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Flashcards in Ophthalmology Deck (43):
1

retinal detachment

spontaneous
high risk: post cataract- surgery
"curtain's comes down and stays down"
tx: refer all detachments
positions head, allows gravity to slow the progression
80% get better

2

amaurosis fugal

curtains comes and goes back up in a few minutes
TIA, hx or risk of artheroscleroris
emboli on carotid circulation
tx: endarterectomy

3

retinal artery occasion

emboli comes into retinal after and does not pass and get ischemia
most are embolic but can be thrombotic
*painless sudden loss of vision
signs: early--> distal to occlusion ( blood separation - box scarring)
cherry red spot- more ischemia
infraction
tx: true emergency
place pressure

4

retinal vein occlusion

older people with lots of plaque
wake up in am and vision blurry
exam: blood and thunder
neovascularization
tx: resolve on own
laser tx

5

optic neuritis

inflammation of nerves
happens in chronic disease ( MS, autoimmune, infection)
exam: loss of pupillary reaction to light, loss of color vision, pain with EOM

tx: may resolve on own 2-3 wks
steroids, IV

6

glaucoma

increase in IOP with optic n damage
RF: AA, DM, HTN, Fam hx, Hx eye tumors, retinal detach

7

what is the pathophys of glaucoma?

resistance to drainage of aqueous humor--> pressure on posterior chamber--> pressure on optic nerve

8

Open angle glaucoma

asymptomatic, rise in IOP
chamber is open
bowing of iris on exam
arcuate scotomata
central vision spread
tx: prostoglandin- promote drainage
beta blockers
carbonic any drate

tx: iridectomy

9

angle closure

OCULAR Emergency
sudden complete occlusion
pain, blurred vision
n/v
conjunctive injection,
fixed mid-dilated pupil

tx: beta blocker
carbonic andydrate
mannitol
laser iridectomy

10

how to do glaucoma screening

check anterior chamber angle-
optic nerve exam- cup/disc ration: > 0.5
IOP> 21 mmHG

11

cataracts

product of age
acquired- sun exposure. inflamm, DM
congenital

12

macular degneration

Drusen- colloid bodies, deposit in Bruch's membrane--> blocks nutrients in eyes
Dry AMD: only Drusen--> atrophy of retina, more common
Wet AMD--> neovascular, bleed a lot

sxs; blurry vision, central los of vision
sign: atrophy, loss of pigment, macular sccaring, bleeding
tx: laster photo
Lucentis is, Macugen
no cure
eye supplements

13

retinopathy

DM- T1DM- screen 3-5 years after dx
T2DM- screen right away
-3 types:
Background: simple ( microaneuryms)
pre-prolferat- cotton wool spots
proliferative- neovascu
HTNive: diffuse arteriolar narrowing, " copper wire" , " silver wire"

tx: rear, laser photocoag, tx underlying dz.

14

blepharitis

dandruff of eyelids
staph or strep
sx: irrigation, burning, FB sensation
signs: anterior blepharitis
tx: scrub daily, massage of sections, topical abs,
oral abx
oral abs- recurrent

15

dacryoscysitis

inflammation of lacrimal duct
sxs; pain, swelling,tearing
signs
tx: warm to cool compressed
oral abs
I and D
surgery- putting in tubes

16

hordeolum ( stye)

infection of sebaceous glands ( staph)
sxs: subacute onset, mild painful nodule or pustule on lid
signs: pointed, red, tender
tx: warm compress, topical ab ( fluroquino/ polymixin/ trimeth)
I and D

17

chalazion

occur post hordeolum
painless
signs: grayish discoloration
local conjunctive erythema
tx; warm compress
triamcinolone injections
cut it out

18

ectropion- lids turn outward
entropian- likes turn inward

causes: scarring of lid, related to age paralytic, mechanics
sx: irrigation, burning, FM sensation
tx: surgical correction

19

xanthelasma

idiopathic, hyper lip in DM
all cosmetic
excise

20

epithelial inclusion cyst

traumatic implantation of epidermis into dermis or plugged follicle
slow growing, white round firm
ddx: neoplasm
tx: excision

