Red Eye

Question 1

causes of red eye

Answer 1

conjunctivitis, acute closed angle glaucoma, iritis, scleritis, episcleritis, trauma, keratitis, subconjunctival haemorrhage

Question 2

presentation acute closed angle glaucoma

Answer 2

acute uniocular attacks with headache, nausea, painful red eye, blurred vision, haloes around light

Question 3

normal intraocular pressure

Answer 3

15-20

Question 4

signs acute closed angle glaucoma

Answer 4

oval non reactive pupil, loss of red reflex, hypermetropia

Question 5

cause acute closed angle glaucoma

Answer 5

blocked flow of aqueous from anterior chamber via canal of Schlemm. intraocular pressure rises to >30mmHg

Question 6

treatment acute closed angle glaucoma

Answer 6

pilocarpine 2-4% drops. acetazolamide stat. mannitol. topical steroids and antihypertensives. peripheral iridectomy

Question 7

what is iritis

Answer 7

inflammation of anterior uvea- anterior uveitis (ciliary body is involved)

Question 8

features iritis

Answer 8

pain- aching may be aggravated by reading, red, photophobia, watery, blurred vision

Question 9

signs iritis

Answer 9

redness, inflammatory cells and flare- exudate detected by slit lamp examination, keratic precipitates, miosis, intraocular pressure can be low high or normal, fundus

Question 10

causes iritis

Answer 10

herpes virus, trauma, fuchs heterochromic cyclitis, arthritides, ankylosing spondylitis, reiters syndrome, psoriatic arthritis, IBD, juvenile chronic arthritis, sarcoidosis, behcets, syphilis

Question 11

investigations iritis

Answer 11

ESR, FBC, ACE level, HLA typing

Question 12

treatment iritis

Answer 12

topical steroids- prednisolone drops, betamethasone, dexamethasone. cyclopentolate (dilates eye), intravitreal and biological agents

Question 13

what test is +ve in iritis

Answer 13

talbots test

Question 14

complications iritis

Answer 14

cataract, glaucoma, macular oedema

Question 15

bacterial conjunctivitis signs

Answer 15

red eye with purulent discharge

Question 16

viral conjunctivitis signs

Answer 16

red eyes with watery discharge

Question 17

commonest virus in conjunctivitis

Answer 17

adenovirus

Question 18

bacterial causes conjunctivitis

Answer 18

staph aureus, staph epidermidis, strep pneum, H influena, chlamydia trachomatis

Question 19

is the acuity affected in conjunctivitis

Answer 19

no

Question 20

what happens to the pupil in conjunctivitis, ant uveitis/iritis, acute glaucoma

Answer 20

normal, small, large

Question 21

treatment conjunctivitis

Answer 21

chloramphenicol drops or fusidic acid

Question 22

do you get papillae or follicles in bacterial conjunctivitis

Answer 22

papillae in bacterial, follicles in viral and chlamydial

Question 23

features of allergic conjunctivitis

Answer 23

rapid onset. itch, lid swelling, conjunctival oedema

Question 24

what can allergic conjunctivitis be due to

Answer 24

pollen or other allergens. settles after a few hours

Question 25

treatment allergic conjunctivitis

Answer 25

antihistamine drops eg emastidine

Question 26

what happens to acuity in anterior uveitis and acute closed angle

Answer 26

reduced

Question 27

what are episcleritis and scleritis

Answer 27

inflammation of the opaque ocular outer wall- white of the eye

Question 28

features episcleritis and scleritis

Answer 28

aching and redness, which are more severe in scleritis

Question 29

in epi or scleritis can the sclera look blue

Answer 29

in episcleritis- engorged vessels that can be moved over the area. scleritis- engorged vessels run deeper

Question 30

presentation episcleritis

Answer 30

eye aches dully and tender. acuity ok. no discharge.

Question 31

what can episcleritis be associated with

Answer 31

rarely- systemic disease- rheumatic fever, PAN, SLE

Question 32

treatment episcleritis

Answer 32

self limiting. topical or systemic NSAIDs

Question 33

which is a more serious condition- scleritis or episcleritis

Answer 33

scleritis

Question 34

presentation scleritis

Answer 34

severe pain, common to be associated with systemic disease, visual disturbance not uncommon

Question 35

what is scleritis

Answer 35

vasculitis of the sclera

Question 36

what can happen to sclera in scleritis

Answer 36

thinning also corneal thinning and perforation can occur

Question 37

underlying systemic disorders in scleritis

Answer 37

connective tissue disorders, RA, SLE, herpes zoster ophthalmicus

Question 38

treatment scleritis

Answer 38

topical and systemic steroids, NSAIDs, immunosuppressants

Question 39

what is keratitis

Answer 39

corneal inflammation- white area on the cornea

Question 40

compications keratitis

Answer 40

scarring and vascularisation- corneal opacification and astigmatism- visual loss