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Eyes Flashcards

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1
Q

How does bacterial conjunctivitis differ from viral conjunctivitis?

A

Bacterial has purulent discharge and eyelid crusting, while viral is watery and often associated with an upper respiratory infection.

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2
Q

What precautions should be taken to prevent transmission of conjunctivitis?

A

Hand hygiene, avoiding shared towels, and disinfecting contaminated surfaces.

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3
Q

When is ophthalmology referral necessary in the management of conjunctivitis?

A

If symptoms persist >10 days, vision is affected, or if there is concern for keratitis.

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4
Q

What are the hallmark signs of acute angle closure glaucoma?

A

Sudden eye pain, halos around lights, mid-dilated fixed pupil, and increased intraocular pressure.

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5
Q

What medications should be avoided in patients with potential acute angle closure glaucoma?

A

Anticholinergics, sympathomimetics, and decongestants, as they can precipitate an attack.

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6
Q

What is the definitive treatment to prevent recurrence of acute angle closure glaucoma?

A

Laser peripheral iridotomy.

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7
Q

What are the risk factors for retinal detachment?

A

Myopia, trauma, prior eye surgery, and diabetic retinopathy.

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8
Q

How does retinal detachment differ from posterior vitreous detachment?

A

Retinal detachment presents with a curtain-like vision loss, while posterior vitreous detachment causes floaters and flashes without vision loss.

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9
Q

What is the most common cause of a stye?

A

Staphylococcus aureus infection of an eyelash follicle or gland.

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10
Q

How do you differentiate a stye from a chalazion?

A

A stye is painful and acute, while a chalazion is chronic and non-tender.

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11
Q

What is the best initial treatment for a stye?

A

Warm compresses and eyelid hygiene; antibiotics if infection spreads.

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12
Q

What are the hallmark symptoms of retinal detachment?

A

Sudden loss of vision, flashes of light, and a curtain-like shadow over vision.

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13
Q

What are risk factors for retinal detachment?

A

Myopia, trauma, prior eye surgery, and diabetic retinopathy.

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14
Q

What is the emergency management of a retinal detachment?

A

Immediate ophthalmology referral for surgical repair (scleral buckle, pneumatic retinopexy, or vitrectomy).

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15
Q

What is the most common cause of viral conjunctivitis?

A

Adenovirus.

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16
Q

How does viral conjunctivitis differ from bacterial conjunctivitis?

A

Viral conjunctivitis has watery discharge, preauricular lymphadenopathy, and is often bilateral, whereas bacterial conjunctivitis has purulent discharge.

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17
Q

What precautions should be taken to prevent the spread of viral conjunctivitis?

A

Hand hygiene, avoiding eye rubbing, disinfecting shared items, and avoiding contact lens use.

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18
Q

What are the hallmark symptoms of allergic conjunctivitis?

A

Bilateral itching, redness, tearing, and stringy discharge, often associated with seasonal allergies.

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19
Q

How does allergic conjunctivitis differ from viral and bacterial conjunctivitis?

A

Allergic conjunctivitis has intense itching and clear discharge, whereas viral conjunctivitis is watery and bacterial is purulent.

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20
Q

What is the first-line treatment for allergic conjunctivitis?

A

Antihistamine eye drops (e.g., olopatadine) and avoidance of allergens.

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21
Q

What is the most common cause of preseptal cellulitis?

A

Spread from a local infection, such as sinusitis or insect bites.

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22
Q

How does preseptal cellulitis differ from orbital cellulitis?

A

Preseptal cellulitis does not involve pain with eye movement or proptosis, while orbital cellulitis does.

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23
Q

What is the appropriate management for preseptal cellulitis?

A

Oral antibiotics (e.g., amoxicillin-clavulanate) and close follow-up.

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24
Q

What are the distinguishing features of orbital cellulitis?

A

Proptosis, pain with eye movement, decreased vision, and ophthalmoplegia.