21

orbital cellulitis

more common in kids- 2nd to sinusitis
low grade fever, fatigue,
signs, red, sluggish pupillary reflex, cannot more their eyes
tx: abs, IV then po 2-3 weeks
need to do CT
am-sublac, cephalon,
monitor closely

22

viral conjunctivitis

adenovirus- most common
acute onset- red, watery d/c
peri-aurical adenopathy-tender
self-limited
cold-warm compressed

23

bacterial conjunctivitis

staph aureus, h. f.u. moraxella, pseudomonas ( contact)
- red, irritated, bila, mucopurulent exudate,
niseria- topical abs, systemic ( copious unlit)
tx: broad spectrum absx: fluoroquinolone, polymyxin, sulfa

24

chlamydial conjunctivitis

STI
scant mucopurulent d/c
non-tender periauricular adenoma, follicular response
tx; system tetra, topical abx

25

allergic conjunctivitis

seasonal
more edema
strongly mucoid d/c
tx: topical anti-histamin

26

Pinguecula

fleshy, yellow/brown conjunctival mass
-nasal side toward cornea
causes: chronic sun, trauma, dry/ windy conditions
- no sxs, no tx

27

pterygium

triangular wedge- shaped fleshy
grown on the cornea--> vision issues
tx; remove by surgery

28

dry eye

idiopathic, aging, contact wears, RA, scleroderma, meds

clinical; irrigation, dryness, redness, FB
dx: artificial tears, ointment
punctual plug
Restates

29

herpes simplex kerastis

ocular EMERGENCY
HSV 1>> HSV 2
very photophobic
exam: dendritic lesions
tx: REFER, topical anti-viral, No steroids

30

herpes zoster

HSV in the original nerve
clinical: pain, HA, photophobia, vesicular rash, lesions on tip of nose-- ( on cornea)
tx: refer, IV valtrex, topica stenosi
prevention: Zosetavax > 50 y/o

31

cordial ulcer

infection/ inflamma
h/o trauma, contact wearing
- exam: pain, phothophbia, dense cordial infiltrate
tx: REFER, scraping, Gram stain,
tx causative agent, avoid contact use

32

corneal abrasion

cut to cornea
photophobia, blepharospasm, search for FB
tx: topical anesthetic at first only
cycloplegia, systemic analgesic
abx ointment, pressure patch ( max 24 hours)
f/u daily until gone

33

FB

cornea- more dangerous
sxs: painful, tearing,
exam: evert lid, fluroscene,
tx: use forceps, needles,
lead/rust-
suspect laceration

34

subconunctival hemorrhage

after Valsalva
bening
resolves 2-3 weeks

35

orbital fx

trauma to a eye
trapped inferior rectus--> cannot look up

tx: CT scan, REFER
increase in IOP-->retinal detachment
no sneezing, blow your nose

36

hyphema

RBC in the anterior chambers
associated with trauma
call chile protection services
shaken baby syndrome
pain, blurry vision, neoplasm,
tx: refer

37

radiant energy burn

6-12 hours pain the eye, red, tearing, photophobic
tx: cycloplegia, abx ointment,
pressure patch, systemic analgesic
wear sunglasses

38

lid laceration/

keep pt sill, avoid pressure
REFER- call surgeon

39

chemical burns

water, water,
cycloplegic

40

colon blindness

x linked - males
red, green
ishihara plates

41

amblyopia

loss of visual acuity not correctable by glasses

- due to mechanical issue

42

strabismus

angle/ degrees of misalignment is equal in all directions of gaze
- more congenial / genetic

- incomitant- degrees of misalignment differs with direct of gaze - due to neurologic disorder or trauma

43

strabismus test

cover/ uncover test:
heterotropia- cover normal eye, affected will move in place
heterophoria- cover suspected eye, uncover and misalignment may become apparent
tx: amblyopia: patch good eye
strabismus: glasses,