Eyes

Question 1

Corneal Ulcer Presentation

Answer 1

Soft contact lens wearer
Severe eye pain
Foreign body sensation
Tearing
Photophobia

Question 2

Corneal Ulcer Physical Exam

Answer 2

Use penlight/slit lamp/fluorescein Whitish lesion on cornea

Question 3

Corneal Ulcer Treatment

Answer 3

refer to ED

Question 4

Herpes Keratitis Presentation

Answer 4

Acute onset of unilateral sxs
Severe eye pain
Blurred vision 
Tearing
Photophobia

Question 5

Herpes Keratitis Physical Exam

Answer 5

Fluorescein dye/strips
NOT SPLIT LAMP
Fern-like lines on cornea

Question 6

Herpes Keratitis Treatment

Answer 6

Refer to ED

Question 7

Corneal Abrasions Presentation

Answer 7

Severe eye pain
Tearing
Foreign body sensation
Round or irregular shaped abrasions on cornea

Question 8

Acute Angle-Closure Glaucoma Presentation

Answer 8

Elderly
Acute onset severe eye pain
Headache
N/V
Halos around lights
Lacrimation
Decreased vision

Question 9

Acute Angle-Closure Glaucoma Physical Exam

Answer 9

Mid/dilated oval pupil 4-6mm
Cloudy cornea
Cupping of optic nerve
Conjunctival inj
Increased lacrimation

Question 10

Acute Angle-Closure Glaucoma Treatment

Answer 10

Refer to ED

Question 11

Optic Neuritis Presentation

Answer 11

Caucasian women 20-30
Loss of visual acuity over hr-days
Central blind spot
Aphasia, parenthesis, abnormal gait
Fatigue
Increase temp worsens sxs
Recurrent episodes

Question 12

Optic Neuritis Treatment

Answer 12

Refer to neurologist

Question 13

Orbital Cellulitis Presentation

Answer 13

Acute onset
Erythematous swollen eyelid
Proptosis
Eye pain with movement
Reduced EOMs 
Recent rhino sinusitis/URI

Question 14

Orbital Cellulitis Treatment

Answer 14

Refer to ED

Question 15

Retinal Detachment Presentation

Answer 15

Sudden onset of floaters
Flashes of light (photopsia)
Curtain vision

Question 16

Retinal Detachment Treatment

Answer 16

Refer to ED

Question 17

Blepharitis Presentation

Answer 17

Inflamed edges of eyelids
Irritated, itchy, scale
Assoc w/ dandruff, seborrheic derm, rosacea

Question 18

Visual Fields of Confrontation

Answer 18

Peripheral vision

Question 19

20/60 meaning

Answer 19

Patient can see at 20 feet what normal vision can see at 60

Question 20

Contact lens-related keratitis presentation

Answer 20

Contact lenses irresponsible wearer
Acute onset
Red eye
Blurred vision
Tearing
Photophobia
Foreign body sensation

Question 21

Contact lens-related keratitis pharm treatment

Answer 21

Topical ophthalmic abx 
Ciprofloxacin
Ofloxacin
Trimethoprim-polymyxin B
3-5x/day

Question 22

Eye pain prescription

Answer 22

Topical aculuar 1 gtt qid
Hydrocodone with acetaminophen
(use for 48 hours)

Question 23

Hordeolum (stye) presentation

Answer 23

Acute onset 
Swollen, red, warm abscess of hair follicle and sebaceous gland of eyelid
Slow growing
May spontaneously rupture
H/o blepharitis

Question 24

Hordeolum (stye) treatment

Answer 24

Hot compress x 5-10 min bid-tid until drainage
Dicloxacillin or erythromycin PO qid if preseptal cellulitis
Refer to optho for I&D if needed

Question 25

Chalazion presentation

Answer 25

``` Gradual onset Small superficial nodule on upper eyelid Feels like bead Discrete and movable Painless Slow growing May cause blurred vision ```

Question 26

Chalazion treatment

Answer 26

Refer to optho for I&D or corticosteroid inj

Question 27

Pinguecula presentation

Answer 27

Raised yellow to white, small round growth in bulbar conjuctiva chronic sun exposure

Question 28

Pterygium presentation

Answer 28

Yellow triangular, wedge shaped thickening of conjunctive Extends across cornea on the nasal side Chronic sun exposure Foreign body sensation

Question 29

Pterygium treatment

Answer 29

Refer to optho for weak steroid drops Artificial tears for irritation Sunglasses with UVAB protection

Question 30

Subconjunctival Hemorrhage Presentation

Answer 30

Sudden onset Bright red blood in one eye Painless C/b coughing, sneezing, straining, anticoags, eye trauma

Question 31

Primary open-angle glaucoma presentation

Answer 31

``` Elderly, Diabetics African or Caucasian Gradual onset Increased IOP >22 Peripheral vision lost first (missing words when reading) Disc cupping ```

Question 32

How to check IOP?

Answer 32

Tonometer

Question 33

Normal IOP

Answer 33

8-22 mmHg

Question 34

Primary open angle glaucoma treatment

Answer 34

Betimol 0.5% drops (BB) Latanoprost drops (prostaglandin) Bronchospasm (c/i asthma, COPD), bradycardia (c/i HF, heart block)

Question 35

Anterior Uveitis Presentation

Answer 35

Insidious onset of eye pain Conjunctival injection No discharge like in conjunctivitis

Question 36

Anterior Uveitis Treatment

Answer 36

Refer to optho w/i 24 hours

Question 37

Blepharitis treatment

Answer 37

Johnson’s baby shampoo scrub Erythromycin drops to eyelids bid Warm compresses bid for itch/debris

Question 38

Age-related macular degeneration presentation

Answer 38

``` Smokers Elderly Gradual or sudden onset Painless Loss of central vision, peripheral intact Straight lines distorted/curved ```

Question 39

Age-related macular degeneration treatment

Answer 39

Amsler grid | Refer to optho for lutein and zeanthin w/ zinc

Question 40

Sjörgen’s Syndrome presentation

Answer 40

AI disorder Dry eyes Dry mouth Sxs > 3 months Sandy/gritty sensation Using artificial tears Dental carries Inflamed salivary glands

Question 41

Sjörgen’s Syndrome Treatment

Answer 41

Refer to rheumatology

Question 42

Ectropion

Answer 42

Eyelid turned out | May cause dry eye

Question 43

Entroption

Answer 43

Eyelid turned in | May cause irritation

Question 44

Causes of herpes keratitis

Answer 44

Herpes simplex self-inoculation from cold sore | Varicella zoster of trigeminal nerve (CN V)

Question 45

Diabetic retinopathy finding

Answer 45

Cotton wool spots

Question 46

Hypertensive retinopathy finding

Answer 46

Copper and silver wire arterioles | Nicking

Question 47

Cataracts presentation

Answer 47

Difficulty with glare esp at night Halos around lights Blurred vision