EYES Flashcards

Question

What are the types of Hordeolum?

Answer 1

1. External Hordeolum: Affects the glands near the eyelash base, causing a red bump on the outer eyelid. 2. Internal Hordeolum: Involves the meibomian glands inside the eyelid, leading to a deeper, painful swelling. ## Footnote Mnemonic: “EXternal = Outside, INternal = Inside.”

Answer 2

Bacteria (Staphylococcus aureus) infect the oil glands in the eyelid (Zeis or Moll), causing a blocked gland and inflammation. ## Footnote Mnemonic: “Staph attacks the glands.”

Answer 3

Sudden onset of a painful, swollen, red bump on one eyelid. More common in children and people with previous eyelid issues. ## Footnote Mnemonic: “One painful, swollen eyelid.”

Answer 4

1. Children: Higher risk due to immature gland function. 2. Poor Hygiene: Not cleaning the eyelids or using old makeup. 3. Contact Lenses: Poor cleaning habits increase risk. 4. Blepharitis: Chronic eyelid inflammation increases susceptibility. ## Footnote Mnemonic: “Kids, Cleanliness, Contacts, Chronic.”

Answer 5

1. Tenderness: The eyelid is painful to touch. 2. Swelling and Redness: Localized to the affected area. 3. Pus Discharge: Sometimes, a small amount of pus may be visible. ## Footnote Mnemonic: “Pain, Redness, Pus.”

Answer 6

1. When did it start? 2. Has this happened before? 3. Is there any change in vision? 4. How bad is the pain? 5. Any exposure to chemicals, or eye injuries? 6. Current medications and health conditions? ## Footnote Mnemonic: “Start, Repeat, Sight, Pain, Cause, Meds.”

Answer 7

1. Inspect both eyes for redness, swelling, and discharge. 2. Turn the eyelid to check for any internal swelling. 3. Check for redness or abnormal areas on the white of the eye. 4. Feel around the eye for any swollen lymph nodes. ## Footnote Mnemonic: “Look, Flip, Check, Feel.”

Answer 8

1. Visual Acuity: Check vision clarity. 2. Culture Test: Only if the stye keeps coming back. 3. Diabetes Screening: If there are repeated styes. ## Footnote Mnemonic: “Vision, Bacteria, Blood Sugar.”

Answer 9

1. Chalazion: Painless, firm lump inside the eyelid. 2. Blepharitis: Red, crusty eyelids with no lump. 3. Xanthelasma: Yellowish lumps on the eyelids. 4. Conjunctivitis: Red, watery eyes without a painful bump. 5. Foreign Body: Irritation from something in the eye. ## Footnote Mnemonic: “Chalazion, Blepharitis, Xanthelasma, Conjunctivitis, Foreign.”

Answer 10

1. Sudden vision changes. 2. Severe pain not relieved by treatment. ## Footnote Mnemonic: “Vision, Severe Pain.”

Answer 11

1. If the infection spreads to the entire eyelid. 2. If the stye doesn’t improve with treatment. ## Footnote Mnemonic: “Spreading or Stubborn.”

Answer 12

1. Apply warm compresses 3-4 times a day. 2. Keep eyelids clean; use baby shampoo if needed. 3. Avoid touching or squeezing the stye. 4. Discard old makeup and use new, clean products. ## Footnote Mnemonic: “Warm, Wash, Don’t Touch, Discard.”

Answer 13

1. Often not needed; most styes heal on their own. 2. Use antibiotic ointments like erythromycin if necessary. 3. Oral antibiotics for severe cases or if infection spreads. ## Footnote Mnemonic: “Wait, Ointment, Oral if severe.”

Answer 14

No, most styes drain and heal on their own. Using over-the-counter drops is usually unnecessary. ## Footnote Mnemonic: “Let it heal itself.”

Answer 15

Use warm compresses to encourage drainage. If needed, a doctor may drain it and apply antibiotic ointment. ## Footnote Mnemonic: “Compress First, Drain if Needed.”

Answer 16

No, most styes drain and heal on their own. Using over-the-counter drops is usually unnecessary. ## Footnote Mnemonic: “Let it heal itself.”

Answer 17

Use warm compresses to encourage drainage. If needed, a doctor may drain it and apply antibiotic ointment. ## Footnote Mnemonic: “Compress First, Drain if Needed.”

Answer 18

1. Don’t squeeze or pop the stye. 2. Throw away old eye makeup. 3. Keep eyelids clean to prevent recurrence. 4. Wash hands often to avoid spreading infection. ## Footnote Mnemonic: “Don’t Pop, Discard, Clean, Wash Hands.”

Answer 19

1. Ophthalmic ointments: Polymyxin B sulfate and bacitracin zinc. 2. Erythromycin ointment: Applied to the conjunctival sac several times a day if incision and drainage are required. ## Footnote Example sentence: Erythromycin ointment is commonly prescribed for Hordeolum.

Answer 20

For recurrent crops of styes that don’t respond to topical treatment. This helps reduce the risk of recurrence after consulting a physician. ## Footnote Additional information: Oral antibiotics may be necessary in cases of persistent styes.

Answer 21

Most styes drain and heal spontaneously without medication, and self-medication can lead to unnecessary use of antibiotics. ## Footnote Additional information: It is important to consult a healthcare professional before using any medication for Hordeolum.

Answer 22

Ophthalmic antibacterial ointment, like erythromycin, should be applied to prevent further infection and promote healing. ## Footnote Example sentence: After incision and drainage, pharmacological therapy helps in preventing secondary infections.

Answer 23

Iritis is inflammation of the iris, the colored part of the eye. It is a type of anterior uveitis causing pain, light sensitivity (photophobia), blurred vision, and a constricted or irregular pupil. If untreated, it can lead to serious complications like glaucoma and vision loss. ## Footnote Example sentence: The patient presented with severe eye pain and photophobia, indicating possible iritis.

Answer 24

Causes: Autoimmune disorders (e.g., ankylosing spondylitis, reactive arthritis), infections (e.g., syphilis, HIV/AIDS), eye trauma, and genetic predisposition (HLA-B27). Risk Factors: 1. HLA-B27 genetic alteration. 2. STIs like syphilis and HIV/AIDS. 3. Autoimmune conditions. 4. Smoking increases risk. ## Footnote Additional information: Genetic predisposition to iritis is linked to the HLA-B27 gene.

