Lecture V Flashcards Preview

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Flashcards in Lecture V Deck (70):
1

Flashes and floaters = ?

Retinal detachment

2

What are the 9 diagnostic steps of the red eye?

1. Visual Acuity
2. Pattern of injection
3. Conjunctival d/c
4. Corneal Opacification
5. Corneal epithelial defects
6. A/C depth
7. Pupil irregularities
8. IOP, EOM limitations
9. Proptosis

3

True or false: if there is decreased vision with an injected eye, you should always refer

True

4

What should be done with preseptal cellulitis?

-X-ray if h/o trauma
-Systemic abx

5

What is the treatment for preseptal cellulitis?

Warm compresses and systemic abx

6

What is the treatment for orbital cellulitis?

Hospitalization and abx

7

What are the usual etiologies of orbital cellulitis?

Extensions of bacterial sinusitis

8

What are the s/sx of orbital cellulitis?

-External erythema/edema
-Impaired motility
-Proptosis
-Optic nerve involvement

9

What is the major difference between preseptal and orbital cellulitis?

Orbital cellulitis has actual inflammation of the orbit, leading to EOM restriction

Also, Optic nerve involvement may appear with orbital cellulitis

10

What are the fundoscopic exam findings of orbital cellulitis?

Disc edema
Decreased vision

11

What are the bacteria that usually cause orbital cellulitis? (3)

Staph
Strep
M. Catarrhalis

12

What is the treatment for fungal orbital cellulitis?

Surgical debridement

13

What is the indication for surgical intervention for orbital cellulitis?

If unresponsive to 24 hr abx

14

What are the complications of orbital cellulitis? (3)

-Cavernous sinus thrombosis
-Meningitis
-Brain abscesses

15

What are the s/sx of Herpes zoster orbital cellulitis?

-intense pain/discomfort
-Itching
-Photophobia
-Vesicles

16

Does HZO cross midline?

No

17

What are the ocular complications of HZO? (4)

-Conjunctivitis
-Keratitis
-Uveitis
-Glaucoma

18

What is the indication for referral for HZO?

If eye s/sx occur

19

What are the complications of HZO?

-optic neuritis
-EOM dysfunction

20

What is the leading cause of infectious blindness in the US?

HZO

21

What may be seen in the cornea with HZO? What can this lead to?

Neovascularization
Blindness

22

What is the treatment for HZO?

Acyclovir or valacyclovir

23

What is the prognosis of congenital NLDO?

80% resolve after 8 months (most within a few days)

24

What are the manifestations of congenital NLD obstructions?

-Amniotocele, mucocele
-Dacryocystitis
-tearing and mattering

25

What is Dacryocystitis?

an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac

26

What is the treatment for congenital NLD obstruction? (drugs, home care, surgical)

-Topical/systemic abx
-Massage tear sac daily
-Probing and irrigation

27

What are the causes of acquired NLO? What are these essentially like?

-2/2 polyp, or tumor
-Essentially dacryocystitis

28

What is the treatment for acquired NLO? (2)

-systemic abx
-surgery after medically treated

29

What is blepharitis? What usually causes it? (2)

Chronic inflammation of the lid margin

-Staph or seborrheic combination

30

What are the s/sx of blepharitis? (3)

FB sensation
Burning
Mattering

31

What is the treatment for blepharitis?

-Warm, moist compresses
-abx sol QID (at night)

32

gtt/ ou BID?

ONe drop, both eyes, BID

33

What is ocular surface disease? What are the two types?

"dry eye syndrome"
-Aqueous tear deficiency OR evaporative compromised lipid layer

34

What are the three layers of tear film that sit on top of the cornea, in order from superficial to deep?

-Lipid layer
-Aqueous layer
-Mucin layer

35

What are the s/sx of aqueous tears deficiency?

-Burning
-FB sensation
-Photophobia
-Tearing

36

What is the most common manifestation of CT disease?

Aqueous tears deficiency

37

What is the pathophysiology behind excessive tearing?

Due to the poor quality of tears, a small area drys out, and sends signals to produce more tears.

38

What are the causes of aqueous tear deficiency states?

-aging
-RA
-Systemic medications

39

Why are women more commonly affected with aqueous tear deficiency?

The tearing reflex is a testosterone regulated system--thus menopause causes an increase in the incidence of dry eyes

40

What is the constellation of Sjogren's syndrome?

-Dry eye
-Dry mouth
+/- CT disorders

41

What is the treatment for ocular surface diseases?

-Artificial tears
-Lubricating ointment at night
-Lid hygiene
-Topical anti-inflammatory

42

What is the abx that can be used to lower the melting point of the oils in the tears?

Doxycycline

43

What drug class is notorious for causing dry eyes?

Diuretics

44

What is the treatment for styes/hordeolum? (2)

-Warm compresses and abx drop
-Incision with curettage if no response

45

What are styes/hordeolum?

Acute inflammation of glands of the eyelid (Zeis or moll glands)

46

What are chalazions? Are they painful? What gland are they derived from?

a generally painless cyst in the eyelid that is caused by inflammation of a blocked meibomian gland,

47

What are ectropions? Treatment?

Eyelid turns outward

Surgery

48

What are the s/sx of ectropions?

burning, tearing mattering, keratitis

49

What is the treatment for ectropions?

abx and may surgery

50

What the s/sx of entropions?

-FB sensation
-Tearing, mattering, abrasion

51

What is the treatment for entropion?

Abx and surgery

52

What is the treatment for styes/chalazions?

Warm compresses
Incision with curettage if no response to medical therapy

53

What are the viruses that usually cause conjunctivitis?

-Adenovirus
-HSV
-Zoster

54

Stringy. white mucus d/c = ?

Allergy

55

Purulent d/c = ?

Bacteria

56

Clear d/c = ?

Viruses/chemicals

57

Preauricular LAD with conjunctivitis usually signals what type of infx?

Viral

58

Raccoon eyes = ?

Allergies

59

What are the s/sx of allergic conjunctivitis?

Bilateral itchiness with hyperemia and lid edema

60

How effective are avoidance of allergens?

Not very

61

What are the drugs that can be used to treat allergic conjunctivitis?

-Antihistamines
-Decongestant
-Tear substitutes

62

Why are ocular decongestants stupid?

Rebound vasodilation

63

What is the MOA of crolom?

Mast cell stabilizer

64

What is the MOA of alamast?

Mast cell stabilizer

65

What are the most efficacious drugs for allergic conjunctivitis? Why are these not used more often?

Steroids

May develop a steroid induced glaucoma

66

What are the systemic therapies for allergic conjunctivitis? How effective are these? Why?

-Oral antihistamines

-Ineffective against ocular symptoms, and dry the eyes out

67

What is the hallmark of macular degeneration?

Macular drusen

68

What is the major indication for cataract surgery?

Affecting patient's ADL

69

What is keratitis?

Corneal inflammation, leading to a erythema, gritty feeling, and photophobia

70

Cobblestoning beneath the lids = ?

Allergic conjunctivitis