Ophthalmology Flashcards
(107 cards)
1
Q
Vesicular rash involving the tip of the nose or eyelid margins
A
Hutchinson’s sign. Herpes zoster opthalmicus
2
Q
TX for herpes zoster
A
high dose acyclovir w within 72 hours afte eruption fo the rash
3
Q
inward turn of the eyelid
A
entropion
4
Q
Tx for entropion
A
surgery if the lashes rub on the cornea
5
Q
outward turning of the lower lid
A
Ectropion
6
Q
Tx for ectropion
A
Surgery if ectropion causes excessive tearing, exposure keratitis or a cosmetic problem
7
Q
chronic bilateral inflammation of the lid margins. Presents with irritation, burning, itching, scales on the lashes
A
anterior blepharitits
8
Q
Tx for anterior blepharitits
A
remove scales w/ damp cotton applicator and baby shampoo, antistaph abx eye ointment
9
Q
Inflammation of the eyelids secondary to dysfunction of the meibomian glands
A
posterior blepharitis
10
Q
Tx for posterior blepharitits
A
low dose systemic abx, short term topical steroids
11
Q
what does posterior blepharitits have a strong association w/?
A
acne rosacea
12
Q
infection of the lacrimal sac due to obstruction fo the nasolacrimal system, usually unilaterla. Often in infants or people over 40
A
dacryocystitits
13
Q
What causes acute dacryocystitis?
A
staph auerua and beta hemolytic strep
14
Q
tx for dacryocystitits
A
adult- dacryocystorhinosotmy
baloon dilation or probe in peds
can add systemic abx
15
Q
painful, localized red, swollen, acutely tender area on the upper or lower lid
A
hordeolum (internal- meiboian gland external- stye)
16
Q
Tx for hordeolum
A
warm compresses, abx ointment,
17
Q
chronic ganulomatous inflammation of a meibomian gland
A
chalazion
18
Q
nontender, hard swelling on the upper or lower lid of the eye
A
chalazion
19
Q
tx of chalazion
A
warm compresses, oral tetracycline, incision and curettage, +/- intranasal steroids
20
Q
Tx for bacterial conjunctivitis
A
polymyxin B/ trimethoprim TID abx
21
Q
why is gonococcal conjunctivitis considered an opthalmologic emergency
A
possible for corneal perforation
22
Q
Tx for gonococcal conjunctivitis
A
topical abx (erythromycin or sulfa)
23
Q
tx for gonococcal conjunctivitis if cornea is perforated
A
5 day course of parenteral ceftriaxone
24
Q
recurrent b/l follicular jonjunctivitis, epithelial keratitis and corneal vascularization
A
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
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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
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• 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)
