The Red Eye Flashcards
(98 cards)
1
Q
most common cause of red eye?
A
conjuctivitis
2
Q
when does subconjuctival haemorrhage most commonly occur?
A
in older patients with friable vessels or patients on warfarin. when they sneeze/cough/strain
3
Q
how is a subconjuctival haemorrhage managed?
A
-usually left alone, it is self limiting
4
Q
in what situation is orbital cellulitis often seen?
A
in a child with a sinus infection
5
Q
what are the things that make the ocular defences?
A
- lids
- tears
- conjuctivae
- epithelium
6
Q
what secretion is released from the lids?
A
meibomian
7
Q
what lid is more important in protecting the eye?
A
the upper lid
8
Q
what is an achey pain in the eye classic of?
A
intraocular infection
9
Q
what is an itch in the eye normally caused by?
A
allergy
10
Q
what type of discharge is associated with a bacterial infection?
A
purulent, sticky discharge
11
Q
what is mucoid discharge classic of?
A
allergic type reaction
12
Q
what does redness maximal at the limbus usually indicate?
A
an intra-ocular infection or keratitis
13
Q
what is the term for inflamed eyelids?
A
blepharitis
14
Q
what are the 2 different types of blepharitis?
A
anterior and posterior
15
Q
what can be seen in anterior blepharitis?
A
seborrhoeic (sqamous) scales on the lashes
16
Q
what pathogen often infects the lash follicle in anterior blepharitis?
A
staphlococcal
17
Q
where is most of the redness seen in blepharitis?
A
at the lid margin
18
Q
what is the problem in posterior blepharitis?
A
meibomian gland dysfunction
19
Q
where is the reddness seen in posterior blepharitis?
A
in deeper part of lid
20
Q
symptoms of blepharits?
A
- similar to conjuctivitis
- gritty eyes
- foreign body sensation
- mild discharge
21
Q
in a seborrhoeic anterior bleparitis, what are the signs?
A
- lid margin red
- a lot of scales and dandruff on margin
22
Q
what anterior blepharitis affects the lashes more?
A
a staphylococcal blepharitis
23
Q
what are the signs in a staphylococcal blepharitis?
A
- lid margin red
- lashes distorted, loss of lashes, ingrowing lashes
- styes, ulcers of lid margin
- corneal staining, marginal ulcers
24
Q
what is the correct term for ingrowing lashes?
A
trichiasis
25
what happens to the meibomian glands in posterior blepharitis?
the openings are pouting and swollen
26
what is around the gland openings in posterior blepharitis?
dried secretions
27
what is the result of dried secretions and swollen gland openings in posterior blephartis?
Meibomian Cysts
28
what is another name for meibomian cysts?
chalazia
29
what is associated (50%) with posterior blepharitis?
Acne Rosaecea
30
how can a meibomian cyst cause a stygmatism?
if it gets too big it can press on the eyeball
31
what is the treatment of blepharitis?
- lid hygiene- daily bathing/warm compresses
- supplementary tear drops
- oral doxycycline
32
how long should doxycycline be given for in blepharitis?
2-3 months
33
what are the infective causes of conjuctivitis?
viral, bacterial, chlamydial
34
what can cause a non-infective conjuctivitis?
- allergy
- chemicals/drugs
- skin diseases eg eczema
35
what is a viral conjuctivitis usually preceeded by?
a viral URTI
36
where is the redness more diffuse in conjuctivitis?
towards the fornices
37
what is the fornices?
space between the eyeball and eye socket
38
what is meant by chemosis?
oedema
39
what lymph glands are typically swollen in a viral conjuctivitis?
pre-auricular
40
how long does an acute bacterial conjuctivitis take to clear up without antibiotics?
about 14 days
41
most common organisms causing acute bacterial conjuctivitis?
- staph. aureus
- strep. pneumonia
- h.influenzae
42
what are papillae seen in?
bacterial conjuctivitis
43
what things can cause a follicular conjuctivitis?
- virus
- chlamydial infection
- drugs
44
what drugs can cause a follicular conjuctivitis?
propine, trusopt
45
what is the appearance and site of follicular conjuctivitis secondary to chlamydial infection?
raised white dots with redness around the base on the inner upper lip surface
46
what are the layers of the cornea from anterior to posterior?
- epithelium
- stroma
- endothelium
47
what is keratitis?
inflammation of the cornea
48
what are the causes of a central corneal ulcer?
