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Flashcards in Ophthalmology Deck (107):
1

Vesicular rash involving the tip of the nose or eyelid margins

Hutchinson's sign. Herpes zoster opthalmicus

2

TX for herpes zoster

high dose acyclovir w within 72 hours afte eruption fo the rash

3

inward turn of the eyelid

entropion

4

Tx for entropion

surgery if the lashes rub on the cornea

5

outward turning of the lower lid

Ectropion

6

Tx for ectropion

Surgery if ectropion causes excessive tearing, exposure keratitis or a cosmetic problem

7

chronic bilateral inflammation of the lid margins. Presents with irritation, burning, itching, scales on the lashes

anterior blepharitits

8

Tx for anterior blepharitits

remove scales w/ damp cotton applicator and baby shampoo, antistaph abx eye ointment

9

Inflammation of the eyelids secondary to dysfunction of the meibomian glands

posterior blepharitis

10

Tx for posterior blepharitits

low dose systemic abx, short term topical steroids

11

what does posterior blepharitits have a strong association w/?

acne rosacea

12

infection of the lacrimal sac due to obstruction fo the nasolacrimal system, usually unilaterla. Often in infants or people over 40

dacryocystitits

13

What causes acute dacryocystitis?

staph auerua and beta hemolytic strep

14

tx for dacryocystitits

adult- dacryocystorhinosotmy
baloon dilation or probe in peds
can add systemic abx

15

painful, localized red, swollen, acutely tender area on the upper or lower lid

hordeolum (internal- meiboian gland external- stye)

16

Tx for hordeolum

warm compresses, abx ointment,

17

chronic ganulomatous inflammation of a meibomian gland

chalazion

18

nontender, hard swelling on the upper or lower lid of the eye

chalazion

19

tx of chalazion

warm compresses, oral tetracycline, incision and curettage, +/- intranasal steroids

20

Tx for bacterial conjunctivitis

polymyxin B/ trimethoprim TID abx

21

why is gonococcal conjunctivitis considered an opthalmologic emergency

possible for corneal perforation

22

Tx for gonococcal conjunctivitis

topical abx (erythromycin or sulfa)

23

tx for gonococcal conjunctivitis if cornea is perforated

5 day course of parenteral ceftriaxone

24

recurrent b/l follicular jonjunctivitis, epithelial keratitis and corneal vascularization

chlamydial deratoconjunctivitis

25

tx for chlamydial keratoconjunctivitis

oral tetracycline or erythromycin for 3-5 weeks

26

what typically causes viral conjunctivitis

adenovirus

27

red palpebral conjunctiva with copious watery discharge and scanty exudate

viral conjunctivitis

28

what is an associated symptoms w/ viral conjunctivitis

pharyngitits, fever, malaise, preauricular adenopathy

29

tx for viral conjunctivitis

warm compress TID

30

dry, red and scratchy eyes associated w/ aging, systemic drugs, hereditary disorder, systemic diseases

keratoconjunctivitis sicca

31

diagnosis of keratoconjunctivitis sicca

+ schirmer's test (filter paper)

32

patient will have edema of the conjuntiva, cobblestone papillae, and have itching, tearing, redness

allergic conjunctivitis

33

Tx for allergic conjunctivitis

antihistamine or mast cell stabilizer drops

34

painful red eye with photophobia,
tearing, circumcorneal injection, +/‐ discharge

kreatitis/ corneal ulcer

35

• S/Sx : cornea is hazy usually with a central ulcer,
+/‐ hypopyon
• Usually aggressive and often due to prolonged
contact wearing or corneal trauma

bacterial keratitis

36

etiology of bacterial keratitis

pseudomonas, strep, staph, moraxella

37

Tx for Gram + bacterial keratitis

ceaphlosporin drops

38

tx for gram - bacterial keratitis

fluoroquinolone or aminoglycoside drops

39

branching ulcer of the eye seen with fluorescent examination

herpes simplex keratitis

40

Tx for herpes simplex keratitis

ganciclovir opthalamic gell 0.15% 5 times daily
oral acyclovir 400 mg 5 times daily x 10 days

41

Abrupt onset of fever, proptosis, restriction of
extraocular movements, swelling and redness
of the lids

orbital cellulitis

42

Tx for orbital cllulitis

IV abx

43

what causes orbital cellulitits

infection of the paranasal sinuses

44

Bilateral lens opacities causing blurred vision &
gradual visual loss without pain or redness

cataract

45

Risk factors for cataracts

smoking, corticosteroid use

46

Severe pain and blurred vision, halos around lights, moderately dilated fixed pupil

acute (angle-closure) glaucoma

47

RF for acute angle closure glaucoma

elderly, farsightedness, asians , pupillary dilation

48

what medications cause pupillary dilation

atropine, imipramine, atrovent

49

what is normal eye pressure (measure with tonometry)

12-22 mmHg

50

Tx for acute angle closure glaucoma

IV acetazolamide, IV mannitol, beta blocker drops, pilocarpine (miotic aent), laser peripheral iridotomy

51

slow bilateral increase of intraocular pressure leading to peripheral vision loss

chronic open angle glaucoma

52

what will be seen on exam with open angle galucoma

pathologic cupping of the optic discs

53

Tx for open angle glaucoma

prostaglandin analogues (lantanoprost), Beta blocker drops (timolol), pilocarpine, laser trabeculoplasty

54

inflammation of the iris, ciliary body or choroid

uveitis

55

What conditiosn is uveitits associated with?