Answer 25

Photophobia: Sensitivity to light. Throbbing Eye Pain: Moderate to severe, usually in one eye. Blurred Vision: Hazy or unclear vision. Constricted or Irregular Pupil: Due to swelling of the iris. Mnemonic: “Pain, Light, Blur, Pupil”. ## Footnote Example sentence: The patient complained of severe eye pain and blurred vision, consistent with iritis.

Answer 26

1. Ciliary Flush: Deep, dull red halo around the iris and cornea. 2. Pupil Changes: Smaller, irregular pupil due to iris inflammation. 3. Normal Cornea: Cornea remains clear. 4. Tearing: Watery eye without discharge. ## Footnote Example sentence: The ciliary flush was evident during the physical exam, indicating possible iritis.

Answer 27

Diagnostic Approach: Clinical diagnosis; immediate referral to an ophthalmologist. No specific diagnostic tests required. Red Flags: 1. Extreme, unrelenting eye pain. 2. Decreased vision or sudden vision changes. ## Footnote Additional information: Immediate referral is crucial in suspected cases of iritis to prevent complications.

Answer 28

1. Conjunctivitis: Red eye, often with discharge, no deep pain or photophobia. 2. Keratitis: Corneal inflammation, severe pain, vision changes. 3. Blepharitis: Inflammation of eyelid margins, no deep eye pain or photophobia. 4. Seasonal Allergies: Itchy, watery eyes, no pain or photophobia. ## Footnote Additional information: Differential diagnosis helps distinguish iritis from similar eye conditions.

Answer 29

1. Glaucoma: High eye pressure, possible vision loss, no ciliary flush. 2. Hordeolum (Stye): Painful lump on the eyelid, not involving the eyeball. 3. Chalazion: Painless lump inside the eyelid. 4. Corneal Abrasion/Trauma: Often has a history of injury, sharp pain, and tearing. ## Footnote Example sentence: The differential diagnosis ruled out glaucoma and stye in the patient presenting with eye pain.

Answer 30

1. Subconjunctival Hemorrhage: Painless red patch on the sclera, no pain or vision changes. 2. Inflamed Pterygium/Pinguecula: Localized conjunctival inflammation, no deep eye pain. ## Footnote Additional information: Less common conditions may mimic iritis symptoms but require different management.

Answer 31

Management: Immediate referral to an ophthalmologist for diagnosis and treatment. Referral: Necessary for all cases of iritis to prevent complications like glaucoma and permanent vision loss. ## Footnote Example sentence: The patient was promptly referred to an ophthalmologist for iritis management.

Answer 32

1. Glaucoma: Increased eye pressure damaging the optic nerve. 2. Cataracts: Lens opacity due to prolonged inflammation or steroid use. 3. Posterior Synechiae: Iris and lens adhesions, causing vision issues. 4. Permanent Vision Loss: Due to damage from uncontrolled inflammation. ## Footnote Additional information: Timely treatment can prevent serious complications associated with untreated iritis.

Answer 33

1. Adhere to Treatment: Follow the prescribed regimen to avoid complications. 2. Recognize Early Signs: Seek immediate help if symptoms like photophobia or eye pain recur. 3. Avoid Triggers: For those with autoimmune or recurrent iritis, avoid known triggers. 4. Quit Smoking: Reduces risk and severity of iritis. ## Footnote Additional information: Patient education plays a crucial role in preventing iritis recurrence.

Answer 34

Often, the patient or witness (in case of a child) reports a foreign object entering the ear. ## Footnote Example sentence: The child complained of ear pain after putting a small toy in their ear.

Answer 35

Pain (dull or severe), feeling of fullness or pressure in the ear, and loss of hearing. ## Footnote Additional information: Symptoms may vary depending on the size and type of foreign object.

Answer 36

Swelling, redness, otorrhea (discharge), and a foul smell. ## Footnote Example sentence: The doctor observed redness and discharge in the ear upon examination.

Answer 37

Gritty sensation, pain, and scratchy sensation. History of recent injury or contact lens use. ## Footnote Additional information: Contact lens wearers are at increased risk of foreign bodies in the eye.

Answer 38

Nasal discharge, epistaxis (nosebleed), nasal obstruction, and mouth breathing. ## Footnote Example sentence: The patient presented with nosebleeds and difficulty breathing through the nose.

Answer 39

Visual inspection is the primary diagnostic approach. Do not attempt to remove foreign objects protruding from the eye; refer immediately. ## Footnote Example sentence: The doctor used an otoscope to examine the ear for foreign bodies.

Answer 40

Blepharitis, corneal abrasion, and conjunctivitis. ## Footnote Additional information: Differential diagnoses help rule out other possible causes of eye symptoms.

Answer 41

Cholesteatoma and acute otitis media with perforation. ## Footnote Additional information: Cholesteatoma is a rare but serious condition that can mimic symptoms of a foreign body in the ear.

Answer 42

Sinusitis, upper respiratory infection (URI), and allergic rhinitis. ## Footnote Additional information: Allergic rhinitis can present with similar symptoms to a foreign body in the nose.

Answer 43

Foreign bodies in the ear canal occur more frequently in children than adults. ## Footnote Additional information: Children are curious and may insert objects into their ears.

Answer 44

Sharp objects can perforate the eardrum, and organic objects may swell and occlude the canal. ## Footnote Example sentence: Immediate medical attention is needed if a sharp object is suspected in the ear.

Answer 45

Do not remove objects protruding from the eye; refer immediately to prevent further damage. ## Footnote Additional information: Removing objects from the eye without proper training can lead to complications.

Answer 46

Button batteries, magnets, or superabsorbent beads can cause severe tissue damage and warrant urgent removal. ## Footnote Additional information: Ingestion or insertion of small objects in the nose can lead to serious complications.

Answer 47

Suspected penetration of the tympanic membrane with potential damage to middle ear structures. Symptoms such as ear pain, vertigo, nystagmus, ataxia, otorrhea, facial nerve paralysis, or hearing loss. ## Footnote Additional information: Otolaryngologists specialize in ear, nose, and throat conditions.