- viral
- fungal
- bacterial
- acanthamoeba
49
what causes peripheral corneal ulcers?
Autoimmune conditions
- RA
- hypersensitivity
- rarely, GPA
50
In the UK, what kind of patients get a fungal corneal ulcer?
immunosuppressed patients
51
what is the pain like in a corneal ulcer?
severe- needle like pain
52
what virus can affect the corneal sensation?
herpes viruses
53
what are the symptoms of a corneal ulcer?
- pain
- photophobia
- profuse lacrimation
- may be reduced vision
- red eye
54
signs of corneal ulcers?
- redness
- corneal reflex abnormal
- corneal opacity
- hypopyon may be present
55
where is the redness seen in corneal ulcers?
circumcorneal - around the cornea
56
what is a hypopyon?
fluid level of white blood cells - inflammatory exudate
57
what kind of ulcer does H.simplex virus cause?
dendritic ulcer
58
what can happen to the edge of limbus in an auto-immune ulcer?
becomes obscured
59
in what conditions does a corneal ulcer form due to exposure keratitis?
- thyroid disease eg in proctosus in Graves
| - VII palsy
60
what does keratoconjuctivitis sicca mean?
dry eye
61
how does Sjorgens manifest in the eyes?
dry eyes
62
what conditions can cause neurotrophic keratitis leading to a corneal ulcer?
H zoster in ophthalmic division of trigeminal
63
what vitimin defiency can cause a corneal ulcer?
vit A
64
how is the cause identified in a corneal ulcer?
'corneal scrape' for gram stain and culture
65
what is the treatment for a bacterial corneal ulcer?
ofloxacin hourly
66
what is the treatment fora herpetic corneal ulcer?
aciclovir ointment 5 times a day
67
what is given to treat autoimmune corneal ulcers?
oral/topical steroids
68
what are the autoimmune causes of anterior uveitis?
-reiter's, UC, Ank Spon, Sarcoidosis
69
malignant causes of anterior uveitis?
leukemia
70
infective causes of anterior uveitis?
-TB, syphylis, herpes simplex, herpes zoster
71
what is anterior uveitis often mistreated as?
conjuctivitis
72
symtoms of anterior uveitis?
- pain
- vision may be reduced
- photophobia
- red eye
73
where is the redness most obvious in anterior uveitis?
circumcorneal - at the limbus
74
signs of anterior uveitis?
- ciliary injection
- cells and flare in anterior chamber
- keratic precipitates
- hypopyon
- small or irregular pupil
75
what is the term for an irregular pupil?
synechiae
76
where can the keratic precipitates be seen in anterior uveitus?
in inferior 1/3rd of cornea
77
treatment of anterior uveitis?
- topical steroids
| - mydriatics
78
what topical steroid is given to treat anterior uveitis?
Pred Forte 1%
79
what mydriatic is used in anterior uveitis and how often is it given?
cyclopentolate 1% BD
80
what systemic disease is episcleritis associated with?
gout
81
what usually iniates episcleritis?
a late night, lack of sleep
82
how is episclertits managed?
it is self-limiting, no serious associations
83
what can occur in recurrent episcleritis?
nodules
84
how can you differentiate between episcleritis and scleritis?
- scleritis is painful
| - apply vasoconstrictor drop to eye and the vessels will blaunche in episcleritis but they wont in scleritis
85
what is scleritits associated with?
serious systemic vasculitis eg RA, GPA
86
what is meant by the sign 'violaceous hue' in scleritis?
injection of deep vascular plexus
87
what would you expect in the phenylephrine test in scleritis?
vessels will not blaunche
88
what other feature in the eye often accompanies scleritis?
uveitis
89
treatment for scleritits?
oral NSAIDS, oral steroids, steroid sparing agents
90
what supportive treatment can be given in episcleritis?
lubricants, topical NSAIDS, possibly mild steroids
91
are hypermetropes or myotropes more likely to get acute closed angle glaucoma?
hypermetropes
92
where is the maximal redness in acute closed angle glaucoma?
at the limbus
93
why does IOP rise actutely in ACAG?
drainage angle is closed
94
what is the main symptom of ACAG?
severe pain, can make patient sick
95
where is the injected blood vessels most predominant in ACAG?
around cornea -limbus
96
what is the appearance of the cornea in ACAG?
cloudy (oedematous)
97
what state is the pupil in in ACAG?
mid dilated
98
how does the eye feel in ACAG?
stony hard
