QuestionSBA
QuestionChoice
This is incorrect. Anterior uveitis should be considered in patients with a painful red eye. However, it is typically also associated with blurred vision and headaches.
10027635
e
Anterior uveitis
QuestionChoice
This is incorrect. Although this can also present with a red eye, eye itching, irritation and excessive tearing would also be present. Pain is typically not as severe.
10027633
c
Conjunctivitis
QuestionChoice
This is correct. Scleritis presents with a painful red eye and pain on eye movements. It is more common in those with autoimmune conditions such as rheumatoid arthritis. Mild scleritis tends to be treated with NSAIDs and more severe or necrotising scleritis can be treated with corticosteroids.
10027631
a
Scleritis
QuestionChoice
This is incorrect. This is inflammation of the optic nerve and causes painful eye movements. However, optic neuritis is also associated with vision loss and red-green colour discrimination deficits, which this patient does not have.
10027634
d
Optic neuritis
QuestionChoice
This is incorrect. Although episcleritis also presents with a red eye, episcleritis is inflammation of the episclera underneath the conjunctiva. Episcleritis tends to present with milder pain, and episcleral vessels will blanch. Management is mostly supportive and can include the use of artificial tears for symptomatic relief.
10027632
b
Episcleritis
Concept
Chapter
2693
5993
Episcleritis and Scleritis
Topic
140
Ophthalmology
17924
A 43 year old male attends eye casualty complaining of a painful right eye. He describes the pain as 9/10 in severity which becomes worse when he moves his eye. He denies any headaches or blurred vision.

The only medical history of note is rheumatoid arthritis for which he takes methotrexate and folic acid.

On examination, the sclera is diffusely erythematous. Fluorescein eye stain does not detect any foreign bodies, and episcleral vessels do not move or blanch when pressed with a cotton bud. Visual acuity and colour vision is normal.

Which of the following is the most likely diagnosis?
a