Eye concerns

Question 1

Name 7 DDx for red eye

Answer 1

• Conjunctivitis
• FB
• Angle-Closure Glaucoma
• Keratitis
• Subconjunctival hemorrhage
• Anterior uveitis
• Reactive arthritis
• Lyme disease

Question 2

Name 5 components of physical examination for red eye concerns

Answer 2

Pupils assessment
Lid inspection
Eyelid inversion
Visual acuity (Snellen chart)
If needed: Fluorescein staining

Question 3

What is the first-line treatment for uncomplicatedbacterial conjunctivitis

Answer 3

Topical antibiotics (Polysporin)

Question 4

What is the preferred antibiotic for conjunctivitis in a patient who wears contact lenses? Which bacteria should be covered?

Answer 4

Moxifloxacin eye drops
(covers Pseudomonas)

Question 5

Name 5 red flag symptoms for eye concerns

Answer 5

Sudden vision loss (partial or complete)

Severe eye pain

New-onset diplopia

Flashes and/or new floaters (especially with visual field defect “curtain”)

Photophobia with decreased vision

(Other acceptable answers: chemical exposure, penetrating trauma, proptosis, painful red eye in contact lens wearer.)

Question 6

Which medication should be avoided in keratitis?

Answer 6

Steroids

Question 7

Name 3 systemic conditions that can have red eyes

Answer 7

Rheumatoid arthritis (episcleritis/scleritis)

Inflammatory bowel disease (uveitis/episcleritis)

Systemic lupus erythematosus (episcleritis/scleritis)

(Other acceptable answers: Sarcoidosis, Ankylosing spondylitis, Reactive arthritis, vasculitides.)

Question 8

What does globe pain with palpation can indicate?

Answer 8

Scleritis

Question 9

Name 4 S+S of glaucoma

Answer 9

painful red eye, halos, headache, nausea

Question 10

What is the preferred diagnostic modality for glaucoma?

Answer 10

Tonometry

Question 11

When should ESR be ordered in a red eye?

Answer 11

If temporal arteritis is suspected (age >50, headache, jaw claudication, vision changes).

Question 12

What investigation is preferred if an intraocular foreign body is suspected?

Answer 12

CT scan of the orbit (avoid MRI).

Question 13

What is the universal prophylaxis for neonatal conjunctivitis?

Answer 13

Topical erythromycin ophthalmic ointment given to all newborns shortly after birth (within the first 24 hours).

Question 14

How do you differentiate allergic from infectious conjunctivitis? (3)

Answer 14

Allergic → itchy, bilateral, watery

Viral → watery, preauricular node

Bacterial → purulent discharge

Question 15

Why should steroids be avoided in keratitis?

Answer 15

They can worsen infection and increase risk of corneal perforation

Question 16

Name 3 systemic diseases associated with iritis

Answer 16

Ankylosing spondylitis

Crohn’s disease

Lupus

Question 17

What is a synonim for bacterial keratitis?

Answer 17

Corneal ulcer

Question 18

What is the main pathogmonic sign of bacterial keratitis on exam?

Answer 18

White spot on cornea
(accompanied by red eye, FB sensation and photophobia)

Question 19

What is the spot diagnosis method for herpetic viral keratitis?

Answer 19

Orange fluorescein + Cobalt blue light demonstrating a branching pattern

Question 20

What is an abnormal IOP?

Answer 20

≥21 mmHg

Question 21

Name three agents used foracute angle-closure glaucoma

Answer 21

Acetazolamide

Timolol

Pilocarpine

(Also acceptable: Mannitol, Brimonidine.)

Question 22

What are the two management strategies for a patient with a blunt trauma in which you suspect globe rupture?

Answer 22

Eye shield + penetrating injury

Question 23

Definitive treatment for angle-closure glaucoma

Answer 23

Laser peripheral iridotomy