QuestionSBA
QuestionChoice
This would be used in the treatment of bacterial conjunctivitis, which would also cause a red eye but would present with green/yellow discharge and a foreign body sensation rather than an irregular pupil and photophobia.
10028347
b
Topical chloramphenicol
QuestionChoice
This scenario describes a case of anterior uveitis, an inflammation of the middle layer of the eye. The mainstay of treatment is typically steroids combined with drugs like atropine/cyclopentalone to prevent adhesions between the iris and the lens (posterior synechiae). The back pain mentioned may suggest this patient has anterior uveitis related to ankylosing spondylitis.
10028346
a
Topical steroids
QuestionChoice
Whilst this may help improve pain, it would not adequately address the underlying inflammation in the eye. The history of back pain responsive to NSAIDs suggests an underlying ankolysing spondylitis.
10028350
e
NSAIDs
QuestionChoice
This is typically used in the treatment of a stye or chalazion and would be unlikely to help resolve the inflammation in a case of anterior uveitis.
10028348
c
Hot compress
QuestionChoice
This is the surgical management of acute angle closure glaucoma. Whilst this can present with a painful red eye, it is less likely to affect this patient age group and more commonly causes a fixed mid-dilated pupil than an irregular one. Blurry vision and nausea are also common features of acute angle closure glaucoma.
10028349
d
Laser peripheral iridotomy
Concept
Chapter
2693
6054
Uveitis
Topic
140
Ophthalmology
18067
Anterior uveitis often presents with eye pain, photophobia, and irregular pupil, and is commonly treated with topical steroids.
A 21-year-old male has a red and painful left eye. He describes difficulty looking at bright lights and increased tearing of the eye.

On examination, his left pupil is irregular in shape.

He has no past medical history but takes ibuprofen regularly for early morning back pain.

Given the likely diagnosis, which treatment is most likely to be commenced?
a