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Eye Disorders Flashcards

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1
Q

What is blepharitis? Who is it common in?

A

Inflammation of both eyelids

Down syndrome & eczema

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2
Q

What causes anterior blepharitis (skin & base of eyelids)?

A
  1. Infectious: S. aureus or S. epidermis, viruses

2. Seborrheic

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3
Q

What causes posterior blepharitis?

A

Meibomian gland dysfunction (a/w rosacea & allergic dermatitis)

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4
Q

What are the s/s of blepharitis?

A

Eye irritation/itching

Eyelid: burning, erythema, crusting, scaling, red-rimming* & eyelash flaking

+/- entropion or ectropion

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5
Q

How do you treat anterior blepharitis?

A

Eyelid hygiene, warm compresses

Azithromycin sol or ointment

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6
Q

How do you treat posterior blepharitis?

A

Eyelid hygiene, regular massage/expression of the meibomian gland

If severe, unresponsive –> systemic tetracyclines or azithromycin

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7
Q

What is entropion? Who is it MC in?

A

Eyelid & lashes turned inward

MC in elderly

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8
Q

What causes entropion?

A

May be caused by spasms of the orbicularis oculi muscle

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9
Q

What does entropion look like?

A

Eyelashes may cause corneal abrasion/ulcerations, erythema, tearing, increased sensitivity

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10
Q

How do you treat entropion?

A

Surgical correction if needed

Lubricating eye drops

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11
Q

What is ectropion? Who is it MC in?

A

Eyelid & lashes turned outward (tends to be B/L)

MC in elderly, but can be congenital, infectious, CN 7 palsy

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12
Q

What causes ectropion?

A

Relaxation of the orbicularis oculi muscle

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13
Q

What is a chalazion?

A

Painless granuloma of the internal meibomian sebaceous gland –> focal eyelid swelling

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14
Q

What are s/s of a chalazion?

A

Nontender* eyelid swelling –> rubbery nodule

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15
Q

How do you treat a chalazion?

A

Eyelid hygiene, warm compress

If large & affecting vision –> Corticosteroid inj or incision + curettage

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16
Q

How can you tell the difference btwn a chalazion & a hordeola?

A

Chalazions are larger, firmer, slower growing & less painful

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17
Q

What is a hordeolum (stye)?

A

Local abscess of the eyelid margin

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18
Q

Describe an external hordeolum vs internal hordeolum

A

External: inf of eyelash follicle or external sebaceous glands near the lid margin

Internal: inflammation/inf of the meibomian gland

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19
Q

What are the s/s of a hordeolum?

A

painful, warm, swollen red lump on eyelid

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20
Q

How do you treat a hordeolum?

A

Warm compresses +/- topical abx

+/- I&D if no spontaneous drainage after 48hrs

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21
Q

What is a pterygium?

A

Elevated, SF, fleshy, triangular “growing” fibrovascular mass

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22
Q

What causes a pterygium? & where is it MC?

A

A/w increased UV exposure in sunny climates, sand, wind, & dust

MC in inner corner/nasal side of eye & extends laterally

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23
Q

How do you treat a pterygium?

A

Obs for most +/- artificial tears

Affecting vision –> remove

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24
Q

What is the MC cause of permanent legal blindness & visual loss in elderly?