Answer 48

Posterior foreign bodies not readily visualized, impacted foreign bodies causing marked inflammation, button batteries, magnets, or superabsorbent beads that need urgent removal, and penetrating or hooked foreign bodies. ## Footnote Additional information: Urgent referrals are necessary for certain types of nasal foreign bodies to prevent complications.

Answer 49

Avoid using Q-tips or inserting objects in the ear, seek medical help if an ear foreign body is suspected, and supervise children during play with small objects. ## Footnote Additional information: Prevention is key to avoiding ear foreign bodies in children.

Answer 50

Perforation of the tympanic membrane, infection spreading to the middle ear, and hearing loss if left untreated. ## Footnote Additional information: Complications can arise if ear foreign bodies are not promptly addressed.

Answer 51

Severe nasal obstruction leading to breathing difficulties, tissue necrosis if button batteries or magnets are involved, and infection spreading to adjacent structures. ## Footnote Additional information: Prompt removal of nasal foreign bodies is crucial to prevent serious complications.

Answer 52

Diabetic retinopathy is a retinovascular disease caused by damage to the blood vessels in the retina due to high blood sugar levels in diabetes. It leads to vision problems and occurs in two forms. ## Footnote Example sentence: Diabetic retinopathy is the leading cause of blindness in working-age adults.

Answer 53

1. Nonproliferative Retinopathy: Characterized by microaneurysms, macular edema, lipid exudates, and intraretinal hemorrhages. 2. Proliferative Retinopathy: Involves the growth of new, abnormal blood vessels on the retina, which can lead to severe vision loss. ## Footnote Example sentence: Nonproliferative retinopathy is often asymptomatic until it progresses to more severe stages.

Answer 54

Gradual bilateral vision loss that progresses over time. The patient may initially be asymptomatic or notice decreased vision or floaters as the disease worsens. ## Footnote Example sentence: Patients with diabetic retinopathy may report a gradual decline in vision quality.

Answer 55

1. Duration of Diabetes: Longer duration increases the risk. 2. Glycemic Control: Poor blood sugar control accelerates progression. ## Footnote Example sentence: Patients with poorly controlled diabetes are at a higher risk of developing diabetic retinopathy.

Answer 56

1. Hypertension: High blood pressure worsens damage to retinal blood vessels. 2. Other Microvascular Complications: Includes diabetic nephropathy and neuropathy. 3. Dyslipidemia: Abnormal cholesterol and triglyceride levels. 4. Pregnancy: Temporarily increases the risk and progression due to hormonal changes and fluctuating blood sugar levels. ## Footnote Example sentence: Patients with hypertension should be closely monitored for diabetic retinopathy.

Answer 57

1. Gradually worsening vision. 2. Sudden vision loss. 3. Shapes floating in the field of vision (floaters). 4. Blurred or patchy vision. 5. Eye pain or redness. ## Footnote Example sentence: Blurred vision is a common symptom of diabetic retinopathy.

Answer 58

Screen annually starting 5 years after the onset of diabetes, usually at or after age 15. Early screening can help detect changes before severe damage occurs. ## Footnote Example sentence: Type 1 diabetes patients should undergo regular eye screenings to monitor for diabetic retinopathy.

Answer 59

Screen at the time of diagnosis for all patients, including children and adolescents. Follow-up screenings every 1-2 years, or more frequently if severity dictates. ## Footnote Example sentence: Type 2 diabetes patients should have their eyes checked regularly to detect any signs of diabetic retinopathy.

Answer 60

Pre-Pregnancy: Evaluate patients during pregnancy planning. During Pregnancy: Screen in the first trimester and monitor as needed throughout pregnancy. Postpartum: Screen again within the first year after giving birth. ## Footnote Example sentence: Pregnant women with diabetes need specialized care to manage diabetic retinopathy.

Answer 61

A dilated eye exam allows a detailed view of the retina to check for microaneurysms, hemorrhages, and abnormal blood vessel growth. ## Footnote Example sentence: A dilated eye exam is essential for diagnosing diabetic retinopathy.

Answer 62

1. Corneal Abnormalities: Issues like corneal scarring or dystrophy. 2. Glaucoma: Increased intraocular pressure that damages the optic nerve. 3. Cataracts: Clouding of the lens, causing blurry vision. ## Footnote Example sentence: Differential diagnosis of diabetic retinopathy involves ruling out other eye conditions.

Answer 63

It is one of the leading causes of vision loss worldwide and the principal cause of impaired vision in patients between 25 and 74 years old, significantly impacting quality of life. ## Footnote Example sentence: Diabetic retinopathy poses a major public health challenge globally.

Answer 64

1. Sudden vision loss. 2. New or worsening floaters. 3. Significant vision changes. 4. Flashes of light or a shadow over the visual field, which may indicate retinal detachment. ## Footnote Example sentence: Severe diabetic retinopathy requires immediate medical attention.

Answer 65

Patients should be referred to an optometrist or ophthalmologist for: 1. Regular screening every 1-2 years. 2. Immediate referral if experiencing sudden vision loss, severe symptoms, or advanced retinopathy. ## Footnote Example sentence: Referral to a specialist is crucial for managing diabetic retinopathy.

Answer 66

Maintaining good blood sugar control can slow the onset and progression of diabetic retinopathy, reducing the risk of severe complications. ## Footnote Example sentence: Proper glycemic control plays a key role in managing diabetic retinopathy.

Answer 67

Hypertension: Increases damage to retinal blood vessels, worsening the condition. Dyslipidemia: Abnormal cholesterol levels increase the risk of retinal damage. ## Footnote Example sentence: Hypertension and dyslipidemia are important risk factors for diabetic retinopathy.

Answer 68

Pregnancy can temporarily increase the risk and progression of diabetic retinopathy due to hormonal changes and fluctuations in blood sugar levels, requiring closer monitoring. ## Footnote Example sentence: Pregnant women with diabetes need specialized care to manage diabetic retinopathy.

Answer 69

A chalazion is a chronic inflammation of a meibomian gland in the eyelid due to blocked ducts, resulting in a painless nodule. ## Footnote Example sentence: She was diagnosed with a chalazion after noticing a small nodule on her eyelid.

