Red Eye, Ddx

Front 1

what are your first steps in assessing red eye?

Back 1

1. assess pain,
2. visual acuity,
3. type of eye discharge,
4. pupillary abnormalities

Front 2

what are the si/sx of bacterial conjunctivitis?

Back 2

1. minimal pain, no vision changes
2. purulent discharge
3. no pupillary changes
4. rarely preauricular adenopathy (only c/ Neisseria gonorrhoeae)

Front 3

what are causes of bacterial conjuncitivits?

Back 3

1. S. pneumo
2. Staph spp.
3. N. gonorrhoeae
4. Chlamydia trachomatis (in neonates and sexually active adults)

Front 4

what is tx for bacterial conjunctitivits?

Back 4

(purulent discharge, rare preauricular adenopathy)
1. topical sufacetamide or
2. erythromycin

Front 5

what are si/sx of viral conjuncitivits?

Back 5

1. minimal pain, no vision changes
2. watery discharge
3. no pupillary changes
4. often preauricular adenopathy
5. often pharyngitis (adenovirus)

Front 6

what are causes of viral conjucntivitis?

Back 6

1. m/c is adenovirus
2. HSV
3. varicella
4. EBV
5. influenza
6. echovirus
7. coxsackie virus

Front 7

what is tx for viral conjunctivitis?

Back 7

1. no tx required
2. self-limiting dz

Front 8

what are si/sx of allergic conjuncitivitis?

Back 8

1. no pain, vision, or pupil changes
2. marked pruritus
3. b/l watery eyes

Front 9

what are the causes of allergic conjunctivitis?

Back 9

1. allergy
2. hay fever

Front 10

what is tx for allergic conjunctivitis?

Back 10

1. antihistamine or
2. steroid drops

Front 11

what are si/sx of hyphema?

Back 11

1. pain, no vision changes
2. no discharge, no pupil changes
3. blood in anterior chamber of eye, fluid level noted

Front 12

what is the cause of hyphema?

Back 12

(blood in anterior chamber of eye, fluid level noted)
1. blunt ocular trauma

Front 13

what is tx of hyphema?

Back 13

blood in anterior chamber of eye, fluid level noted
tx=eye patch to decrease movement

Front 14

what are si/sx of xerophthalmia?

Back 14

1. minimal pain, vision blurry, no pupillary changes, no discharge
2. Bitot's spots visble on exam (desquamated, conjunctival cells)

Front 15

what are Bitot's spots?

Back 15

1. desquamated, conjunctival cells
2. seen in xerophthalmia

Front 16

what are causes of xerophthalmia?

Back 16

1. sjogren's disease or
2. vit A def

Front 17

what is tx for xerophthalmia?

Back 17

1. artificial tears
2. vit A

Front 18

how do you dx xerophthalmia?

Back 18

1. dx by Schirmer test=place filter paper over eyelid, if not wet in 15 min=dx
2. keratoconjunctivitis sicca (sjogren's disease)

Front 19

what are si/sx of corneal abrasion?

Back 19

1. painful, with photophobia
2. no pupil changes
3. watery discharge
4. dx by fluorescein stain to detect areas of corneal defect

Front 20

what are causes of corneal abrasion?

Back 20

1. direct trauma to eye (finger, stick, etc.)

Front 21

what is tx for corneal abrasion?

Back 21

1. abx
2. eye patch
3. examine daily

Front 22

what are si/sx of keratitis?

Back 22

1. pain, photophobia, tearing
2. decreased vision
3. herpes shows classic dendritic branching on fluorescein stain
4. pus in anterior chamber (hypopyon) is a grave sign

Front 23

what are the causes of keratitis?

Back 23

1. adenovirus
2. HSV (shows classic dendritic branching on fluorescein stain)
3. Pseudomonas
4. S. pneumoniae
5. Staphylococcus spp.
6. Moraxella (often in contact lens wearers)

Front 24

what is tx for keratitis?

Back 24

1. emergency!!
2. immediate Ophthalmology consult
3. tx=topical vidarabine for herpes

Front 25

what is uveitis?

Back 25

1. inflamm of the iris, ciliary body and/or choroid

Front 26

what are si/sx of uveitis?

Back 26

(inflamm of the iris, ciliary body and/or choroid)
1. pain
2. miosis
3. photophobia
4. flare and cells seen in aqueous humor on slit-lamp examination

Front 27

what are causes of uveitis?

Back 27

1. seen in seronegative spondyloarthropathy
2. inflammatory bowel disease
3. sarcoidosis
4. infxn (CMV, syphilis)

Front 28

what is tx for uveitis?

Back 28

1. tx underlying dz

Front 29

what are si/sx of angle-closure glaucoma?

Back 29

1. severe pain
2. decreased vision, halos around lights
3. fixed mid-dilated pupil
4. eyeball firm to pressure

Front 30

what is the cause of angle-closure glaucoma?

Back 30

1. decreased aqueous humor outflow via canal of Schlemm
2. mydriatics can also cause

Front 31

where do you find severe eye pain, decreased vision and fixed mid-dilated pupils?

Back 31

Angle closure glaucoma!
d/t decreased aqueous humor outlfow via canal of Schlemm

Front 32

how do you tx angle-closure glaucoma?

Back 32

1. emergency
2. IV mannitol and acetazolamide
3. laser iridotomy for cure