A

Macular degeneration

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25
What are RFs for macular degeneration?
>50 Caucasians Females Smokers
26
Describe dry (atrophic) macular degeneration
Gradual breakdown of the macula --> gradual blurring of central vision Drusen: small, round, yellow-white spots on the outer retina (scattered, diffuse)
27
Describe wet (neovascular or exudative) macular degeneration
new, abnormal vessels grow under the central retina, which leak & bleed --> scarring
28
What are the s/s of macular degeneration?
B/L blurred or loss of central vision (including detailed & colored vision) Scotomas, metamorphopsia, micropsia
29
How do you diagnose wet macular degeneration?
Fluorescein angiography
30
How do you treat dry macular degeneration?
Amsler grid | Zinc, Vit A/C/E
31
How do you treat wet macular degeneration?
Intravitreal anti-angiogenics (Bevacizumab - inhibits blood vessel growth) Laser photocoagulation Optical tomography
32
What is the MC cause of new, permanent vision loss/blindness in 25-74yo?
Diabetic retinopathy
33
What causes diabetic retinopathy?
maculopathy
34
What is diabetic retinopathy?
Blood vessel damage --> ischemia, edema Glycosylation --> capillary breakdown
35
Describe nonproliferative diabetic retinopathy
Microaneurysms --> blot & dot, flame-shaped hemorrhages Cotton wool spots, hard exudates Not a/w vision loss
36
How do you treat nonproliferative diabetic retinopathy?
Panlaser Glucose control
37
Describe proliferative diabetic retinopathy
Neovascularization: new, abnormal blood vessel growth, vitreous hemorrhage
38
How do you treat proliferative diabetic retinopathy?
VEGF inhibitors (Bevacizumab) Laser photocoagulation Glucose control
39
Describe maculopathy (type of diabetic retinopathy)
macular edema or exudates, blurred vision, central vision loss
40
What causes maculopathy?
macular microaneurysm leakage
41
How do you treat maculopathy?
Laser
42
What is hypertensive retinopathy?
damage to retinal blood vessels from long-standing HTN
43
Describe grade I of hypertensive retinopathy
Arterial narrowing, copper wiring moderate, silver wiring severe
44
Describe grade II of hypertensive retinopathy
AV nicking
45
Describe grade III of hypertensive retinopathy
Flame shaped hemorrhages, cotton wool spot
46
Describe grade IV of hypertensive retinopathy
Papilledema (malignant HTN)
47
What are s/s of a corneal abrasion?
FB sensation, tearing, red & painful
48
How do you diagnose a corneal abrasion?
Fluorescein staining: "ice rink" / linear abrasions
49
How do you treat a corneal abrasion?
If large --> patching (no longer than 24hrs) DO NOT PATCH IN CONTACT LENS WEARERS OR PSEUDOMONAS - Place on FQ eye drops (cipro)
50
What is the MC cause of viral conjunctivitis?
Adenovirus Swimming pool MC source MC in children
51
What are the s/s of viral conjunctivitis?
FB sensation, erythema & itching May be accompanied by viral sx
52
What does viral conjunctivitis look like on PE?
Preauricular lymphadenopathy, copious watery discharge Often B/L May have punctate staining on slit lamp
53
How do you treat viral conjunctivitis?
Supportive (cool compress, artificial tears) +/- antihistamines (olapatadine)
54
What are s/s of allergic conjunctivitis?
Erythema May have allergic sx
55
What does allergic conjunctivitis look like on PE?
Cobblestone mucosa to the inner/upper eyelid Itching, tearing, redness, stringy discharge Usually B/L +/- chemosis
56
How do you treat allergic conjunctivitis?
Topical antihistamines (H1 blockers): Olopatadine, pheniramine/naphazoline Topical NSAID: ketorolac Topical corticosteroids
57
What is the MC cause of bacterial conjunctivitis?
S. aureus, Strep penumo
58
What are s/s of bacterial conjunctivitis?
Purulent discharge, lid crusting
59
How do you treat bacterial conjunctivitis?
Topical erythromycin, FQ, sulfas, aminoglycosides If contact wearer --> cover pseudomonas w/ FQ or aminoglycoside
60
What causes orbital cellulitis?
Secondary to sinus infections (ethmoid 90%) S. aureus, S. pneumo, GABHS, H. flu May be caused by dental/facial inf or bacteremia
61
What are s/s of orbital cellulitis?
Decreased vision, pain w/ ocular movement, proptosis
62
How do you diagnose orbital cellulitis?
High resolution CT/MRI
63
How do you treat orbital cellulitis?
IV vanco, clinda, cefotaxime, ampicillin, amox
64
What is the cause of iritis?
Systemic inflammatory disease: a/w HLA-B27 spondyloarthropathies, sarcoid, Behcet's Infectious: CMV, toxoplasmosis, syphilis, TB Trauma
65
What are s/s of anterior iritis?
unilateral ocular pain/redness/photophobia Excessive tearing Usually occurs after blunt trauma
66
What are s/s of posterior iritis?
blurred/decreased vision, floaters
67
What does iritis look like on PE?
Ciliary injection (limbic flush), consensual photophobia Inflammatory cells & flare within the aqueous humor
68
How do you treat anterior iritis?
Topical steroids, scopolamine, topical cycloplegics
69
How do you treat posterior iritis?
system corticosteroids
70
What do cataracts look like on PE?
absent red reflex, opaque lens
71
What causes retinal artery occlusion?
MC 50-80y w/ atherosclerotic disease
72
What are the s/s of retinal artery occlusion?
Acute, sudden monocular vision loss Often preceded by amaurosis fugax
73
How do you diagnose retinal artery occlusion?
Funduscopy: 1. Pale retina w/ cherry-red macula 2. Box car appearance of retinal vessels
74
How do you treat retinal artery occlusion?
Decrease IOP (acetazolamide) Revascularization (orbital massage to dislodge clot)
75
What are the s/s of acute angle closure glaucoma?
severe, sudden onset of unilateral ocular pain +/- N/V, HA Vision changes: halo around lights, peripheral vision loss
76
What does acute angle closure glaucoma look like on PE?
Erythema, "steamy" cornea Mid-dilated, fixed, nonreactive pupil, eye feels hard to palpation
77
How do you diagnose acute angle closure glaucoma?
Increased IOP by tonometry "Cupping" of optic nerve on funduscopy
78
How do you treat acute angle closure glaucoma?
1. Acetazolamide = 1st line (decreases aqueous humor production) 2. Topical BB (Timolol) 3. Miotics/cholinergics (pilocarpine, carbachol) 4. Alpha 2 agonists 5. Peripheral iridotomy = definitive tx AVOID ANTICHOLINERGICS, SYMPATHOMIMETICS
79
What are the s/s of chronic open angle glaucoma?
Gradual B/L painless peripheral vision loss
80
What does chronic open angle glaucoma look like on PE?
Cupping of optic discs
81
How do you treat chronic open angle glaucoma?
Prostaglandin analogs 1st line (Lantanoprost) BB, alpha2agonists, acetazolamide Laser Surgery = last line
82
How do you diagnose a foreign body or corneal abrasion?
Pain relieved w/ analgesic drops Fluorescein staining: corneal abrasion = "ice rink"/linear abrasions
83
How do you treat an ocular foreign body?
Check visual acuity 1st Remove w/ sterile irrigation or moistened sterile cotton swab Abx drops (topical erythromycin, polymyxin/trimethoprim, sulfacetamide, cipro) 24hr ophtho follow up

Family Med EOR (15 decks)

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