Answer 70

It is caused by the occlusion of the meibomian gland ducts, leading to lipogranulomatous inflammation. ## Footnote No additional information.

Answer 71

Swelling on the eyelid. Nontender, hard, pea-sized nodule inside the lid margin. Discomfort or irritation, but usually no pain. ## Footnote No additional information.

Answer 72

Onset, course, and duration of symptoms. Visual disturbances (blurred or loss of vision). History of eye trauma or foreign body. Pain or tenderness in the eyelid. Past eye problems and treatments. Use of contact lenses or glasses and duration. Previous self-treatment attempts. ## Footnote No additional information.

Answer 73

Inspect for foreign bodies and subconjunctival mass. Palpate for a hard, nontender nodule on the tarsus, away from the lid margin. Check for preauricular adenopathy. Differentiate from hordeolum (stye), which is painful and on the lid margin. ## Footnote No additional information.

Answer 74

Chronic Dacryocystitis: Inflammation of the lacrimal sac, usually with pain and swelling near the inner corner of the eye. Hordeolum (Stye): Acute, painful infection of a sebaceous gland on the lid margin, often confused with chalazion but tender to touch. Blepharitis: Chronic inflammation of the eyelid margins with itching and redness, often leading to recurrent chalazia. Xanthelasma: Yellowish cholesterol deposits on the eyelids, which appear as raised plaques but are not related to meibomian glands. Cellulitis of the Eyelid: Diffuse redness, warmth, and swelling of the eyelid, often with systemic symptoms like fever, requiring urgent treatment. ## Footnote No additional information.

Answer 75

A visual acuity examination to assess for vision impact and complications like astigmatism. ## Footnote No additional information.

Answer 76

Large, central, or deep lesions affecting vision. Persistent symptoms after 48 hours of treatment. Signs of infection or cellulitis. ## Footnote No additional information.

Answer 77

Warm compresses to promote drainage. Avoid self-medication with antibiotics. For large chalazia: intralesional steroid injection or surgical excision by an ophthalmologist. ## Footnote No additional information.

Answer 78

Re-evaluate within 24 hours. Continue ointment or drops for 4 days after resolution. Refer to ophthalmologist if symptoms persist beyond 48 hours. ## Footnote No additional information.

Answer 79

A corneal abrasion is the loss of the corneal epithelial tissue, either superficial or deep, usually due to trauma or injury to the eye. ## Footnote Example sentence: The patient presented with a corneal abrasion after being hit in the eye with a tree branch.

Answer 80

Common causes of corneal abrasions include direct trauma (e.g., fingernail scratch, foreign body), improper use of contact lenses, chemical exposure, and accidental rubbing of the eye. ## Footnote Example sentence: The patient developed a corneal abrasion after getting a chemical in their eye while cleaning.

Answer 81

Typical symptoms of a corneal abrasion include sudden onset of sharp eye pain, foreign-body sensation in the eye, watery eye (tearing), mild photophobia (light sensitivity), blurred vision, and headache. ## Footnote Example sentence: The patient complained of sharp eye pain and blurred vision, indicating a possible corneal abrasion.

Answer 82

Patient history for a corneal abrasion should include onset, duration, and course of symptoms, mechanism of injury, visual changes, occupation, sports or activities involving eye exposure, use of protective eyewear, history of eye infections, and use of contact lenses. ## Footnote Example sentence: During the patient history, it was revealed that the individual had a history of recurrent corneal erosions.

Answer 83

In the physical exam for a corneal abrasion, inspect the eye for signs of trauma, redness, or foreign body, check for conjunctival discharge, perform a fluorescein stain test, evaluate visual acuity, and check for associated symptoms like headache, photophobia, redness, itching, or tearing. ## Footnote Example sentence: The physician conducted a physical exam and performed a fluorescein stain test to confirm the presence of a corneal abrasion.

Answer 84

The key diagnostic test for a corneal abrasion is the fluorescein stain test. The presence of an epithelial defect that stains with fluorescein dye indicates a corneal abrasion. ## Footnote Example sentence: The fluorescein stain test confirmed the diagnosis of a corneal abrasion in the patient.

Answer 85

Why are the following conditions considered differential diagnoses for a chalazion? 1. Chronic Dacryocystitis: This condition involves inflammation of the lacrimal sac, presenting with pain, swelling, and tenderness near the inner corner of the eye. It can be confused with a chalazion due to its location and swelling near the eye, but differs in tenderness and systemic symptoms. 2. Hordeolum (Stye): A stye is an acute, painful infection of a sebaceous gland on the lid margin. It is often confused with a chalazion due to similar location and appearance, but styes are typically tender and painful, unlike the painless chalazion. 3. Blepharitis: Chronic inflammation of the eyelid margins often leads to recurrent chalazia. It presents with redness, irritation, and crusting at the lid margins, and can cause similar symptoms of discomfort and swelling as a chalazion. 4. Xanthelasma: These are yellowish cholesterol deposits on the eyelids, presenting as raised plaques. Although they share a similar location with chalazia, they are not related to the meibomian glands and do not cause inflammation or tenderness. 5. Cellulitis of the Eyelid: This is a diffuse bacterial infection of the eyelid tissue, presenting with redness, warmth, and swelling, often with fever and systemic symptoms. It can be mistaken for a severe chalazion, but cellulitis is more widespread and accompanied by systemic signs.

Answer 86

Approximately 2.4 million eye injuries occur annually in the United States, with corneal abrasions accounting for about 10% of new admissions to eye emergency units. ## Footnote Example sentence: The epidemiology report highlighted the significant number of corneal abrasions in emergency eye units.

Answer 87

Red flags that indicate the need for immediate referral for a corneal abrasion include large or central lesions risking scarring, deep or penetrating wounds, persistent symptoms beyond 48 hours, and signs of infection. ## Footnote Example sentence: The patient was immediately referred for further evaluation due to the presence of red flags like deep corneal wounds and persistent symptoms.

Answer 88

Oral antivirals, such as famciclovir and valacyclovir, are used to reduce viral replication, decrease the severity and duration of the rash, and lower the risk of complications, including postherpetic neuralgia and ocular involvement.

