Eye Conditions Flashcards
1
Q
Clinical Findings of Viral Conjunctivitis
A
- tearing with profuse, clear, water discharge
- can have crusting in morning but mostly watery discharge
- burning, sandy gritty feeling in one eye
- fever, HA, anorexia, fatigue, URI symptoms
- adenovirus has triad of pharyngitis, conjunctivitis, and fever
- pharyngitis
- enlarged preauricular lymphadenopathy
- photophobia
2
Q
Treatment for Viral Conjunctivitis
A
- no antivirals needed; self-limiting
- NO steroids!!
- topical antihistamines olopatadine
- warm or cool compresses
- OTC ophthalmic lubricants (refresh, genteal)
- may take 2-3 wks to resolve
- could get worse before it gets better
3
Q
Clinical Findings of Allergic Conjunctivitis
A
- bilateral redness
- watery stringy discharge
- itching (cardinal sign)
- “shiners” (dark circles)
- conjunctival edema which can cause bulging or conjunctiva past lid margins
- rubbing eye worsens symptoms
- hx of seasonal allergies
- sneezing, nasal congestion, wheezing
4
Q
Treatment of Allergic Conjunctivitis
A
- removal of allergens
- cool compresses
- OTC artificial tears (refrigerate them)
- topical antihistamine/decongestants (ketoifen, naphacon A - use on > 3 yo; olopatadine, lodoxamine)
- no topical NSAIDs
- no topical steroids
- may use OTC systemic antihistamines if demonstrate sneezing, nasal congestion
5
Q
Causes of Bacterial Conjunctavitis
A
- H. influenzae most common in kids greater than 7
- S. aureus
- S. pneumoniae
- Moraxella catarrhalis
** most common in winter
6
Q
Clinical Findings of Bacterial Conjunctivitis
A
- complaints of redness and discharge in one eye but can also be bilateral
- affected eye is “stuck shut” in the AM, foreign body sensation, photophobia
- prurulent discharge , sticky
- discharge is white, yellow, or green and thick and globular
- discharge reappears within minutes after wiping lids
7
Q
Treatment of Bacterial Conjunctivitis
A
- broad spectrum abx
- trimethorprim polymixin B sulfate (> 2 months age) QID for 5-7 days
- azithromycin (> 1 yo) BID for 2 days, QD for 5 days
- fluoroquinolones (-floxacin) for severe cases, must be > 12 months old
- aminoglycosides (tobramycin) 1-2 drops q4h; if severe 1-2 drops qh and then taper
8
Q
Clinical Findings of Hordeolum
A
- AKA “stye”
- acute inflammation or infection of the oil gland (meibomian gland) causing red, tender bump in lid
- painful
- tender, swollen furuncle seen
- may look like a pimple
- usually caused by S aureus
9
Q
Treatment for Hordeolum
A
- keep lids clean
- hygiene important
- gently shampoo lids
- warm compresses QID
- bacitracin or erythromycin ophthalmic ointment q4h for 10 days
** Refer if it enlarges and furuncle does not rupture on own or if multiple, recurrent hordeolum seen
10
Q
Clinical Findings of Chalazion
A
- painless, mildly erythematous with slight welling to eyelid, looks like rubbery nodule
- after a few days, swelling respolves and a slow-growing, round, nonpigmented, painless mass remains, can be size of pea
- may persist for a long time
11
Q
Treatment of Chalazion
A
- most resolve over a few days to few weeks
- warm compresses 15 min QID
- Refer if lesions are presistent
12
Q
What is Blepharitis?
A
- acute or chronic inflammation of eyelash follicles, usually bilateral
- blocks the oil glands in the eyelids
- more common in kids with DM or rosacea
13
Q
Treatment of Blepharitis
A
- scrub eyelashes or lids with gentle shampoo to debride scales
- warm compress 5-10 min BID-QID, and wipe
- massage meibomian secretions if its the cause
- lash lice treated with petroleum jelly and permethrin shampoo
14
Q
What is a pterygium?
A
- fibrovascular mass of thickened bulbar conjunctiva that extends beyond the limbus onto the cornea
- triangular in shape
- more commonly found on nasal side of orbit
15
Q
Causes of pterygium
A
Caused by irritation from sunlight, wind, dust, fumes, or airborne allergens
