Flashcards in Lecture V Deck (70):
Flashes and floaters = ?
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
True or false: if there is decreased vision with an injected eye, you should always refer
What should be done with preseptal cellulitis?
-X-ray if h/o trauma
What is the treatment for preseptal cellulitis?
Warm compresses and systemic abx
What is the treatment for orbital cellulitis?
Hospitalization and abx
What are the usual etiologies of orbital cellulitis?
Extensions of bacterial sinusitis
What are the s/sx of orbital cellulitis?
-Optic nerve involvement
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
What are the fundoscopic exam findings of orbital cellulitis?
What are the bacteria that usually cause orbital cellulitis? (3)
What is the treatment for fungal orbital cellulitis?
What is the indication for surgical intervention for orbital cellulitis?
If unresponsive to 24 hr abx
What are the complications of orbital cellulitis? (3)
-Cavernous sinus thrombosis
What are the s/sx of Herpes zoster orbital cellulitis?
Does HZO cross midline?
What are the ocular complications of HZO? (4)
What is the indication for referral for HZO?
If eye s/sx occur
What are the complications of HZO?
What is the leading cause of infectious blindness in the US?
What may be seen in the cornea with HZO? What can this lead to?
What is the treatment for HZO?
Acyclovir or valacyclovir
What is the prognosis of congenital NLDO?
80% resolve after 8 months (most within a few days)
What are the manifestations of congenital NLD obstructions?
-tearing and mattering
What is Dacryocystitis?
an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac
What is the treatment for congenital NLD obstruction? (drugs, home care, surgical)
-Massage tear sac daily
-Probing and irrigation
What are the causes of acquired NLO? What are these essentially like?
-2/2 polyp, or tumor
What is the treatment for acquired NLO? (2)
-surgery after medically treated
What is blepharitis? What usually causes it? (2)
Chronic inflammation of the lid margin
-Staph or seborrheic combination
What are the s/sx of blepharitis? (3)
What is the treatment for blepharitis?
-Warm, moist compresses
-abx sol QID (at night)
gtt/ ou BID?
ONe drop, both eyes, BID
What is ocular surface disease? What are the two types?
"dry eye syndrome"
-Aqueous tear deficiency OR evaporative compromised lipid layer
What are the three layers of tear film that sit on top of the cornea, in order from superficial to deep?
What are the s/sx of aqueous tears deficiency?
What is the most common manifestation of CT disease?
Aqueous tears deficiency
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.
What are the causes of aqueous tear deficiency states?
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
What is the constellation of Sjogren's syndrome?
+/- CT disorders
What is the treatment for ocular surface diseases?
-Lubricating ointment at night
What is the abx that can be used to lower the melting point of the oils in the tears?
What drug class is notorious for causing dry eyes?
What is the treatment for styes/hordeolum? (2)
-Warm compresses and abx drop
-Incision with curettage if no response
What are styes/hordeolum?
Acute inflammation of glands of the eyelid (Zeis or moll glands)
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,
What are ectropions? Treatment?
Eyelid turns outward
What are the s/sx of ectropions?
burning, tearing mattering, keratitis
What is the treatment for ectropions?
abx and may surgery
What the s/sx of entropions?
-Tearing, mattering, abrasion
What is the treatment for entropion?
Abx and surgery
What is the treatment for styes/chalazions?
Incision with curettage if no response to medical therapy
What are the viruses that usually cause conjunctivitis?
Stringy. white mucus d/c = ?
Purulent d/c = ?
Clear d/c = ?
Preauricular LAD with conjunctivitis usually signals what type of infx?
Raccoon eyes = ?
What are the s/sx of allergic conjunctivitis?
Bilateral itchiness with hyperemia and lid edema
How effective are avoidance of allergens?
What are the drugs that can be used to treat allergic conjunctivitis?
Why are ocular decongestants stupid?
What is the MOA of crolom?
Mast cell stabilizer
What is the MOA of alamast?
Mast cell stabilizer
What are the most efficacious drugs for allergic conjunctivitis? Why are these not used more often?
May develop a steroid induced glaucoma
What are the systemic therapies for allergic conjunctivitis? How effective are these? Why?
-Ineffective against ocular symptoms, and dry the eyes out
What is the hallmark of macular degeneration?
What is the major indication for cataract surgery?
Affecting patient's ADL
What is keratitis?
Corneal inflammation, leading to a erythema, gritty feeling, and photophobia