Answer 89

Referral to an ophthalmologist is indicated if there is: 1. Eye Involvement: Any signs of conjunctivitis, keratitis, uveitis, or visual disturbances. 2. Nasociliary Involvement: Presence of Hutchinson’s sign (lesions on the tip or side of the nose), indicating a higher risk of ocular complications. 3. Persistent Symptoms: Ongoing pain or rash despite antiviral treatment.

Answer 90

1. Severe eye pain, redness, or decreased vision. 2. Vesicular rash involving the tip of the nose (Hutchinson’s sign). 3. Symptoms suggestive of optic neuritis, such as sudden vision loss or eye pain with movement. 4. Signs of orbital cellulitis (swelling, redness, and pain around the eye).

Answer 91

• HZO: Involves reactivation of the varicella-zoster virus and typically affects the V1 dermatome with a painful rash. It can lead to severe ocular complications like uveitis and keratitis. • Herpes Simplex Keratitis: Caused by herpes simplex virus (HSV-1) and usually presents with dendritic corneal ulcers, without the characteristic vesicular rash of HZO.

Answer 92

1. Zoster Vaccine (Shingrix): Recommended for individuals over 50 years to reduce the risk of shingles and postherpetic neuralgia. 2. Management of Immunosuppressive Conditions: Monitoring and adjusting immunosuppressive therapy to minimize the risk of reactivation. 3. Prompt Antiviral Treatment: Early initiation of antiviral therapy at the onset of symptoms can reduce severity and complications.

Answer 93

Topical or systemic corticosteroids may be used in conjunction with antivirals to reduce inflammation in cases of severe keratitis, uveitis, or scleritis, but only under close supervision by an ophthalmologist to prevent worsening of viral replication.

Answer 94

Postherpetic neuralgia (PHN) is a complication of HZO characterized by persistent pain in the affected dermatome after the rash has healed. It results from nerve damage caused by the viral infection and can be severe and long-lasting, impacting quality of life.

Answer 95

1. Oral Antiviral Therapy: To reduce the risk of developing PHN. 2. Analgesics: Such as acetaminophen or NSAIDs for pain relief. 3. Antidepressants (e.g., amitriptyline): For neuropathic pain. 4. Anticonvulsants (e.g., gabapentin): To reduce nerve pain. 5. Topical Lidocaine Patches: For localized pain relief.

Answer 96

Herpes Zoster Ophthalmicus (HZO) is a viral infection caused by the reactivation of the varicella-zoster virus, affecting the ophthalmic branch (V1) of the fifth cranial nerve (trigeminal nerve), leading to a painful, unilateral rash and potential eye complications.

Answer 97

• Painful, burning rash along the distribution of the trigeminal nerve (V1). • Vesicular lesions on the forehead, eyelid, and tip of the nose (Hutchinson’s sign). • Eye involvement can include redness, pain, and sensitivity to light. • Possible vision changes, such as blurred vision or loss of visual acuity.

Answer 98

Hutchinson’s sign is the presence of vesicular lesions on the tip or side of the nose. It indicates nasociliary nerve involvement and a higher risk of ocular complications in HZO.

Answer 99

1. Advanced age (typically over 50 years). 2. Immunocompromised state (HIV, chemotherapy, or immunosuppressive therapy). 3. History of chickenpox or previous varicella-zoster virus infection. 4. Stress or trauma, which can trigger reactivation of the virus.

Answer 100

1. Keratitis: Inflammation of the cornea, leading to scarring and vision loss. 2. Uveitis: Inflammation of the middle layer of the eye, causing pain and redness. 3. Glaucoma: Increased intraocular pressure due to uveitis or trabeculitis. 4. Optic Neuritis: Inflammation of the optic nerve, potentially leading to vision loss. 5. Postherpetic Neuralgia: Persistent pain in the affected area after the rash has healed.

Answer 101

1. Famciclovir 500 mg TID for 7-10 days. 2. Valacyclovir 1 g TID for 7-10 days. These antiviral medications help to reduce the severity and duration of the infection.

Answer 102

Dry Eye Disease (DED) is a chronic condition characterized by insufficient tear production or increased tear evaporation, leading to inflammation and damage to the ocular surface, resulting in discomfort and visual disturbance.

Answer 103

1) Decreased Tear Production: Often due to aging, certain medications (antihistamines, beta-blockers), or autoimmune diseases like Sjögren's syndrome. 2) Increased Tear Evaporation: Caused by factors such as low humidity environments, prolonged screen use, and eyelid disorders like meibomian gland dysfunction. 3) Imbalance in Tear Composition: Disruption in the balance of water, mucus, and oil in the tear film.

Answer 104

*Sensation of dryness, grittiness, or burning in the eyes. *Blurred vision that often improves with blinking. *Increased tear production as a reflex to dryness (paradoxical tearing). *Eye redness and sensitivity to light (photophobia). *Difficulty wearing contact lenses or performing tasks like reading or using a computer for long periods.

Answer 105

Ocular Lubricants (Artificial Tears): These are used to supplement the natural tear film and provide temporary relief from dryness and irritation. Example: Systane Gel: Apply to lower eyelid 3-4 times a day (TID-QID).

Answer 106

Ophthalmic Corticosteroids: Reduce inflammation on the ocular surface. --Fluorometholone: 1-2 drops BID to QID for 2-4 weeks. --Loteprednol 0.5%: 1-2 drops QID for 2-4 weeks. Cyclosporine Ophthalmic Solution: Immunomodulatory agent that reduces ocular surface inflammation. --Dosage: 1 drop BID. Lifitegrast Ophthalmic Solution: Lymphocyte function-associated antigen-1 (LFA-1) antagonist that reduces T-cell mediated inflammation. --Dosage: 1 drop BID.

Answer 107

Artificial tears replace or supplement the natural tear film but do not target the underlying cause of Dry Eye Disease. They provide temporary relief by lubricating the eye and reducing symptoms of dryness and irritation.

Answer 108

Cyclosporine is an immunosuppressive agent that reduces inflammation and helps increase tear production by suppressing the local immune response in the lacrimal gland and ocular surface.

