Lecture V Flashcards by tcarlso 3

Flashes and floaters = ?

Retinal detachment

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What are the 9 diagnostic steps of the red eye?

Visual Acuity
Pattern of injection
Conjunctival d/c
Corneal Opacification
Corneal epithelial defects
A/C depth
Pupil irregularities
IOP, EOM limitations
Proptosis

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

True

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What should be done with preseptal cellulitis?

X-ray if h/o trauma

- Systemic abx

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What is the treatment for preseptal cellulitis?

Warm compresses and systemic abx

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What is the treatment for orbital cellulitis?

Hospitalization and abx

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What are the usual etiologies of orbital cellulitis?

Extensions of bacterial sinusitis

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What are the s/sx of orbital cellulitis?

External erythema/edema
Impaired motility
Proptosis
Optic nerve involvement

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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

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What are the fundoscopic exam findings of orbital cellulitis?

Disc edema

Decreased vision

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

Staph
Strep
M. Catarrhalis

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What is the treatment for fungal orbital cellulitis?

Surgical debridement

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What is the indication for surgical intervention for orbital cellulitis?

If unresponsive to 24 hr abx

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What are the complications of orbital cellulitis? (3)

Cavernous sinus thrombosis
Meningitis
Brain abscesses

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

intense pain/discomfort
Itching
Photophobia
Vesicles

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Does HZO cross midline?

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What are the ocular complications of HZO? (4)

Conjunctivitis
Keratitis
Uveitis
Glaucoma

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What is the indication for referral for HZO?

If eye s/sx occur

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What are the complications of HZO?

optic neuritis

- EOM dysfunction

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

HZO

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

Neovascularization

Blindness

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What is the treatment for HZO?

Acyclovir or valacyclovir

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What is the prognosis of congenital NLDO?

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

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What are the manifestations of congenital NLD obstructions?

Amniotocele, mucocele
Dacryocystitis
tearing and mattering

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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)

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

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

- 2/2 polyp, or tumor | - Essentially dacryocystitis

What is the treatment for acquired NLO? (2)

- systemic abx | - 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)

FB sensation Burning Mattering

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?

- Lipid layer - Aqueous layer - Mucin layer

What are the s/sx of aqueous tears deficiency?

- Burning - FB sensation - Photophobia - Tearing

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?

- aging - RA - Systemic medications

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?

-Dry eye -Dry mouth +/- CT disorders

What is the treatment for ocular surface diseases?

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

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

Doxycycline

What drug class is notorious for causing dry eyes?

Diuretics

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 Surgery

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?

- FB sensation | - Tearing, mattering, abrasion

What is the treatment for entropion?

Abx and surgery

What is the treatment for styes/chalazions?

Warm compresses | Incision with curettage if no response to medical therapy

What are the viruses that usually cause conjunctivitis?

- Adenovirus - HSV - Zoster

Stringy. white mucus d/c = ?

Allergy

Purulent d/c = ?

Bacteria

Clear d/c = ?

Viruses/chemicals

Preauricular LAD with conjunctivitis usually signals what type of infx?

Viral

Raccoon eyes = ?

Allergies

What are the s/sx of allergic conjunctivitis?

Bilateral itchiness with hyperemia and lid edema

How effective are avoidance of allergens?

Not very

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

- Antihistamines - Decongestant - Tear substitutes

Why are ocular decongestants stupid?

Rebound vasodilation

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?

Steroids May develop a steroid induced glaucoma

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

- Oral antihistamines | - Ineffective against ocular symptoms, and dry the eyes out

What is the hallmark of macular degeneration?

Macular drusen

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

Cobblestoning beneath the lids = ?

Allergic conjunctivitis

Lecture V Flashcards

(70 cards)