mild discharge</p>

Question 6

<p>What can blephritis be associated with?</p>

Answer 6

<p>Conjunctivitis
Keratitis
Episcleritis </p>

Question 7

<p>What cells are affected in a seborrhoeic blephritis?</p>

Answer 7

<p>Squamous cells</p>

Question 8

<p>What are the signs of a seborrhoeic blephritis?</p>

Answer 8

<p>Red margin
Scales
Dandruff
</p>

Question 9

<p>Is the any lash involvement in seborrhoeic blephritis?</p>

Answer 9

<p>No</p>

Question 10

<p>What tissue is affected in staphylococcal blephritis?</p>

Answer 10

<p>Lash follicle </p>

Question 11

<p>What are the signs of staphylococcal blephritis?</p>

Answer 11

<p>Red margin</p>

Lash loss
Trichiasis (ingrowing)
Corneal staining

Question 12

Why do you get corneal staining in staphylococcal blephritis?

Answer 12

Staph. exotoxin production

Question 13

What are the causes of anterior blephritis?

Answer 13

Seborrhoeic

Staphyococcal

Question 14

What causes posterior blephritis?

Answer 14

Meibomian gland disease

Question 15

What are the signs in Meibomian gland disease?

Answer 15

Meibomian cysts
Lid margins unaffected
Meibomian glands swollen
Dry eyes (inspissated)

Question 16

Why do the eyes feel dry with meibomian cysts?

Answer 16

Meibomian glands produce meibum
Meibum moisturises eye
Blocked gland causes dry eyes

Question 17

How can belphritis be treated?

Answer 17

Lid hygeine
Tear drops
Oral doxycycline 2-3 months if severe

Question 18

What are the symptoms of conjunctivitis?

Answer 18

Red eye
Foreign body sensation
Gritty eye
Sticky discharge
Itch (if allergic)

Question 19

Is vision affected in conjunctivitis?

Answer 19

No

Question 20

What are the signs of conjunctivitis?

Answer 20

Diffuse injected vessels
Discharge
Sub conjunctival haemorrhage
Chemosis (oedema)

Question 21

What types of organisms can cause conjunctivitis?

Answer 21

Bacteria
Viruses
Drugs
Allergens

Question 22

What organisms can cause bacterial conjunctivitis?

Answer 22

Staph. aureus
Strep. pneumoniae
H. Influenzae

Question 23

What are the signs of bacterial conjunctivitis?

Answer 23

Pink papillae

Question 24

How long does bacterial conjunctivitis last?

Answer 24

self limiting

14 days

Question 25

How can bacterial conjunctivitis be treated?

Answer 25

Topical antibiotics

Question 26

What viruses can cause conjunctivitis

Answer 26

Adenovirus Herpes simplex Herpes zoster

Question 27

What are the signs of viral conjunctivitis?

Answer 27

White follicular involvement

Question 28

What else can cause white follicular conjunctivitis?

Answer 28

Chlamydia

Question 29

What are causes of chronic conjunctivitis?

