Eye Disorders

A 30 YO male presents with a 3-day history of left eye redness, associated with mucopurulent discharge that causes his eyelids to be stuck together especially upon awakening from sleep. His VA is unchanged. What is the likely diagnosis?

• Bacterial conjunctivitis

• Viral conjunctivitis

• Allergic conjunctivitis

• Vernal Keratoconjunctivitis

Answer explanation

Diffuse redness of the conjunctiva, mucopurulent discharge, visual acuity not affected, eyelids stuck together in the morning is suggestive of bacterial conjunctivitis.

What is the appropriate management?

• Topical antihistamine

• Supportive therapy (artificial tears, cold compresses)

• Topical antibiotics

• Topical decongestants

A 20 YO female presents with eye redness and discomfort that initially involved her left eye and then spread to the right. Associated with bilateral watery discharge and tender swelling in front of both ears. Her VA is unaffected. What is the likely diagnosis?

• Allergic conjunctivitis

• Viral conjunctivitis

• Vernal Keratoconjunctivitis

• Bacterial conjunctivitis

Answer explanation

Contagious “both eyes involved after a few days”, watery discharge, pre-auricular lymph nodes swelling, and intact vision is suggestive of viral conjunctivitis.

What is the appropriate management?

• Topical antihistamine

• Supportive therapy (artificial tears, cold compresses)

• Topical antibiotics

• Topical decongestants

A 14 YO girl presents to the clinic complaining of recurrent episodes of bilateral eye redness and itchiness, associated with sneezing and a mucoid discharge from her eyes and nose. What is the likely diagnosis?

• Bacterial Conjunctivitis

• Viral Conjunctivitis

• Vernal Keratoconjunctivitis

• Allergic Conjunctivitis

Answer explanation

Bilateral eye involvement, transient, itchy, mucoid discharge and sneezing is suggestive of allergic conjunctivitis.

What is the appropriate management?

• Topical antihistamine

• Supportive therapy (artificial tears, cold compresses)

• Topical antibiotics

• Ophthalmology referral

An 8 YO boy, known to have asthma, presents with a 2-year history of intense itchiness and burning/foreign body sensation of both eyes, associated with a thick mucoid discharge and increased sensitivity to light. What is the likely diagnosis?

• Bacterial Conjunctivitis

• Viral Conjunctivitis

• Vernal Keratoconjunctivitis

• Allergic Conjunctivitis

Answer explanation

• - Pathology: bilateral recurrent form of ocular allergy that may lead to giant papillary conjunctivitis, limbal inflammation, or both.

• - Onset: before the age of 10-years, usually in boys.

• - Associated with history of asthma or eczema.

What is the appropriate management?

• Oral antihistamines, topical lubricants and ophthalmology referral

• Supportive therapy (artificial tears, cold compresses)

• Topical antibiotics

• Ophthalmology referral

A 40 YO man presents with a 10 year history of redness and irritation. Associated with a noticeable change over his left eye. What is the likely diagnosis?

• Bacterial corneal ulcer

• Acute anterior uveitis

• Corneal abrasion

• Pterygium

Answer explanation

Wing shaped degeneration of the conjunctiva that grows over the cornea, usually from nasal side, crosses the limbus into the cornea.

What is the appropriate management?

• Surgical removal is only indicated when it extends >2mm over limbus.

• Tear substitutes and mild topical steroid, if inflamed

• Limiting UV exposure (wearing dark glasses)