EENT Precision & Pearls #1 (Eye) Flashcards
(93 cards)
Bacterial conjunctivitis is MCC by what bacteria? What are the symptoms?
Staph Aureus
-Purulent discharge
-unilateral
-lid crusting (eye stuck shut in morning)
-no vision changes, no itching
Treatment for Bacterial conjunctivitis (both non-contact lens wearer, and contact lens wearer)
-Non contact lens: Topical ABX (Erythromycin ointment, Trim-Poly B, Moxifloxacin, Ofloxacin)
-Contact lens use: Topical Ciprofloxacin or Ofloxacin
What bacteria are you concerned about covering if the patient wears contact lens’?
Pseudomonas Aeruginosa
Viral conjunctivitis, MCC by _______, is MC in children. What is something that spreads this condition and what are the symptoms
Adenovirus
Swimming pools –> outbreaks
-Starts unilaterally –> bilaterally
-FBS/grittiness
-Copious watery tearing
-Preauricular LAD
-Punctate staining
Treatment for viral conjunctivitis
Supportive (cool compresses, artificial tears, antihistamines)
On the other hand, symptoms of allergic conjunctivitis include
-Conjunctival erythema with normal vision
-Other allergic symptoms (congestion, sneezing)
-Often bilateral
-Cobblestone mucosa
-chemosis (conjunctival edema)
-watery discharge
Treatment for allergic conjunctivitis
-Symptomatic
–Topical antihistamines (Olopatadine, Pheniramine-Naphzoline)
Neonatal conjunctivitis (ophthalmia-neonatorum), is conjunctivitis contracted during delivery. What are the causes in the following time frames:
-Day 1:
-Day 2-5:
-Day 5-7:
Day 1: Chemical conjunctivitis caused by silver nitrate
Day 2-5: Gonococcal MCC
Day 5-7: Chlamydia MCC
Management for Gonococcal conjunctivitis
is there anything you can do to prevent this?
IM or IV Ceftriaxone
Prophylaxis: Topical Emycin ointment
Management for Chlamydia conjunctivitis in a neonate
is there anything you can do to prevent this?
Oral Erythromycin
No prophylaxis effective to prevent this condition
What should you give an adult with chlamydial conjunctivitis?
Azithromycin 1000mg single dose, Doxycycline, Tetracycline, or Erythromycin
Cataract is ________ and some of the causes/risks for developing these include….
What are some symptoms of this?
Lens opacification (thickening)
Aging (MC), Congenital, Smoking, Corticosteroid use, DM, Trauma
Halos around lights, difficulty driving at night, painless/slow progressive blurry vision, absent red reflex, opaque lens
If the patient has a corneal abrasion, what is seen on slit lamp examination?
With fluoroscein stain, ice rink/linear abrasions.
Evert the eyelid to look for foreign bodies
Management for an ocular foreign body/ocular abrasion (contact lens vs non contact lens)
-Eye wash and irrigation, topical anesthetic
-Non contact lens: Emycin ointment, Tri-Poly B
-Contact lens: Topical Cipro or Ofloxacin
-DO NOT PATCH if Pseudomonas expected (contact lens use)
When should you remove a rust ring with an ocular foreign body?
in 24 hours with a burr
Management for a sub conjunctival hemorrhage
-Check VA, EOM’s, slit lamp, IOP
-If history of trauma, rule out ruptured globe and retrobulbar hemorrhage
-Give artificial tears, most resolve spontaneously and on their own
Keratitis is corneal inflammation or a corneal ulcer. If bacterial in nature, what is the MCC in a non-contact lens wearer? How about if they do wear contacts?
What are the risks for this condition?
Staph A, Strep
Pseudomonas
Improper contact lens usage (MC), Immunosuppression, dry ocular surface
Symptoms of keratitis include…
What diagnostic is done and what do you see with bacterial keratitis?
What do you see with herpes keratitis?
Pain, redness, vision changes, photophobia, FBS, ciliary injection, hazy cornea
Slit lamp: increased uptake of fluoroscein stain
Herpes: dendritic branching with fluoroscein stain
Treatment for bacterial keratitis?
Treatment for herpes keratitis?
-Fluoroquinolone topical (Moxifloxacin)
-Herpes: Topical Antivirals (Trifluridine) or PO Acyclovir
What is photokeratitis, what is it from, and what is seen on fluoroscein stain on slit lamp?
Excessive UV exposure (snow/sun, welding, sun lamps)
Presents 6-12 hours after exposure
Diffuse defects on staining
Describe a pterygium
What are some risks associated with this condition?
Elevated, fleshy, triangular shaped growth that starts medially (nasally) and grows outward
UV exposure in tropical climates, sand, wind, dust exposure
On the other hand, describe a pinguecula and explain some risks associated with it
Slowly growing thickening of the conjunctiva. Yellow, slightly elevated nodule on nasal side of sclera that doesn’t grow onto the cornea
Eye irritation (dry, windy, sunny)
Dacryocystitis is an infection of the lacrimal sac due to __________.
The MCC is _____, but other causes are Staph Aureus and GABHS.
Obstruction of the nasolacrimal duct
Staph Epidermidis
Symptoms of dacryocystitis
-Tearing, tenderness, warmth, swelling to medial/canthal side of lower lid area
-May have purulent discharge