Answer 29

``` Glaucoma medication Chlamydia Keratoconjunctivitis sicca Sub tarsal foreign body Lacrimal disease ```

Question 30

What are the signs of drug induced conjunctivitis?

Answer 30

White follicluar

Question 31

What part of the eye does keratitis affect?

Answer 31

Cornea

Question 32

What are the symptoms of keratitis?

Answer 32

Needle like pain Photophobia Profuse lacrimation (tears) Reduced vision

Question 33

Why is pain so severe in keratitis?

Answer 33

Cornea has many nerve fibres | Very sensitive to pain

Question 34

What are the signs of keratitis?

Answer 34

Corneal opacity May have hypopyon May see staining from flouriscene

Question 35

What is hypopyon?

Answer 35

Pus in anterior chamber

Question 36

What would be a sign of bacterial keratitis?

Answer 36

Purulent pus

Question 37

What can be a viral cause of keratitis and what sign would you see?

Answer 37

Herpes simplex | Dendritic ulcer

Question 38

How does Herpes simplex affect the eye?

Answer 38

Reduces sensation to the cornea | Dendritic ulcer

Question 39

How would you see a dendritic ulcer?

Answer 39

Using flouriscene

Question 40

How does eposure cause keratitis?

Answer 40

Eye dries out | Epithelium breaks down

Question 41

What can be and underlying reason for exposure?

Answer 41

Thyroid eye disease (exophthalmus) | CN VII nerve palsy (no blinking)

Question 42

What is keratoconjunctivitis sicca? What can cause this?

Answer 42

Dry eye syndrome | Sjogren's

Question 43

What is a neurotrophic cause of keratitis?

Answer 43

Herpes zoster

Question 44

Why does herpes zoster affect the cornea?

Answer 44

CN V1 involvement

Question 45

What vitamin deficiency can cause keratitis?

Answer 45

Vitamin A deficiency

Question 46

What investigations can be done for keratitis?

Answer 46

Corneal scrape Gram stain Culture

Question 47

What treatment for autoimmune keratitis?

Answer 47

Steroids (oral/topical)

Question 48

How can you treat bacterial keratitis?

Answer 48

Ofloxacin

Question 49

How are contact lens wearers treated with keratitis?

Answer 49

Need different antibiotics

Question 50

How can you treat herpectic viral keratitis?

Answer 50

Antiviral Aciclovir ointment (5 times daily)

Question 51

What do you look for on examination of keratitis?

Answer 51

Corneal light reflex vascularisation opacity oedema

Question 52

How do you examine the cornea?

Answer 52

Anaesthetic if photophobia | Use flouriscene for corneal abrasion

Question 53

What are the symptoms of anterior uveitis?

Answer 53

Pain Reduced vision Photophobia Circumcorneal injected vessels

Question 54

What are the signs of anterior uveitis?

Answer 54

``` Cilliary injection White cells in anterior chamber Keratic precipitate Hypopyon Synechiae ```

Question 55

What is synechiae?

Answer 55

Small/irregular pupil

Question 56

What autoimmune conditions cause anterior uveitis?

Answer 56

``` Ulcerative collitis (HLA B27) Ankylosing spondylitis (HLA B27) Sarcoidosis Reiter's ```

Question 57

What infections may cause anterior uveitis?

Answer 57

TB Syphilis (prostitute's eye) Herpes simplex Herpes Zoster

Question 58

How do you treat anterior uveitis?

Answer 58

Topical steroids 1% prednisolone 4-8 weeks Mydriatics cycopentolate 1% BD

Question 59

What are the signs of episceritis?

Answer 59

Partial inflammation of sclera | Nodules

Question 60

What condition is episcleritis associated with?

Answer 60

Gout

Question 61

What is the treatment for episcleritis?

Answer 61

Lubricants Topical NSAIDS Mild steroids

Question 62

Why should you be cautious with contact lens wearers?

Answer 62

More risk of infection

Question 63

What are the symptoms of scleritis?

Answer 63

Boring pain | Red thick injected vessels

Question 64

What are the signs of scleritis?

Answer 64

Deep vascular injection | Associated uveitis

Question 65

What conditions are associated with scleritis?

Answer 65

Rheumatoid arthritis | Wegner's

Question 66

How is scleritis treated?

Answer 66

Oral NSAIDs Oral steroids Steroid sparing agents

Question 67

What is the aetiology of acute closed and glaucoma?

Answer 67

Drainage from trabecular meshwork closed Aqueous can't drain Raised IOP Optic nerve compression

Question 68

What are the symptoms of acute closed angle glaucoma?

Answer 68

Severe pain | Nausea and Vomiting

Question 69

What are the signs of acute closed angle glaucoma?

Answer 69

Circumcorneal injection Corneal opacity Mid dilated pupil (before event) Stony hard eye

Question 70

Why is there corneal opacification?

Answer 70

Aqueous build up cause oedema

Question 71

Who get AACG?

Answer 71

Elderly | Hypermetropic

Question 72

Why is hypermetropia a risk factor for AACG?

Answer 72

Shorter eye Smaller iridocorneal angle Easier to close