Answer 109

Ophthalmic corticosteroids, such as fluorometholone and loteprednol, reduce ocular surface inflammation. They are used short-term to manage moderate to severe symptoms and are tapered off to prevent side effects like increased intraocular pressure or cataract formation.

Answer 110

1) Increased Intraocular Pressure: Prolonged use can lead to glaucoma. 2) Cataract Formation: Long-term use increases the risk. 3) Secondary Infections: Corticosteroids can suppress the immune response, increasing susceptibility to infections.

Answer 111

Lifitegrast is an LFA-1 antagonist that works by inhibiting the interaction between T-cells and the ocular surface, reducing inflammation and improving symptoms in moderate to severe Dry Eye Disease. Dosage: 1 drop BID.

Answer 112

1) Environmental Changes: Use a humidifier in dry environments and avoid direct exposure to fans or air conditioning. 2) Screen Time Management: Take regular breaks during prolonged screen use to reduce eye strain and dryness. 3) Eyelid Hygiene: Regular cleaning of eyelids with warm compresses to help unblock meibomian glands. 4) Blinking Exercises: Encourage complete blinking to spread tears evenly across the ocular surface

Answer 113

1) Omega-3 Fatty Acid Supplements: May improve tear film stability and reduce inflammation. 2) Warm Compresses: Applied to the eyelids to help unblock meibomian glands. 3) Punctal Plugs: Small devices inserted into the tear ducts to prevent tear drainage and increase moisture on the ocular surface.

Answer 114

1) When symptoms do not improve with first-line treatments like artificial tears. 2) If there are signs of ocular surface damage or secondary infection. 3) For advanced treatments such as punctal plugs or prescription medications like cyclosporine or lifitegrast.

Answer 115

1) Chronic Discomfort: Persistent irritation and discomfort affecting quality of life. 2) Ocular Surface Damage: Including corneal ulcers or keratitis. 3) Impaired Vision: Due to corneal damage or irregularities. 4) Increased Risk of Infection: Due to compromised tear film and ocular surface integrity.

Answer 116

Blepharitis is an inflammation of the eyelid margins, often appearing as red, scaly, greasy flakes with crusted lid margins. It can be caused by seborrheic dermatitis or a staphylococcal infection at the lid edge.

Answer 117

1) Seborrheic Blepharitis: Caused by excessive shedding of skin cells and blockage of glands, often associated with seborrheic dermatitis. 2) Staphylococcal Blepharitis: Caused by colonization of the eyelid edge with Staphylococcus bacteria, leading to infection and inflammation.

Answer 118

**Symptoms: Burning and itching, tearing, photophobia (sensitivity to light), dry eyes, and recurrent styes or chalazia. **Physical Exam: ****Redness, swelling, and erythema of the eyelid margins. ****Dry, flaky secretions on the lid margins and eyelashes. ****Presence of greasy scales or crusts on the eyelids. ****Possible dry eyes and signs of inflammation around the eyes.

Answer 119

Diabetes: Increases susceptibility to infections. Candida: Fungal infections can worsen inflammation. Seborrheic Dermatitis: Associated with excessive skin cell shedding. Acne Rosacea: Chronic skin condition that can affect the eyelids.

Answer 120

Onset and duration of symptoms. Presence of itching, burning, or pain in the eye. Factors that make symptoms worse or better. Recent changes in personal care products like soaps, creams, or shampoos. History of similar symptoms or episodes in the past. Any changes in vision or new eye pain since the last eye exam. Contributing factors such as allergies, environmental irritants, or contact lens use.

Answer 121

Inspect for erythema, edema, dryness, and scaling of the lid margins. Examine the eyes for red reflex and check sclera, pupil, and iris for abnormalities. Assess visual acuity using the Snellen chart for children older than 3 years. Observe extraocular movements (EOMs) and check for any limitations. Note any crusting or flaking on the eyelashes and lid margins.

Answer 122

Conjunctivitis: Inflammation of the conjunctiva with discharge and redness. Eyelid Malignancy: Persistent lumps or lesions on the eyelid that do not resolve. Hordeolum (Stye) or Chalazion: Localized swelling on the eyelid, often painful and red. Meibomian Gland Dysfunction: Blocked oil glands causing dry eyes and inflammation. Upper Respiratory Infection or Sinusitis: Can cause referred pain and inflammation near the eyes.

Answer 123

Blepharitis is one of the most frequently encountered ocular conditions, especially in individuals with chronic skin conditions like seborrheic dermatitis or acne rosacea. It can be recurrent and persistent.

Answer 124

For recurrent or severe episodes that do not respond to initial treatment. When there is associated visual impairment or suspicion of complications like meibomian gland dysfunction. If there is a potential secondary infection or development of styes/chalazia.

Answer 125

1) Lid Hygiene: Clean the lid margins with a warm washcloth and baby shampoo BID-TID until improved, then once daily for maintenance. 2) Artificial Tears: To alleviate dry eyes and improve comfort. 3) Anti-Seborrheic Shampoos: For patients with seborrhea of the scalp, use these shampoos to reduce skin shedding and inflammation.

Answer 126

1) Lid Hygiene: Primary treatment for all types of blepharitis. 2) Erythromycin 0.5% Ointment: ½ inch applied to the lid margins QHS (first-line for bacterial or mixed types). 3) Tobramycin 0.3% Ointment: ½ inch applied to the lid margins QHS, especially in cases with mixed seborrheic and bacterial causes or meibomian gland dysfunction.

Answer 127

Blockage of the meibomian glands can prevent the proper flow of oil and mucus into the tear duct, leading to dry eyes, inflammation, and increased risk of bacterial colonization, which can exacerbate blepharitis.

Answer 128

1) Regular Lid Hygiene: Clean eyelids regularly to remove debris and prevent blockages. 2) Manage Underlying Conditions: Treat seborrheic dermatitis or acne rosacea effectively. 3) Avoid Irritants: Use hypoallergenic products and avoid eye makeup if it triggers symptoms. 4) Maintain Good Hand Hygiene: To prevent bacterial contamination of the eyelids.

Answer 129

A cataract is a condition where the lens of the eye loses its transparency, becoming cloudy or opaque, leading to decreased vision. It often appears as a pearly gray area in the lens.

