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HEENT > Eyes > Flashcards

Eyes Flashcards

(52 cards)

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1
Q

Physical Exam of Eyes

A

Visual acuity, discharge, redness, mobility (cardinal fields of gaze), pupils, ocular pressures, opthalmoscopic exam, head and neck lymphadenopathy

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2
Q

Ophthalmic Red Flags

A

Decreased vision (sudden and painless) Pain with light, movement, N&V Trauma—hyphema, orbital fracture Corneal abrasion Uveitis Foreign body Periorbital cellulitis Associated neurological deficits (weakness, numbness)

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3
Q

Age Related Eye Diseases (AREDS)

A

Cataracts, Glaucoma, Diabetic Retinopathy, Macular Degeneration

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4
Q

Cataracts Risk Factors

A

Age, DM, truama, smoking, steroids, sunlight

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5
Q

Cataracts Treatment

A

Stronger glasses Surgery

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6
Q

Cataracts PE

A

Dull red reflex, opaque pupil

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7
Q

Cataracts: C/O

A

Blurry vision, light rings around objects, gradual decrease in vision

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8
Q

Central Opacity Cataracts

A

Vision loss and glare with bright lights Distance < Near vision

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9
Q

Peripheral Cataracts

A

Dont affect vision until larger

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10
Q

Age-Related Macular Degeneration (AMD)

A

Diminished central vision due to aging macule (center of retina)

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11
Q

Age-Related Macular Degeneration (AMD) Risk Factors

A

Europeans with fair skin, female, +FH, smoking, poor exercise and diet habits

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12
Q

Age-Related Macular Degeneration (AMD) PE

A

Fundi = drusen

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13
Q

Drusen

A

Yellow/white deposits on fund Represents focal degeneration

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14
Q

Dry AMD

A

Non-neovascular More common with less severe effects on vision

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15
Q

Wet AMD

A

Neovascular (grows new blood vessels) Some success with laser treatment

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16
Q

AREDS supplements

A

Vit. C & E Zinc Beta-Carotene Lutein Zeaxanthin

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17
Q

Glaucoma

A

Damage to optic nerve 2/2 high intraocular pressures (> 21 mmHg) Causes cupping of optic nerve

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18
Q

Primary vs. Secondary Glaucoma

A

Primary: open angle and angle closure (more common) Secondary: trauma, inflammation

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19
Q

Glaucoma Risk Factors

A

Age, Blacks>Whites, Genetics

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20
Q

Glaucoma Assessment

A

Symptoms of open-angle glaucoma: asymptomatic elevation of IOP; “silent blinder” Symptoms of angle-closure glaucoma: painful red eye, decrease visual acuity, nausea & vomiting. Requires emergency treatment PE corneal cloudiness, diffuse red eye, slow pupillary response

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21
Q

Glaucoma Treatment

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A

Therapy goal is to stabilize IOP in normal range Topical agents: cholinergics (Pilocarpine), anticholinesterases, Beta blockers (Timolol), prostaglandins, alpha agonists, CAI’s Laser and surgery if meds fail Cautious use of topical steroids in eyes or anticholinergics

22
Q

Diabetic Retinopathy

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A

2/2 long term DM, poor glycemic control, smoking, renal disease, HTN, pregnancy

23
Q

Diabetic Retinopathy Sx

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A

Vision loss, “floaters”

