The red eye Flashcards Preview

Opthalmology > The red eye > Flashcards

Flashcards in The red eye Deck (18):
1

What is blepharitis?

-inflamed eyelids
-can be anterior or posterior

2

What is anterior blepharitis? how does this affect the conjunctiva? what else can this involve?

• Inflammation of the lid margin is concentrated in the lash line can accompanied by squamous debris around the eyelashes
• Conjunctiva becomes injected
• In severe disease cornea is affected
(Blepharokeratitis)
• Small infiltrates or ulcers may form in the peripheral cornea
(marginal keratitis)

3

What causes anterior blepharitis?

Seborrhoeic (squamous) scales on the lashes
Staphylococcal – infection involving the lash follicle
Lid margin redder than deeper part of lid

4

What are the clinical signs seen in seberrhoeic blepharitis?

Lid margin red
Scales ++
Dandruff+
(No ulceration, lashes unaffected)

5

What are the clinical signs seen in staphylococcal blepharitis?

-lid margin red

-Lashes distorted, loss of lashes, ingrowing lashes - trichiasis

-Styes, ulcers of lid margin

-corneal staining, marginal ulcers (due to exotoxin)

6

What is posterior blepharitis ? what is it also known as?

• This is also known as meibomian gland dysfunction

Meibomian glands are usually obstructed by squamous debris

7

How is posterior blepharitis different from anterior blepharitis?

redness is in deeper part of lid
lid margin often quite normal looking

8

What are the signs seen in posterior blepharitis? what is this also assoc. with?

-Lid margin skin and lashes unaffected

-M.G. openings pouting & swollen

-Inspissated (dried) secretion at gland openings

-Meibomian Cysts (chalazia)

--Associated with Acne Rosacea (50%)

9

How is anterior and posterior blepharitis managed?

Lid hygiene – daily bathing / warm compresses

Supplementary tear drops

Oral doxycycline for 2-3 months

Very difficult to eradicate

10

What is anterior uveitis also known as?

iritis

11

What are the different:
-autoimmune
-infective
-malignant
-other
causes of anterior uveitis

Autoimmune:
-Reiter’s, ulcerative colitis, ankylosing spondylitis, sarcoidosis

Infective:
-T.B, syphilis, herpes simplex, herpes zoster

Malignancy:
-Leukaemia

Other:
-Idiopathic, traumatic, secondary to other eye disorders

12

What are the symptoms of anterior uveitis?

Pain (+ referred pain)
Vision may be reduced
Photophobia
Red eye (circumcorneal)
nb often missed and treated as conjunctivitis

13

What are the signs seen in anterior uveitis

Ciliary injection (i.e. circum-corneal )
Cells & flare in anterior chamber
Keratic precipitates
Hypopyon
Synechiae – causes irregular pupil iris adheres to cornea or lens
Small or irregular pupil

14

What is the treatment of anterior uveitis?

topical steroids
Pred Forte 1% Hourly tapering over 4-8 weeks
Mydriatics eg
Cyclopentolate 1% BD
investigate for systemic associations if recurrent or chronic

15

What is episcleritis? is this common? what is this assoc. with? What is the treatment?

inflamation of the episclera

-Relatively common / no serious associations

-Association with gout

-Recurrent

-Nodules may occur

-Self limiting
-Lubricants / topical NSAIDs / mild steroids

16

What is scleritis?
what is this assoc. with?
what symptoms/signs seen?
what is the treatment?

-Association with serious systemic vasculitides e.g. Rh arthritis, Wegener’s

-PAINFUL +

-Injection of deep vascular plexus – ‘violaceous hue’

-Phenylephrine test

-Associated uveitis common

Treatment:
-Oral NSAIDs
-Oral Steroids
-Steroid Sparing Agents

17

Acute closed angle glaucoma:
-what is this?
-what are the clinical features?

-IOP rises acutely due to the drainage angle being closed (pupil dilatation precipitates it)

-Elderly* hypermetropic – thick glasses

-Severe pain + nausea

-Circumcorneal injection

-Cornea cloudy (oedematous)

-Pupil mid dilated

-Eye stony hard

18

How does subacute closed angle glaucoma present?

Subacute closed angle presents with intermittent attacks typically lasting 1-2 hours and are associated with blurring of vision and haloes around light sources