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OPHTHO > glaucoma, red eye, pupillary & refractory d/o > Flashcards

glaucoma, red eye, pupillary & refractory d/o Flashcards

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1
Q

Marcus gunn

A

decreased DIRECT reaction to light but consensual response intact
swinging flashing test
nerve problem or retinal problem

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2
Q

horner’s syndrome

A

lesion of sympathetic pathway causing miosis, ptosis, no sweating
think tumor, nothing is wrong with eye itself

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3
Q

Argyll robertson

A

pupillary constriction w/ near accommodation but not to light stimulation

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4
Q

4 errors of refraction

A

myopia
hyperopia
presbyopia
astigmatism

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5
Q

myopia

A

nearsightness; eyeball too long that focal point is infront of retina
when object is closer, image can focus on retina but ciliary muscle can’t extend back anymore for farther objects

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6
Q

hyperopia

A

farsightedness; eyeball too short so focal point is behind retina
accommodation is maxed out so lens can’t focus on close objects

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7
Q

presbyopia

A

age-related farsightedness; lens cant change shape for near objects

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8
Q

correction for presbyopia

A

reading glasses or bifocals

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9
Q

astigmatism

A

non-spherical cornea
astigmatic refractive error in cornea so accommodation can’t correct it

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10
Q

correction for astigmatism

A

lenses or refractory surgery

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11
Q

two types of glaucoma

A

primary open-angle & acute angle closure
both involve damage to optic nerve from increased IOP

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12
Q

primary open-angle vs acute angle closure glaucom

A

primary open-angle: chronic, slow progressive & bilateral; no pain; no sx till visual fields are affected
angle-closure: unilateral & sudden onset of severe pain; dilating pupil worsens it; EMERGENCY

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13
Q

which type of glaucoma is worsened when dilated? (via dim lights, cycloplegics, anticholinergics)

A

acute-angle glaucoma

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14
Q

signature visual deficit of glaucoma

A

Halos around light & tunnel vision
NO marcus-gunn

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15
Q

sx of angle-closure glaucoma

A

sudden onset of severe unilateral pain, nausea, vomiting, HA
PE– hazy/steamy cornea, MID-DILATED FIXED pupil, erythema
Eyes feel HARD when palpated

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16
Q

what would a fundoscopic exam reveal with glaucoma?

A

blurred optic disc/cupping of optic nerve

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17
Q

how is angle-closure glaucoma diagnosed? (two ways)

A

tonometry for increased IOP
Gonioscopy to observe narrow chamber

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18
Q

name 4 eyelid inflammation d/o

A

hordeolum/chalazion
blepharitis
ectropion/entropion
dacrystenosis/dacryocystitis

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19
Q

when do you refer a hordeolum/chalazion

A

if sx still there after one month

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20
Q

how do you treat blepharitis

A

scrub w/ baby shampoo
AT & warm compress

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21
Q

how do you treat ectropion & entropions

A

lubricating eye drops & moisture shields
surgery if needed

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22
Q

how do you treat dacryostenosis/dacryocystitis?

A

if its a child– NLD massage
antibiotics (clindamycin, vancomycin + ceftriaxone)
warm compress

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23
Q

when should you refer dacryostenosis

A

if recurrent or not improving

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24
Q

name 6 conjunctival d/o

A

viral conjunctivitis
bacterial conjunctivitis
allergic conjunctivitis
dry eye syndrome
pterygium/pinguecula
subconjunctival hemorrhage