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25
What is the most common cause of orbital cellulitis?
Sinus infections (especially from the ethmoid sinuses).
26
What is the treatment for orbital cellulitis?
IV antibiotics (e.g., vancomycin plus ceftriaxone) and possible surgical drainage if abscess is present.
27
What are the symptoms of a corneal abrasion?
Eye pain, tearing, photophobia, and foreign body sensation.
28
How is a corneal abrasion diagnosed?
Fluorescein staining and Wood’s lamp or slit lamp examination.
29
What is the first-line treatment for a corneal abrasion?
Antibiotic eye drops (e.g., erythromycin), pain management, and avoiding contact lens use.
30
What are the signs of an intraocular foreign body?
Tearing, pain, decreased vision, and a positive Seidel test indicating globe penetration.
31
What is the first step in managing a suspected corneal foreign body?
Evert the eyelid, inspect the eye, and remove with a moistened cotton swab or needle if superficial.
32
When is an urgent ophthalmology referral needed for a foreign body?
If there is deep penetration, signs of infection, or retained metallic debris.
33
What are the signs of an open globe injury?
Peaked pupil, loss of anterior chamber depth, positive Seidel test, and severe vision loss.
34
How should an open globe injury be managed emergently?
Eye shield placement, NPO status, IV antibiotics, antiemetics, tetanus prophylaxis, and urgent ophthalmology consultation.
35
Why should pressure be avoided in suspected open globe injuries?
Any pressure on the eye may worsen extrusion of intraocular contents.
36
What are the symptoms of iritis?
Painful red eye, photophobia, blurred vision, and constricted pupil.
37
How does iritis differ from conjunctivitis?
Iritis has pain, photophobia, and consensual pupillary constriction, whereas conjunctivitis is typically painless.
38
What is the treatment for iritis?
Topical steroids and cycloplegics, with ophthalmology referral.
39
What is the most common cause of bacterial keratitis?
Pseudomonas aeruginosa (especially in contact lens users).
40
How is viral keratitis typically diagnosed?
Fluorescein staining shows dendritic ulcers in HSV keratitis.
41
What is the treatment for bacterial keratitis?
Fluoroquinolone eye drops (e.g., moxifloxacin) and urgent ophthalmology referral.
42
What is blepharitis?
Inflammation of the eyelid margins, often associated with seborrheic dermatitis or Staphylococcus species.
43
What are the key symptoms of blepharitis?
Eyelid redness, crusting, irritation, and foreign body sensation.
44
What is the first-line treatment for blepharitis?
Eyelid hygiene with warm compresses and baby shampoo, plus topical antibiotics if needed.
45
What are the most common causes of painless acute vision loss?
Central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), and retinal detachment.
46
What is the emergency management of Central retinal artery occlusion (CRAO)?
Ocular massage, lowering intraocular pressure, and immediate ophthalmology referral.
47
What distinguishes optic neuritis from other causes of acute vision loss?
Pain with eye movement and an afferent pupillary defect.
48
What are the most common causes of dry eye syndrome?
Meibomian gland dysfunction, aging, Sjögren’s syndrome, prolonged screen time, and environmental factors like wind or air conditioning.
49
How does aqueous-deficient dry eye differ from evaporative dry eye?
Aqueous-deficient dry eye results from decreased tear production (e.g., Sjögren’s syndrome), while evaporative dry eye is due to rapid tear evaporation, often from meibomian gland dysfunction.
50
What are the treatment options for severe dry eye disease that is refractory to artificial tears?
Punctal plugs, prescription anti-inflammatory drops (cyclosporine or lifitegrast), autologous serum tears, and scleral lenses.
51
What is a pinguecula, and how does it differ from a pterygium?
A pinguecula is a small, yellowish, raised lesion on the conjunctiva that does not extend onto the cornea, while a pterygium is a fibrovascular growth that can encroach on the cornea.
52
What environmental factors contribute to pinguecula formation?
Chronic UV exposure, wind, and dust irritation.
53
When should surgical removal of a pinguecula be considered?
If the lesion causes persistent irritation, cosmetic concerns, or chronic inflammation unresponsive to conservative management.
54
What are the risk factors for developing a pterygium?
Chronic UV exposure, dry climates, outdoor occupations, and wind/dust exposure.
55
How does a pterygium affect vision?
If it grows onto the cornea, it can cause astigmatism, corneal scarring, and visual distortion.
56
What are the treatment options for a symptomatic or visually significant pterygium?
Lubricating eye drops for mild cases, surgical excision for vision impairment, and UV protection to prevent recurrence.
57
What are the common causes of a subconjunctival hemorrhage?
Minor trauma (rubbing eyes, sneezing, coughing), hypertension, blood thinners, and coagulation disorders.
58
How can a subconjunctival hemorrhage be differentiated from other causes of a red eye?
It presents as a sharply demarcated, painless red patch on the sclera without discharge, pain, or vision changes.
59
When should a patient with a subconjunctival hemorrhage be referred for further evaluation?
If there is recurrent hemorrhage, associated bleeding/bruising elsewhere, or underlying systemic conditions like coagulopathy or hypertension.
60
What are the most common causes of corneal ulcers?
Bacterial (Pseudomonas, Staphylococcus), viral (HSV), fungal (Candida, Aspergillus), and contact lens-related infections.
61
How is a bacterial corneal ulcer diagnosed and treated?
Diagnosis is made via slit lamp exam with fluorescein staining; treatment includes topical fluoroquinolone antibiotics and urgent ophthalmology referral.
62
What are the potential complications of untreated corneal ulcers?
Corneal scarring, perforation, endophthalmitis, and vision loss.
63
What are the most serious causes of an acute red eye?
Acute angle-closure glaucoma, and scleritis.
64
What symptoms suggest a more benign cause of red eye, such as conjunctivitis?
No pain, no vision loss, and normal pupillary reaction.
65
When should an acute red eye be referred to ophthalmology?
If there is severe pain, vision changes, or signs of serious intraocular disease.
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