CM: Chronic Vision Loss & Trauma Flashcards Preview

Block 9 - Neuro > CM: Chronic Vision Loss & Trauma > Flashcards

Flashcards in CM: Chronic Vision Loss & Trauma Deck (29):
1

Which red eye conditions are vision threatening?

corneal infections (keratitis)
scleritis
hyphema
iritis
acute glaucoma
orbital cellulitis
chemical injury (alkali urgent, acid next day)
should all be recognized and referred to opthalmologist

2

diffuse, erythematous swelling of lids
lids tender to touch, may be swollen shut

cellulitis

3

What is the difference b/w pre-septal/pre-orbital and orbital cellulitis?

pre-septal/pre-orbital - visual acuity, pupils, motility normal, no proptosis
orbital - opposite, motility may be painful, APD

4

When should conjunctivitis be referred?

vision impaired, inf suspected, pt fails to respond to Rx after 3-4 days

5

Conjuncitivitis discharge:
purulent
clear
stringy, white mucus
What caused it?

bacteria
virus (look for preauricular lymphadenopathy)
allergies

6

When should neonatal conjunctivitis consult an opthalmologist?

if pseudomonas suspected - can damage cornea
gonococcal conjunctivitis needs urgent treatment

7

mild, mucopurulent conjunctivitis in a neonate
often accompanied by pneumonitis and otitis media

chlamydia

8

dry eyes, redness, burning, foreign body sensation, reflex tearing, lack of luster

keratoconjunctivitis sicca

9

pain, photophobia, blurred vision

corneal disorder symptoms

10

When is a fluorescein exam appropriate?

aids in detection of irregularities of corneal surface - when abrasion suspected

11

redness, tearing, foreign body sensation, blurred vision, photophobia

corneal abrasion

12

discrete corneal opacity (infiltrate) on exam

bacterial keratitis - don't use steroids!

13

blood in anterior chamber from blunt trauma, red eye, decreased vision, pain, hx of blunt trauma

hyphema

14

circumcorneal redness, pain, photophobia, decreased vision, miotic pupil

iritis - cataract and glaucoma can be complications

15

severe ocular pain, frontal headache, N/V, blurred vision with halos around lights
eye usually red, pupil mid dilated and oval, cornea cloudy

acute glaucoma

16

What are risk factors for macular degeneration?

advanced age
fair skin
family hx of ARMD
smoking and CV dz

17

What can minimize effects of ARMD?

stop smoking, control CV dz, diet high in fruits and vegetables lowers risk, antioxidants, anti-VEGF

18

What are the risk factors for glaucoma?

elevated IOP
African or Hispanic heritage
advanced age
family hx
HTN, diabetes, myopia

19

How is glaucoma managed?

meds: beta blockers, adrenergic agonists, cholinergic agonists, prostaglandin analogs, carbonic anhydrase inhibitors
surgery: laser or filtration, cyclodestructive of ciliary body, insert drainage device

20

When is surgery for cataracts indicated?

significant visual impairment, daily activities curtailed
no current medical Rx

21

What is the epidemiology of ocular trauma?

accounts for 40% of all monocular blindness
80% are male, avg age = 30
lower socioeconomic status more likely
occupational injuries most common, domestic increasing
blunt objects are leading cause
motor vehicle accidents and sports related increasing

22

What do the following terms regarding ocular trauma mean?
a. eyewall
b. closed globe injury
c. open globe injury
d. rupture
e. laceration
f. perforating injury
g. penetrating injury
h. intraocular foreign body
i. contusion
j. lamellar laceration

a. sclera and cornea
b. eyewall does not have full thickness wound
c. eyewall has full thickness wound
d. full thickness wound of eye wall caused by blunt object
e. full thickness wound of eye wall caused by sharp object
f. 2 full thickness: entrance and exit - of eyewall, usually sharp object or missile
g. 1 full thickness laceration of eyewall, usually sharp object
h. causes entrance laceration
i. closed globe injury from blunt object
j. closed globe injury usually from sharp object

23

redness concentrated to palpebral area

conjunctivitis

24

conjunctivitis with copious purulent discharge

suspect n. gonorrhoeae

25

mild conjunctival reaction and lid swelling but no significant discharge in neonate

chemical conjunctivitis (from silver nitrate)

26

swollen lids, purulent exudate, beefy red conjunctiva, conjunctival edema in infant

neonatal gonococcal conjunctivitis - refer to ophthalmologist

27

What are episcleritis and scleritis?

inflammatory redness and tenderness
episcleritis - minimal pain and superficial vessels over cornea involved
scleritis - more dangerous - moderate to severe pain and red eye (with purplish hue), typically signs of systemic dz

28

optic disc cupping

open angle glaucoma

29

What is a cataract?

opacity in crystalline lens of eye