Red eye Flashcards by Priya Gill

what are some common causes of a red eye?

Conjunctivitis (blepharo-conjunctivitis )
Keratitis
Anterior uveitis
Scleritis / Episcleritis
Acute Angle Closure Glaucoma

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what are some rarer causes of red eye?

subconjunctival haemorrhage

orbital disease - cellulitis

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what are important ocular history questions to ask in a red eye presenting complaint?

Pain
itch
discharge  / tearing
photophobia
visual loss
past ocular disorders
contact lenses

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what is blepharitis?

inflamed eyelid

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what two types of blepharitis are there?

anterior and posterior

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what are some causes of an anterior blepharitis?

seborrhoeic (squamous) - scales on the lashes

staphylococcal - infection involving the lash folicle

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how will an anterior blepharitis often present?

lid magin redder than the deeper part of the lid

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what is a cause of posterior blepharitis?

meibomian gland dysfunction (MGD)

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how does posterior blepharitis often present?

redness in deeper part of lid

lid margin often quite normal looking

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what are the symptoms of blepharitis?

similar to conjunctivitis
gritty eyes / foreign body sensation
mild discharge

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what are some signs of a seborrhoeic anterior blepharitis?

lid margin red
scales
dandruff
no ulceration - lashes unaffected

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what are some signs of staphylococcal anterior blepharitis?

lid margin red
Lashes distorted, loss of lashes, ingrowing lashes - trichiasis
Styes, ulcers of lid margin
corneal staining, marginal ulcers (due to exotoxin)

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How does Meibomian gland disease” present?

Lid margin skin and lashes unaffected
M.G. openings pouting & swollen
Inspissated (dried) secretion at gland openings
Meibomian Cysts (chalazia)

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what diseases is Meibomian gland disease commonly associated with?

acne rosacea - 50%

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what is the treatment for blepharitis?

lid hygiene - daily bathing
supplementary tear drops
oral doxycycline for 2-3 months

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What are some infective causes of conjunctivitis?

viral
bacterial
chlamydial

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what are some non-infective causes of conjunctivitis?

allergic
chemical/drugs
skin diseases - eczema

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what are the symptoms of conjunctivitis?

red eye 
foreign body sensation – gritty eye
discharge – sticky eye
Itch = allergy
VISION UNAFFECTED

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what are the signs of conjunctivitis?

Red eye - note pattern of redness – diffuse more towards the fornices
Discharge -
Papillae or Follicles (bumps on inside of eyelid
Sub conj. haemorrhage
Chemosis = oedema
Pre-auricular glands (if viral)

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what is a key sign in bacterial conjunctivitis?

sticky discharge

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what are the most common infecting organisms in bacterial conjunctivitis?

staph. aureus
strep. pneumoniae
H. influenzae

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when is follicular conjunctivitis seen?

viral
chalmaydial
drugs - propane / trruspot

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what is chemosis?

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conjunctival oedema

what are some causes go chronic conjunctivitis?

Study These Flashcards

blepharitis
chlamydial infection
lacrimal disease
sensitivity of topical glaucoma medication
sub-tarsal foreign body

what are some causes of infective corneal ulcers?

viral fungal bacterial acanthamoeba

where do central corneal ulcers present?

centrally

what are some autoimmune causes of corneal ulcer?

Rheumatoid arthritis | hypersensitivity

where do autoimmune corneal ulcers tend to present?

peripherally

what are some symptoms of a corneal ulcer

``` pain - needle like photophobia profuse lacrimation possible reduced vision red eye- circumcorneal ```

what are some signs of a corneal ulcer?

redness - circumcorneal abnormal corneal reflex corneal opacity

what investigations would you do for a suspected corneal ulcer?

corneal scrape for gram stain and culture Staining with fluorescein hypopon - white blood cells forming a fluid level in eye

what shape to ulcers caused by H. simplex tend to be?

dendritic

what diseases are associated with exposure keratitis

``` thyroid problems VII palsy (bells palsy) ```

what disease is associated with Keratoconjunctivitis sicca - dry eye

sjogrens

what vitamin deficiency can cause corneal ulcers?

Vitamin A

what is the problem in neurotrophic keratitis?

reduced sensation in the eye

what are some causes of neurotrophic keratitis?

Diabetes H zoster V1 problem

what is the treatment of a bacterial corneal ulcer?

ofloxacin hourly

What is the treatment for a herpetic corneal ulcer?

Aciclovir ointment 5 x day

What is the treatment of an autoimmune corneal ulcer?

anti-inflammatory agents - oral / topical steroids

what are some autoimmune causes of anterior uveitis?

Reiter's, Ulc colitis, Ank Spondylitis, Sarcoidosis

What are some infective causes of anterior uveitis?

T.B. Syphylis, Herpes simplex, Herpes zoster

What are some malignant causes of anterior uveitis?

leukemia

what are the symptoms of anterior uveitis?

``` Pain (+ referred pain) Vision may be reduced Photophobia Red eye (circumcorneal) (often mistaken as conjunctivitis) ```

what are the signs of anterior uveitis?

``` Ciliary injection (i.e. circum-corneal ) Cells & flare in anterior chamber Keratic precipitates Hypopyon Synechiae - Small or irregular pupil ```

what is the management of anterior uveitis?

topical steroids - red forte 1% hourly tapering over 4-8 hours mydriatics - Cyclopentolate 1% BD Investigate for systematic association

what is associated with episcleritis?

gout

what is scleritis associated with?

serious systemic vasculitides e.g. Rh arthritis, Wegener’s | uveitis

what are the signs and symptoms of scleritis?

painful | injection of deep vascular plexus - violaceous hue

what test can be done for scleritis?

phenylephrine test

what is the treatment for episcleritis?

self-limiting lubricants topical NSAIDs

what is the treatment for scleritis?

oral NSAIDs Oral steroids steroid sparing agents

is acute closed angle glaucoma common or rare?

rare

What happens in acute closed angle glaucoma?

IOP rises do to the drainage angle being closed

what are the signs and symptoms of acute closed angle glaucoma?

``` severe pain and nausea circumcorneal injection cloudy cornea mid dilated pupil stony hard eye ```

Red eye Flashcards

(55 cards)