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25
two most common causes of viral conjunctivitis
adenovirus & enterovirus
26
what sx makes viral diff from other forms of conjunctivitis
tender enlarged preauricular lymphadenopathy typically starts in one eye and moves to other
27
tx for viral conjunctivitis
ATs, COOL compress ok
28
which conjunctivitis requires immediate referral?
bacterial conjunctivitis
29
how is bacterial conjunctivitis diagnosed?
fluorescein staining to look for keratitis or corneal abrasions culture the discharge
30
sx of bacterial conjunctivitis
painless mucopurulent discharge that can crust over
31
how is bacterial conjunctivitis tx? what if person wears contacts?
topical abx-- erythromycin ointment, fluoroquinolones contact wears-- cover pseudomonas w/ ciprofloxacin or topical aminoglycosides
32
which conjunctival condition is seen in post-menopausal women, systemic conditions like Sjorgen's pts w/ blepharitis?
dry eyes syndrome
33
pterygium vs pinguecula
both dysplastic bulbar conjunctiva & sudden eye pain pterygium is when it spreads onto the cornea & could affect vision
34
how are pterygium & pinguecula treated
AT for comfort surgical excision if visually significant pterygium
35
what causes subconjunctival hemorrhages?
benign-- sneezing, blowing nose, eye rubbing
36
which conjunctival d/o is associated with antiplatelets & anticoagulation
subconjunctival hemorrhages
37
sx of subconjunctival hemorrhage
Mild FB sensation & NO vision changes
38
what two things should you evaluate for with subconjunctival hemorrhages?
blood dycrasias HTN if recurrent
39
how are corneal abrasions and FB diagnosed?
pain improves with proparacaine fluorescein reveals linear abrasions of epithelial stains/ice-rink
40
common sx of corneal abrasions & FB
tearing, red painful eye photophobia hard to open eye (blepharospasms)
41
how are corneal abrasions & FB managed?
antibiotic drops erythrmycin ointment, contacts----ciprofloxacin or topical aminoglycosides patch if abrasion is large
42
when should you NOT patch for corneal abrasion or FB?
if pseudomonas aeruginosa is suspected
43
what is the biggest risk factor for corneal ulcers? what are the other 2?
1. wearing contacts! 2. dry ocular surfaces 3. topical corticosteroid use and immunosuppressants
44
what is a corneal ulcer?
serious corneal infection causing white corneal infiltrate can be sight-threatening related to hx of FB or trauma
45
Dx of corneal ulcer
fluorescein stains the white corneal infiltrate scrape & culture it
46
sx of corneal ulcers
pain, photophobia, redness, vision changes difficulty keeping eye open PE-- limbal flush, hazy cornea; hypopyon if severe
47
how are corneal ulcers managed?
intensive eye drops--- moxifloxacin same day referral! don't patch the eye
48
symptoms of herpes simplex/herpetic keratitis
pain, photophobia, redness, blurred vision PE-- ciliary flush, hazy cornea, PREAURICULAR node swollen
49
how is herpetic keratitis treated?
give topical or oral acyclovir refer in 1-2 days
50
hallmark of herpes keratitis used to make diagnosis
dendritic/branching corneal ulceration w/ fluorescein staining
51
symptoms of herpes zoster
hutchingson's sign-- midline painful vesicular rash
52
how is herpes zoster treated
oral acyclovir or valacyclovir (rarely IV) refer for eye movement evaluation
53
what is anterior uveitis/iritis
inflammation of the iris or ciliary body
54
how does anterior uveitis react to proparacaine eye drops
NO improvement!!
55
what two collagen vascular dz is associated w/ anterior uveitis AND Scleritis
RA lupus HLA-IBS, sarcoidosis
56
signs of anterior uveitis
Unilateral severe ocular pain & photophobia redness, blurred or decreased vision PE-- perilimbal flush, consensual photophobia, miosis
57
how is anterior uveitis diagnosed?
AC cells & flare on slit lamp-- haziness d/t proteins in aqueous humor
58
how is anterior uveitis treated?
topical glucocorticoids (steroids) cycloplegics same day referral
59
what is scleritis & episcleritis
autoimmune inflammation of sclera or episclera vision threatening
60
which is associated w/ systemic connective tissue dz like RA and lupus-- scleritis or episcleritis?
scleritis!
61
how is cotten tip test used to distinguish between scleritis and episcleritis?
with episcleritis, the vessels will move!
62
is scleritis/episcleritis vision threatening?
kind of-- refer in 1-2 days
63
sx of scleritis vs episcleritis
EPIscleritis--- focal tenderness, redness, swelling, mild pain scleritis-- deep aching pain, redness; +/- scleral thinning
64
treatment of scleritis vs episcleritis
scleritis-- systemic immunosuppressants episcleritis-- oral or topical NSAIDs
65
what is hyphema
visible blood in anterior chamber of eye
66
what is the most common cause of hyphema?
blunt trauma also related to sickle cell
67
how is hyphema diagnosed?
first wanna r/o life or vision threatening injuries can do CT w/o contrast if globe rupture is suspected
68
how is hyphema treated?
eye shield, bed rest, dim lighting elevate head at least 30 degrees tetracaine for pain
69
what is hypopyon
WBC in anterior chamber; this is a type of anterior uveitis
70
two common causes of hypopyon
HLA-B27 associated uveitis is most common infectious keratitis or endophthalmitis
71
how is hypopyon diagnosed?
anterior chamber or vitreous tap for PCR and culture
72
how is hypopyon managed?
same day referral tx underlying cause
73
chemical keratitis
alkali/basic is more damaging red eyes is preferred if theres white around cornea---stem cell deficiency
74
endogenous vs exogenous endophalmitis
infection in eye d/t endogenous-- infection from other body area exogenous-- entry wound after trauma or surgery
75
how is endophalmitis treated?
aspiration of ocular fluid for culture antibiotic injections
76
preseptal vs orbital cellulitis
orbital-- fat & ocular muscles infected POSTERIOR to orbital septum preseptal-- eyelid & periocular tissue infected ANTERIOR to orbital septum
77
which cellulitis often starts as skin infection, trauma or sinus infection?
preseptal
78
which cellulitis could start as preseptal or sinusitis?
orbital
79
diagnosis to differentiate between preseptal and orbital cellulitis?
CT contrast
80
how do symptoms of preseptal and orbital cellulitis differ?
preseptal-- NORMAL motility, pupils, VA orbital-- IMPAIRED motility, vision; proptosis, chemosis, RAPD both: lid edema and erythema
81
which cellulitis should be referred for emergency consultation
orbital cellulitis
82
which cellulitis can be drained?
ocular
83
what are complications of orbital cellulitis?
optic nerve damage, meningitis cavernous sinus thrombosis

OPHTHO (6 decks)

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