Answer 130

1) Age-Related (Senile Cataracts): The most common type, associated with aging. 2) Drug Reactions: Prolonged use of steroids or certain medications. 3) Injuries: Trauma to the eye can cause cataract formation. 4) Radiation Exposure: UV radiation or radiation therapy to the head or neck.

Answer 131

**Decreased vision. **Blurred or foggy vision, sometimes described as “ghost” images. **Difficulty driving at night due to glare from headlights. **Altered color perception, with colors appearing faded or yellowed. Frequent changes in eyeglass prescriptions. Frequent falls or injuries due to impaired vision.

Answer 132

1) Onset, course, and duration of visual changes. 2) Impact on day and night vision, as well as near and far sight. 3) Which eye is affected or if both eyes are involved. 4) Use of glasses or extra light to improve vision. 5) Medical history, including use of medications like steroids. 6) History of traumatic injury to the eyes. 7) Exposure to UV rays through occupation or leisure activities.

Answer 133

Visual Acuity Test: To assess the extent of vision impairment. Funduscopic Exam: ***Check for the red reflex: A normal eye shows a bright red reflex, while a cataract disrupts this reflex, appearing as dark areas against the red-orange reflex. ***Assess lens opacities and note any dark areas. ***Look for the color of the opacity: Brunescent cataracts have a yellow-brown hue. Peripheral Vision Test: To evaluate the impact on overall vision. Check for Retinal Abnormalities: Look for hemorrhage, scarring, and drusen.

Answer 134

Glaucoma: Increased intraocular pressure with potential optic nerve damage, which can cause vision loss but usually starts with peripheral vision loss. Age-Related Macular Degeneration (AMD): Loss of central vision due to retinal damage, similar to cataracts but typically starts with blurring of central vision. Diabetic Retinopathy: Vision loss due to damage to the blood vessels in the retina, often with retinal hemorrhages and microaneurysms. Temporal Arteritis: Inflammation of the temporal arteries, leading to sudden vision loss, headache, and jaw claudication.

Answer 135

Cataracts are the most common cause of blindness in the world.

Answer 136

Visual disturbance is interfering with daily life, such as causing falls, difficulty reading, or inability to drive safely. Significant glare or halos around lights, especially at night. Difficulty performing activities that require clear vision, such as watching TV or recognizing faces.

Answer 137

If the cataract is causing significant visual impairment. For monitoring by an ophthalmologist to assess the progression and need for surgical intervention. If there are associated symptoms like frequent falls, indicating severe vision impairment. To connect with social workers or community resources for support and assistance with daily activities.

Answer 138

Non-Surgical Management: **Use of stronger lighting and magnifying lenses. **Updating eyeglass prescriptions frequently as the condition progresses. Surgical Management: **Cataract Surgery: Removal of the cloudy lens and replacement with a synthetic intraocular lens (IOL). **Surgery is recommended when visual impairment interferes with daily activities.

Answer 139

Surgery should be based on the level of visual impairment and the impact on quality of life, not just age. Elderly patients can greatly benefit from cataract surgery, which can significantly improve vision and quality of life, allowing them to remain independent.

Answer 140

Most patients regain near-normal or normal vision post-surgery. Enhanced ability to perform daily activities, reduced risk of falls, and better color perception.

Answer 141

Cellulitis is a bacterial infection of the skin and underlying tissues. The two main types affecting the eye are: Periorbital Cellulitis: Involves only the eyelid and surrounding skin, not the orbit. Orbital Cellulitis: A severe infection involving the muscles and fat within the orbit, potentially life-threatening.

Answer 142

Periorbital Cellulitis: Involves only the eyelid and surrounding skin, not the orbit. Orbital Cellulitis: A severe infection involving the muscles and fat within the orbit, potentially life-threatening.

Answer 143

Symptoms: Unilateral eyelid swelling, redness, fever, warmth, and tenderness. Physical Exam: Clear conjunctiva. Eye movements are free and vision is not impaired. No limitation in extraocular movements.

Answer 144

Symptoms: Severe unilateral eyelid swelling, pain, fever, and the patient appears ill. Physical Exam: Ptosis (drooping of the upper eyelid). Chemosis (swelling of the conjunctiva). Conjunctivitis (red, inflamed eyes). Limitation in eye movement and pain with eye movement. Vision changes or loss of visual acuity.

Answer 145

Periorbital Cellulitis: Localized to the eyelid with clear conjunctiva. No restriction in eye movement or vision impairment. Orbital Cellulitis: Involves the orbit with symptoms like ptosis, chemosis, and conjunctivitis. Limited extraocular movements, pain with eye movement, and vision changes.

Answer 146

1) Onset and duration of symptoms. 2) Presence of pain, swelling, and fever. 3)History of trauma, recent sinus infection, or upper respiratory tract infection. 4) Any vision changes or double vision. 5) Recent dental procedures or infections. 6) Family history of similar conditions or autoimmune disorders.

Answer 147

CBC (Complete Blood Count): To check for leukocytosis, indicating infection. Blood Cultures: To identify the causative organism and guide antibiotic therapy.

Answer 148

CBC and Blood Cultures: To confirm infection and identify the causative agent. CT Scan of the Orbit: To assess the presence and extent of abscesses, orbital involvement, and localize the infection. Essential for distinguishing between orbital and periorbital cellulitis.

Answer 149

Orbital cellulitis can lead to: 1)Abscess Formation: Risk of spreading to the brain, causing serious complications like meningitis. 2) Vision Loss: Increased pressure and inflammation within the orbit can damage the optic nerve. 3) Intracranial Spread: Potential for cavernous sinus thrombosis or other intracranial infections. 4) Sepsis: Systemic infection that can be life-threatening.

Answer 150

Thyroid-Associated Orbitopathy: Eye bulging and lid retraction, typically bilateral. Orbital Myositis: Idiopathic inflammation of the eye muscles causing pain and eye movement limitation. Orbital Pseudotumor: Inflammatory mass mimicking a tumor, causing pain, swelling, and vision changes. Granulomatosis with Polyangiitis: Autoimmune inflammation of blood vessels affecting the orbit, presenting with proptosis and pain. Carotid Cavernous Fistula: Abnormal connection between the carotid artery and cavernous sinus, presenting with pulsating exophthalmos and bruit.

