eyes, ears + oral health Flashcards
(44 cards)
why does a baby under a month old need urgent referral if they present with sticky eyes
it can be a sign of chlamydia/ gonorrhoea infection from birth. Need to distinguish between this or conjunctivitis / simple sticky eyes.
what are the 3 causes of conjunctivitis
which is most common
can be caused by viral, bacterial, or allergy infection.
most common is viral infection
name the common symptoms of bacterial conjunctivitis
- yellow white discharge
- bilateral infection (infection in both eyes)
- not itchy
it is usually self-limitinb
name the symptoms of allergic conjunctivitis
- bilateral infection (infection in both eyes)
- itchy
- clear watery discharge
what eye symptoms can indicate a patient has acute glaucoma
- pain in the eye that is more than just discomfort
- impaired vision
- eye may feel hard/tender
patient needs refer for further investigation
which bacteria commonly cause bacterial conjunctivitis
Staphylococcus and Haemophilus influenzae
TRUE OR FALSE:
most cases of bacterial + viral conjunctivitis are self limiting.
True
- most cases recover within a week
how do you use chloramphenicol eye drops + eye ointments for periorbital or orbital cellulitis
chloramphenicol eye drops: use every 2 hours for the first 48 hrs, then use every 4 hours after that.
chloramphenicol eye ointment: use every 4 hours
For both: use for minimum of 5 days even if symptoms improve
what are brolene and golden eye used to treat?
what does the ointment preparation contain compared to the eye drops
used to treat injective conjuctivitis
ointment preparation contains dibromopropamidine isethionate which is antibacterial and antifungal. eye drops contain just propamidine isethionate which is antibacterial
what are the 2 types of treatment for allergic conjunctivitis
how do they work
topical antihistamines: Otrivine-antistin® which contains antazoline and xylometazoline. This contains a vasoconstrictor to relieve redness in eyes
topical mast cell stabilisers: sodium cromoglicate (e.g. Opticrom®). These work by preventing histamine and other inflammatory mediators from being relased by mast cells. need to be used regularly up to 4 times a day to see benefit
which eye drops for allergic conjunctivitis should only be used short term
topical antihistamines e.g Otrivine-antistin® which contains antazoline and xylometazoline
which eye drops for allergic conjunctivitis need to be used regularly to see a benefit
topical mast cell stabilisers: sodium cromoglicate (e.g. Opticrom®
why should people who wear contact lenses be especially aware of bacterial conjunctivitis
it can develop into bacterial keratitis (infection in the cornea) and threaten vision
what should contact lenses wearers do if there is a sign of eye infection
contact lenses should not be worn if theres a sign of infection, during treatment or for 24 hours after treatment has finished
what lifestyle advice can be given to prevent eye infections spreading
- wash hands after touching eyes
- avoid sharing towels and pillows
- cold compress may soothe eyes with any type of conjunctivitis
- if allergic conjunctivitis (try to avoid triggers)
when should you give an urgent referral to ophthalmology for a patient with conjunctivitis
- reduced vision
- orbital cellulitis (infection in fat or muscle around eye)
- periorbital cellulitis (infection in eye lid or round eye)
- eye pain, headache or photophobia (could be meningitis)
- can’t open eye or keep it open
- corneal infection in patients who wear soft contact lenses
what is the first line treatment for dry eyes
hypromellose (best value treatment and there is no evidence to say any other preparations are better)
why is simple eye ointment or Lacri-lube good to use at night time for dry eyes
because they provide long time lubrication of the eyes but can cause short-term blurring of the eyes
what type of eye products should not be used in contact lens wearers
eye ointments
what lifestyle advice can you recommend for good eye care
- soak cotton wool in boiled and cooled water and gently clean eyelids for 2-3 mins at a time
- can use cotton buds to gently remove any crusts from lower lid
TRUE OR FALSE:
80% of middle ear infections
will resolve with no treatment in three days
true
when should you refer a patient having an issue with their ears
- if symptoms are unresolved after 3 days or severe
- if you suspect a foreign body is stuck inside the ear (more likely with children)
- if ear pain is severe or has lasted for more than 3 days
- dulled hearing from otitis media with effusion (middle of ear filled with fluid that looks like glue)
- treatments to remove wax unsuccessful
what is Otitis externa and otitis media?
how do you treat it
otitis externa = inflammation of the outer ear canal/ surface of ear
otitis media= inflammation/infection in middle of ear
These are usually self limiting. simple pain killers can be used in the mean time (paracetamol / ibuprofen)
when should you refer ear pain
if the ear pain is severe or has lasted for more than 3 days
