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Ocular infections and inflammation Flashcards

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1
Q

What is preseptal (periorbital) cellulitis, and what is the general treatment?

A
  • Infection of the eyelid and periocular tissues that is anterior to the orbital septum
  • PO abx and f/u
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2
Q

What is the treatment for postseptal (orbital) cellulitis?

A

Admit with IV abx and consult

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3
Q

What is endophthalmitis?

A

Infection of the globe

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4
Q

What is the only test that definitively distinguishes between periorbital and orbital cellulitis?

A

head CT

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5
Q

What is the ddx for preseptal and postseptal cellulitis? (8)

A
  • Preseptal/postseptalcellulitis
  • Subperiosteal/orbital
  • Cavernous sinus thrombosis
  • Dacryoadenitis/Dacryocystitis
  • Hordoleum
  • Bacterial/viral conjunctivitis
  • Contact dermatitis
  • Herpes zoster/Herpes simplex
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6
Q

What sort of infection is preseptal cellulitis usually associated with?

A

URI

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7
Q

What is epiphora?

A

Excessive tearing

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8
Q

What is the most common precipitating illness leading to postseptal cellulitis?

A

Sinusitis

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9
Q

What are the s/sx that are present in orbital cellulitis, that are not usually found with preseptal cellulitis?

A
  • Pain on EOMs
  • Decreased visual acuity
  • Chemosis
  • Proptosis
  • Abnormal pupillary response
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10
Q

Orbital cellulitis + CN palsy = ?

A

Cavernous sinus thrombosis

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11
Q

What is the treatment for emergently increased IOP in a patient with orbital cellulitis?

A

Lateral canthotomy

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12
Q

What is a stye (external hordeolum)? What does it look like?

A
  • Acute bacterial infection of the sebaceous glands along the eyelid
  • Appears as a pustule along the eyelid margi
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13
Q

What is an internal hordeolum?

A

Acute bacterial infection of the meibomian gland

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14
Q

What is the difference between a style (external hordeolum) and an internal hordeolum?

A

Internal occurs on the inner surface of the tarsal plate

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15
Q

What are the s/sx of a hordeolum?

A

pain
Edema
Erythema

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16
Q

What is the treatment for a hordeolum?

A

Erythromycin abx and warm compresses for 7-10 days.

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17
Q

What is a chalazion?

A

Acute/chronic inflammation of a Zeis oil gland in the tarsal plate

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18
Q

What is blepharitis?

A

Inflammation of the eyelash follicles along the edge of the eyelash 2/2 bacterial infx

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19
Q

What are the s/sx of blepharitis? When are symptoms usually their worst?

A

Burning sensation
photophobia
Blurred vision
Conjunctival injection

Worst in the mornings

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20
Q

What is the treatment for blepharitis?

A

Daily cleansing of eyelash edges

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21
Q

What are the two major diagnoses that need to be distinguished from viral conjunctivitis?

A

Herpes

serious bacterial infx

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22
Q

What is keratoconjunctivitis?

A

Conjunctivitis that includes corneal involvement

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23
Q

What is chemosis?

Study These Flashcards
A

Edema of the conjunctiva

24
Q

What is the abx of choice for treating conjunctivitis in contact lens wearers?

Study These Flashcards
A

Fluoroquinolone

25
What is epidemic keratoconjunctivitis?
Severe adenovirus that usually causes epidemics. More severe s/sx, with associated URI s/sx
26
Viral conjunctivitis is usually preceded by what sort of infection?
URI
27
True or false: follicles in the inferior fornix are common in viral conjunctivitis
True
28
What will fluorescein staining reveal with epidemic keratoconjunctivitis?
Punctate staining
29
What is the treatment for viral conjunctivitis?
Symptomatic, with nasal decongestants and warm compresses
30
How long can viral conjunctivitis last for?
1-3 weeks
31
When should you consult an ophthalmologist regarding the use of ocular steroids?
Always
32
Does herpetic conjunctivitis tend to be unilateral or bilateral?
Unilateral
33
Which cause of conjunctivitis usually has palpable LAD?
herpetic
34
What is the general treatment for herpes conjunctivitis?
Oral antivirals and topical antivirals
35
What is herpes zoster ophthalmicus?
Shingles affecting the V1 (rarely V2, V3) distribution, and eventually the eye
36
What is the treatment for herpes zoster ophthalmicus?
Admission and IV antivirals
37
What causes a corneal ulcer?
breaks in the epithelial barrier allows infection of the underlying corneal stroma
38
What is dacryocystitis?
Infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of the lacrimal sac
39
What are the common causes of a corneal ulcer? (4)
Contact lenses Trauma/surgery Herpes Bells palsy
40
What are the s/sx of uveitis?
- Irregular pupil - Scleral injection - Blurred vision - HA - Floaters
41
What is synechia?
When iris adheres to the cornea, usually from trauma, iritis, or inflammation.
42
What condition can synechia lead to?
Closed angle gluacoma
43
What is the treatment for synechia?
Mydriatics/cycloplegic agents, to keep synechia from forming
44
Why should you never patch an eye to treat a corneal ulcer?
Increases risk of Pseudomonas infection, which can cause rapid, aggressive ulceration with corneal melting and perforation
45
What is the presentation of ultraviolet keratitis?
Slow onset of FB sensation and photophobia after UV exposure, progressing to severe pain
46
What will slit lamp exam show with UV keratitis? Wood's lamp?
Diffuse punctate corneal edema and corneal abrasions
47
What is the treatment and prognosis of UV keratitis?
- Pain control with topical cycloplegics/oral analgesic | - Healing occurs in 24-36 hours
48
What causes the photophobia with uveitis?
Ciliary muscle spasm irritates CN V
49
What can be seen on slit lamp exam with uveitis?
Flare and cells
50
True or false: discharge is common with uveitis?
False
51
What is the classic PE finding of iritis?
Consensual photophobia
52
What is the most common cause of endophthalmitis?
Trauma or surgery to the globe
53
What are the symptoms of endophthalmitis?
- HA - Eye pain - Photophobia - Vision loss
54
What are the signs of endophthalmitis?
- Erythema and edema of lids - Conjunctival and scleral injection - Chemosis - Hypopyon
55
What is the treatment for endophthalmitis?
- Call ophtho - Intravitreal abx and steroids - Admit
56
What is the most common cause of vitreous hemorrhage?
Diabetic retinopathy
57
What are the symptoms of vitreous detachment/hemorrhage?
Sudden painless vision loss and sudden appearance of cobwebs or black spots

Eye Emergencies (5 decks)

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