HLA-B27, ankylosing spondylitis, ulcerative colitis, Crohn's disease, psoriasis, Reiter's yndrome, herpes simplex/ zoster, syphilis

56

S/S of uveitits

acute onset unilateral pain, redness, photophobia, visual loss

57

findings with anterior uveitits (iritis) 4 findings

– Inflammatory cells and flare within the aqueous
– Hypopyon (layered collection of white cells)
– Small pupil & posterior synechiae (adhesions)
– Normal intraocular pressure

58

Tx for uveitits

topical steroids, analgesics, mydriatics

59

how does dilation of the pupil help with uveitits

relieves discomfort and helps prevent posterior synechiae

60

Fleshy, triangular encroachment of the
conjunctiva onto the nasal side of the cornea
• Usually associated with constant exposure to
wind, sun, sand, and dust

Pterygium

61

Tx for pterygium

excision if the growth treatens to interfere w/ vision loss

62

Yellow elevated nodule on either side of the
cornea (more commonly on the nasal side)

pingueculae

63

Tx for pingueculae

artificial tears or short courses of topicals NSAIDs

64

Sudden painless visual loss often upon waking
in the morning

central vein occlusion

65

Risk factors for central vein occlusion

glaucoma, HTN< DM< uveitits, increased lipids, thrombotic disease

66

PE findigns with central vein occlusion

disc swelling, venous dilation, retinal hemorrhages, cotton wool spots

67

Tx for central vein occlusion

treat macular edema with laser tx

68

sudden profound visual loss that has cherry red spots at the fovea, swelling of the retina, cotton wool spots

centray artery occlusion

69

Tx for central artery occlusion

lay patient falt, occular massage, high concentrations of O2, IV acetazolamide and anerior chamber paracentesis, thromboyysis

70

spontaneous or traumatic blurred vision without pain or redness often with flashing lights or new floaters

retinal detachment

71

What will you see on exam with retinal detachment

hanging retina in the vitreous, superior temporal area is most common

72

Tx for retinal detachment

surgery w/ cryotherapy or photocoagulation to the retina

73

“curtain passing vertically across the
visual field with complete monocular visual loss
lasting a few minutes

amaurosis fugax

74

Etiology of amaurosis fugax

retinal amboli from ipsilateral carotid disease

75

Dx for amaurosis fugax

carotid ultrasound or angiography

76

Tx for >70% stenosis of cartodi artery

carotid endarterectomy or stent

77

Tx for carotid stenosis <70%

aspiring (81 mg) or clopidogrel

78

leading cause of new blindness in ages 20-65

diabetic retinopathy

79

Diabetic retinopathy with dilated veins, microaneurysms, retinal hemorrhages, retinal edema dn hard exudates

nonproliferative

80

diabetic retinopathy with neovascularization

proliferative retinopathy

81

are these eye changes seen with chronic HTN or acute HTN?
arterioral narrowing
cotton wool spots
retinal hemorrhages
retinal edema
disc edema

acute HTN

82

what eye chagnes are seen with chronic HTN

silver wiring and copper wiring, AV nicking, flame hsaped hemorrhages, retinal exudates

83

sudden U/L loss of vision and pain with eye movements (vision returns in 2-3 weeks)

optic neuritis

84

what conditions are associated w/ optic neuritis

MS, viral infections (measles, mumps, varicella)

85

S/Symptoms of optic neuritics

Loss of color vision

86

What will be seen on exam with optic neuritits

flam shaped hemorrhages, optic nerve swellign (rare)

87

Tx for optic neuritits

IV steroids

88

optic disc swelling due to raised intracranial pressure, usually B/L

papilledema

89

Etiology of papilledema

idiopathic intracranial HTN (pseudotumor cerebri), tumors, inflammation, edema, encephalitits

90

S/symptoms of papilledema

enlargement of blind spot +/- loss of acuity

91

Tx for papilledema

acetazolamide, optic nerve sheath, fenestration or lumbopoperitoneal shunt

92

Leading cause of permanent visual loss in the
elderly due to atrophy of outer retina
• RF : whites, F>M, family Hx, smoking

macular degeneration

93

S/symptoms of macular degeneration

gradual progressive B/: visual loss.

94

What will be seen on exam with macular degeneration

retinal drusen (yellow deposits around macular region)

95

Tx for macular degeneration

Non, laser photocoagulation may delay the onset of permanent visual loss

96

• Scratch on cornea
• Foreign body sensation
• Exam : evert lid and
observe with
fluorescein dye

coreal abrasion

97

Tx for corneal abrasion

antibiotic drops or ointment

98

after eye foreign body removal what should be done?

polymyxin-bacitracin ophthalmic ointment, examine 24 hours later, rust ring may need removal by ophthalmologist

99

Does a subconjunctival hemorrhage affect vision? where does it stop?

doesn't affect vision, stops at limbus

100

Blood in anterior chamber, causes pain, photophobia, blurred vision

hyphema

101

• Orbital wall fracture due to trauma
• Forces rupture the medial wall and floor of
the globe
• Muscle and fat becomes trapped

blowout fracture

102

what will be seen on PE with blowout fracture

diploplia on upward gaze, enphthalmos

103

Tx for blowout fracture

surgery

104

will have complete ptosis, slightly depressed eye, dilated pupil

3rd nerve paralysis

105

what cuases 3rd nerve paralysis

trauma, DM, HTN

106

upward deviation of the eye causeing vertical diplopia

4th nerve paralysis (cause is trauma) (trochlear)

107

failure of abduction of affected eye cuasing horizontal diploplia

6th nerve paralysis (abducens)