24
Q

Diabetic Retinopathy PE

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A

Retinal “cotton wool spots”, hemorrhages

25
Diabetic Retinopathy Screening
Type 1 DM: annually after 5 years with DM Type 2 DM: at diagnosis, then annually
26
Keratitis Sicca
Dry eyes
27
S/s of dry eyes
blurring, burning, itching FB sensation
28
Dry Eyes treatment
Avoid irritants, sun Hot compresses OTC artificial tears, lubricants Refer to ophthalmology if chronic: Restasis
29
Meds that cause dry eyes
Diuretics, antihistamines, accutaine, anticholinergics
30
Environmental causes of dry eyes
Dry, windy, low humidity
31
Conjunctivitis (Bacterial)
Staph Aureus (most common, can be chronic) Strep pneumoccocus—more common in northern states during winter Haemophilus—warmer zones Moraxella lacunata, E. Coli, Proteus Pseudomonas—contact lens wears
32
Conjunctivitis (Viral)
Adenovirus, Enterovirus, Coxsackie, HSV
33
Hyperacute Bacterial Conjunctivitis
Neisseria, honorrhea, chlamydia
34
Conjunctivitis (Bacterial) PE
Mucopurulent discharge, irritation, lids stuck together Unilateral initially Normal Vision, no pain, no photophobia
35
Conjunctivitis (Bacterial) Treatment
Trimethoprim & polymyxin B (Polytrim) Erythromycin (Ilotycin) Bacitracin Sulfacetamide sodium 10% (Sulamyd, Bleph-10) Flouroquinolones (ofloxacin, ciprofloxin) Warm compresses, Johnson's baby shampoo, frequent hand washing, change contact lens and eye make up
36
Viral Conjunctivitis PE
Mucoid discharge Preauricular lymphadenopathy Diffuse conjunctival erythema Watery discharge. URI symptoms of pharyngits, nasal congestion, low grade fever. No vision problem or pain
37
Allergic Conjunctivitis
History of atopy, allergic rhinitis Watery, itchy, bilateral Mild erythema and edema of lids & conjunctiva
38
Allergic Conjunctivitis Treatment
NSAID’s: Acular (reduces itching and inflammation)(can't use with contacts) Mast cell stabilizer: Alocril, Crolom Antihistamines/mast cell stabilizer: Patanol, Claritin Antihistamine/vasoconstrictor: Naphcon-A Nasalcrom--cromolyn NO Topical Steroids!
39
Hyperacute bacterial conjunctivitis: Neisseria
Transmitted from GU tract Copious purulent discharge Involves surrounding structures red and painful Prompt referral or consultation with an ophthalmologist
40
Inclusion conjunctivitis: Chlamydia
Abrupt onset of ocular discomfort, diffuse erythema, scant to no mucopurulent discharge, follicles on lower palpebral conjunctiva Can progress to keratitis if not treated A/W urethritis/cervicitis Systemic TCN, EMycin or Bactrim for 21 days. Refer
41
Uveitis/Iritis
Blurred vision, pain, photophobia, perilimbal injection, Iritis: small & nonreactive pupil Unilateral or bilateral Idiopathic or R/T systemic disease (TB, ankylosing spondylitis, JRA, sarcoidosis) Rule out trauma and infection Refer immediately to ophthalmologist--steroids
42
Uveitis vs. Iritis
Uveitis: inflammation of anterior and posterior uveal structures (iris, colliery body, choroid) Iritis: inflammation of anterior tract (iris)
43
Perilimbial flush
aka: cilliary flush Redness around cornea
44
Subconjunctival hemorrhage
Bleeding under conjunctiva Occurs spontaneously or with coughing, sneezing, minor trauma Deep, flat, bright red hemorrhage No pain or visual deficit Complete eye exam to r/o conjunctivitis or trauma Reassurance--clears in 2-3 weeks
45
Hyphema
Accumulation of blood in anterior chamber due to trauma Painless, poor pupil reaction, Immediate referral
46
Corneal injury
Abrasion, foreign body, erosion, ulcer Present with pain. Can be tearing, blurred vision, redness Evert the eyelids look for foreign body Stain with fluorescein green with UV light Check corneal surface—white or opaque if ulcerated REFER Don't patch corneal abrasions. Remove foreign body with cotton tip. ? antibiotics
47
Subconjunctival hemorrhage
Bleeding under conjunctiva Occurs spontaneously or with coughing, sneezing, minor trauma Deep, flat, bright red hemorrhage No pain or visual deficit Complete eye exam to r/o conjunctivitis or trauma Reassurance--clears in 2-3 weeks
48
Hyphema
Accumulation of blood in anterior chamber due to trauma Painless, poor pupil reaction, Immediate referral
49
Hordeolum
stye Acute localized painful mass, internal or external Evert eyelid over cotton swab to see internal Warm compresses, antibiotic ointment if inflammed
50
Chalazion
Painless chronic granulomatous nodule Surgical excision
51
Blepharitis
Acute or chronic infection/inflammation of lid margin A/W seborrhea Crusty, erythematous, missing eyelashes, inflammed Daily wash, antibiotic ointment at H.S. for 3 weeks
52

HEENT (4 decks)

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