Answer 151

More common in young children than in older children or adults. Most cases arise as a complication of bacterial rhinosinusitis, with coexisting rhinosinusitis present in 86-98% of cases. Ethmoid sinusitis and pansinusitis are the most likely forms of rhinosinusitis to lead to orbital cellulitis.

Answer 152

Limitation of eye movement or pain with eye movement. Severe eye pain or vision changes. Fever and systemic signs of illness. Rapidly progressing swelling or redness around the eye. Signs of proptosis (bulging of the eye) or decreased visual acuity.

Answer 153

Periorbital Cellulitis: Refer if symptoms worsen or orbital involvement is suspected. Orbital Cellulitis: Requires immediate hospitalization and IV antibiotics. Urgent referral to an ophthalmologist or an emergency department.

Answer 154

Eliminate Infection: Use of appropriate antibiotics to eradicate the infection. Prevent Complications: Early identification and treatment to prevent abscess formation, vision loss, or intracranial spread. Relieve Symptoms: Reduce pain, swelling, and other symptoms. Restore Function: Preserve vision and normal eye movement. Monitor for Recurrence: Ensure complete resolution of infection and educate the patient on signs of recurrence.

Answer 155

inflammation of the conjunctiva, which is the membrane covering the white part of the eyes and the inner eyelids.

Answer 156

classified into four main types: Bacterial Conjunctivitis Viral Conjunctivitis Allergic Conjunctivitis Chemical Conjunctivitis

Answer 157

Red eyes. Eye drainage (type varies). Itching (common in allergic conjunctivitis).

Answer 158

Fast onset within 12-24 hours. Copious purulent or mucopurulent discharge. Burning, stinging, or gritty sensation in the eyes. Crusted eyelids upon awakening, with eyelid swelling. Typically starts in one eye and may progress to both. Beefy-red conjunctiva.

Answer 159

Haemophilus influenzae Streptococcus pneumoniae Staphylococcus aureus Neisseria gonorrhoeae Chlamydia trachomatis

Answer 160

tarts in one eye and may progress to both. Watery discharge with tearing. Sensation of a foreign body in the eye. Systemic symptoms such as runny nose, sore throat, sneezing, and fever. Preauricular or submandibular lymphadenopathy. Photophobia and impaired vision. Vesicular skin lesions and dendritic corneal ulcers in primary herpetic infection.

Answer 161

Adenovirus Coxsackievirus Herpes Simplex Virus (HSV) Human Papillomavirus (HPV) Enteric cytopathic human orphan (ECHO) viruses

Answer 162

Itchy, watery eyes that are always bilateral. Seasonal symptoms, often related to pollen exposure. Eyelid edema without visual changes. Hyperemia of eyes with possible giant papillae on the tarsal conjunctiva. May present with eczema, urticaria, or asthma flare-ups.

Answer 163

Iatrogenic: Caused by miotics, preservatives in eye drops, or contact lens solutions. Occupational: Exposure to irritative chemicals. Irritative: Exposure to household chemicals or pollutants.

Answer 164

Onset, duration, and course of symptoms. Presence and type of discharge (purulent, watery, etc.). Changes in vision since symptoms began. Any recent eye trauma or injury. Past episodes of similar symptoms. Contact with individuals having conjunctivitis. Recent changes in contact lenses, solutions, or cosmetic products. Personal and family history of allergies.

Answer 165

Inspect: **Observe eyes for redness, discharge, and foreign bodies. **Check for lid edema and conjunctival color changes. Palpate: **Palpate preauricular, anterior, and posterior cervical lymph nodes for enlargement. Check visual acuity: **Use the Snellen chart to assess vision. Auscultate: **Heart and lungs to rule out systemic involvement.

Answer 166

**Gram Stain: For discharge if gonococcal infection is suspected, especially in neonates. **Culture for Chlamydia: If suspected based on history and symptoms. **Fluorescein Stain: If foreign body, corneal abrasion, or ulceration is suspected. **Visual Acuity Test: With Snellen chart, assess peripheral vision and extraocular movements (EOMs).

Answer 167

Viral Conjunctivitis: Consider herpetic keratoconjunctivitis if vesicular lesions are present. Bacterial Conjunctivitis: Consider gonorrheal or chlamydial infections if purulent discharge is present. Corneal Abrasion: Sudden onset of pain and photophobia, usually with a history of trauma. Blepharitis: Chronic inflammation of the eyelids with crusting and itching. Drug-Related Conjunctivitis: Linked to recent use of eye drops or medications. Iritis: Presents with photophobia, pain, and vision changes without significant discharge.

Answer 168

Viral conjunctivitis is the most common type. Conjunctivitis occurs in 1% to 12% of newborns.

Answer 169

Suspected periorbital cellulitis or herpes virus infection. Significant vision change or eye pain. Symptoms not responding to treatment. Presence of a corneal ulcer or severe corneal involvement.

Answer 170

Relieve symptoms. Prevent complications and preserve eyesight. Prevent recurrence. Cure or control infection where present. Prevent transmission to others.

Answer 171

No antibiotics or antivirals indicated. Use cold compresses, decongestants, and artificial tears to relieve symptoms.

Answer 172

Polymyxin B/Gramicidin Drops: OTC, for mild cases in adults, q3-4h for 2 days after symptoms resolve. Erythromycin 0.5% Ointment: 1/2 - 1 inch QID (Rx). Fusidic Acid 1% Drops: BID, for children > 2 years. Trimethoprim-Polymyxin B Drops: 1-2 drops q3h. Tobramycin 0.3% Drops or Ointment: 1-2 drops q4h, taper to BID-TID.

Answer 173

Use broad-spectrum drops like Trimethoprim/Polymyxin B drops, Erythromycin ointment, or Fusidic acid drops for moderate to severe cases or treatment failure.

Answer 174

1) Acyclovir 400 mg BID PO for up to 12 months (RxTx). 2) Trifluridine (Viroptic) 1% Solution: 1 drop Q2H while awake (max 9 drops/day) until re-epithelialization, then Q4H (max 5/day) for 7 days post re-epithelialization.

EYES Flashcards

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