Evaluation of the Red Eye - Holgren Flashcards Preview

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Flashcards in Evaluation of the Red Eye - Holgren Deck (21)
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1

Identify this condition and describe the treatment:

pt reports - burning, gritty sensation that gets worse in the evenings

Dry Eyes

common with aging, F >M, often worse when reading

exposure: Bell's palsy, Thyroid eye disease, scarred or malpositioned lids

may be associated with: rheumatological disorders, Stevens-Johnson, systemic meds

tx: artificial tears, lubricating ointment, punctal plug, Restasis, lid taping

2

Identify this condition and describe the treatment:

red, swollen lids and skin

normal: vision, pupils, occular motility, conjunctiva

Anterior (preseptal) cellultis

cause: trauma, URI, sinusitis, otitis

tx: cool compresses, systemic antibiotics

hospitalize if a child < 3

2

Identify this condition and describe the treatment:

spontaneous blood red eye, with normal vision, no pain and no discharge

Subconjunctival Hemorrhage

tx: resolves in 2-3 weeks on own

2

Identify this condition and describe the treatment:

localized or diffuse redness, deep red, pain

pt: history of RA

Episcleritis/Scleritis

scleritis - deep red, pain, can be vision threatening

idiopathic may have rheumatologic/autoimmune associations

tx: refer to ophthalmologist

 

4

Identify this condition and describe the treatment:

red eye, watery discharge, foreign body sensation, dendrite branching

Viral Keratitis

cause: Herpes Simplex Virus (type 1)

refer: STAT

5

Identify this condition and describe the treatment:

thick, red lid margins with crusting, some loss of eye lashes

Blepharitis

staphylococcal, seborrheic (meibomian gland dysfunction)

tx: warm compress, lid hygiene, topical antibiotics ung (ointment), oral antibiotics

5

Identify this condition and describe the treatment:

watery discharge with stringy mucus, itching

pt is an asthmatic

 

Allergic Conjunctivitis

ITENSE ITCHING

hx: allergy, ashtma, atopic/allergic disease

tx: topical antihistamines, mast cell stablizers

6

Causes of this condition

hint: pt was born at 0730 

 

Neonatal Conjunctivitis

Staph, strep, h.flu

N. gonorrhea - refer to ophthalmologist, systemic antibiotics and topical

Chlamydial - topical and oral erythromycin

7

Identify this condition and describe the treatment:

pain, tearing, foriegn body sensation, photophobia, blurred vision

fluroscein exam: 

Corneal Abrasion

tx: cycloplegic drops, oral analgesics with codiene; topical antibiotics; pressure patch 24 hours

refer: if not healed in 24-48 hours

8

Identify this condition and describe the treatment:

red, painful decreased vision with purulent discharge

Bacterial Keratitis

refer STAT

9

Identify this condition and describe the treatment:

pt was at work in a lab and got something in his eye

Chemical Injury

tx: immediate irrigation for 15 minutes, further irrigate until pH is normal

Alkali causes more damage

refer: STAT

11

Identify this condition and describe treatment:

localized or diffuse lid cellulitis, tenderness

Hordeola/chalazia

inflammed lid glands due to obstructed orifces

tx: warm compress, topical antibiotic ung (ointment)

12

Identify this condition and describe the treatment:

severe eye pain, blurred vision, halos around lights, nausea and vomiting

exam: mid-dilated pupil, redness, cloudy cornea, hard eye

Acute Glaucoma

cause: dim lights, drugs, emotional stress

refer: STAT

14

Identify this condition and describe the treatment:

purulent discharge

Bacterial Conjunctivitis

cause: Staph, Steph, Hemophilus Influenzae

tx: warm compress, topical antibiotics, fluroquinolones

if Neisseria gonorrhea systemic antibiotics and hyperpurulent discharge

15

Identify this condition and describe the treatment:

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

Iritis/Uveitis

idiopathic, infectious, sarcoidosis, autoimmune disorders, trauma

refer

16

Identify this condition and describe the treatment:

watery, serous discharge, tender preauricular nodes

Viral Conjunctivitis

cause: Adenoviral, highly contagious

tx: no effective therapy (will clear in 1-2 weeks)

refer: pain, decreased vision, photophobia

17

Identify this condition and describe the treatment:

swollen, red lids and conjuncitva; proptosis; impaired occular motility and painful movement; decreased vision; afferent pupillary defect; optic disc edema

Posterior (orbital) cellulitis

tx: hospitalization, CT scan, blood cultures IV antibiotic

often a fungal infection in immunocompromised 

can lead to cavernous sinus thrombosis, meningitis

18

Vision Threatening Red Eye Disorders

these need to be refered to ophthalmologist ASP!

orbital cellulitis

scleritis

chemical injuries

corneal infection

hyphema

iritis

acute glaucoma

19

Identify this condition and describe the treatment:

inflamamtion and irritation

pt has job exposure to sun, wind and dust

Pinguecula (top photo)/Pterygium (bottom photo)

tx: artifical tears, topical NSAIDs

refer: severe inflammation, or if pterygium is actively growing

20

Identify this condition and describe the treatment:

pt recieved a blow to the face, reports decreased vision and pain

Hyphema

blood in anterior chamber

refer STAT

21

Identify this condition and describe the treatment:

tearing and discharge

Nasolacrimal Duct Obstruction

infected tear sac (Dacryocystitis)

Congenital tx: daily massage, antibiotics if infected, refer if no resolution 6-8 months

Aquired tx: systemic antibiotics if infected, refer if chronic