Ophthalmology in Primary Care Lecture Powerpoint Flashcards Preview

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Flashcards in Ophthalmology in Primary Care Lecture Powerpoint Deck (38):

Corneal abrasion

Patient presents with pain, tearing, and photophobia second to corneal epithelium trauma, clinically diagnosed with fluorscein dye stain, treat with topical antibiotics because increased risk of infection, use topical erythromycin , most of time does not require patching unless large abrasion


Upon removal of foreign body from the eye need referral to ophthalmology to remove..

....residual rust ring


Morgan lens

Contact lens that is connected to IV tube that irrigates the lid and the corneal surface to flush out eyes after chemical burn until pH returns to normal


Numbness in cheeks and upper lip suggests ___ fracture, numbness in eyebrow and forehead suggests ___ fracture

floor, roof


Chalazion (stye)

Blocked meibomian gland or eyelash hair follicle? that presents with a wel defined, subcunaeous nodule within the eyelid


A Chalazion (stye) is NOT a ____

infectious process, don't need antibiotics


Chalazion treatment (3)

-Warm compresses to eyelid
-doxy BID for its anti oil properties (like acne meds)
-intralesional injection of steroids


Dacryocystis treatment (4)

-oral antibiotics augmentin
-IV if severe
-warm compress
-referral for I&D


Preseptal cellulitis lacks these 4 things compared to orbital cellulitis

-no conjunctival redness
-no pain with eye movement
-no restriction of extraocular mobility
-Can treat outpatient instead of admit for IV antibiotics in hospital


Herpes zoster ophthalmicus affects what dermatome?

V1 (ophthalmic division of trigem)


Hutchinson's sign

A rash that involves the nose that predicts herpes zoster ophthalmicus and other diseases associated from this


Typical treatment for bacterial conjunctivitis (2)



"True" pink eye

Viral induced conjunctivitis, watery, droopy lid, pinkish coloration


Clinical sign: Inferior tarsal conjunctival follicles

Pale, dome shaped nodules tender upon palpation in the area around the eye indicative of viral conjunctivitis


Clinical sign: Upper tarsal conjunctival papillae

Small flattened nodules with a central vascular core see on the upper lid indicative of allergic conjunctivitis


3 topical mast cell stabilizers for allergic conjunctivitis



In patients with allergic conjunctivitis want to avoid ____ products because _____

"get the red out", rebound hyperemia when stopped


Contact lens overwear can cause 2 possible conditions

-non infectious overwear can cause vascularity to grow in the cornea
-infectious leads to corneal ulcer


Most common cause of bacterial corneal ulcer

Improper contact lens wear/care


Clinical sign: Dendritic branching staining pattern on flurescin staining of eye

Herpes simplex virus


Elderly patient with "red eye" with nausea and vomiting likely indicates...

....high intraocular pressure


Definitive reatment for acute angle closure glaucoma

Laser peripheral iridotomy


Clinical sign: Leukocoria

When a white pupillary reflex is noted rather than normal on a fundoscopic exam which can indicate malignant lethal tumor called retinoblastoma, assume tumor until proven otherwise


Possible causes of leukocoria (4)

-Coat's disease
-Congenital cataracts


Congenital nasolacrimal ductobstruction

Persistent tearing, crusting of eyelashes


Clinical sign: wet looking eyes, reflex of mucopurulent material from punctum when pressure is applied over lacrimal sac

Indicates congenital nasolacrimal duct obstruction, different from conjunctivitis in that conjunctiva is not injected


How do differentiate between congenital nasolacrimal duct obstruction with congenital glaucoma which also causes tearing?

Enlarged globe and corneal diameter >12mm is indicative of glaucoma


Congenital nasolacrimal duct obstruction treatment (3)

-digital massage 2-4x a day over duct
-moxifloxacin drops or erythromycin ointment
-physical opening of tube



An eye that does not see well due to abnormal visual development, develops during first decade of life and does not worsen later on


Clinical sign: poorer vision in an eye that cannot be improved with glasses



Amblyopia origin (3)

-idiopathic (most common)
-anisometropia (major diff in refractive error between eyes, eye with worse refractive error sends blurred image to retina and visual pathways and visual cortex is not stimulated)
-strabismus (misalignment of eyes either esotropic or exotropic or hyper hypo tropic, if it is intermittent and alternates between two eyes, good vision can still develop but if constant in one eye amblyopia will likely occur


How strabismus can lead to amblyopia

When eyes are misaligned, 2 diff images sent to brain resulting in diplopia, during visual development brain shuts down to deviated eye to avoid diplopia, as reesult visual cortex is not stimulated properly causing poorer vision results in the nonfixating eye


How amblyopia can lead to strabismus

Good vision is an essential stimulus to keeping eyes straight, if one is amblyopic, stimulus is lost and eyes can become misaligned, disuse exotropia being most common mech of this


Adult who has good vision that then becomes double vision is likely due to...

...cranial nerve palsy


Cells in flare/cilliary flush is indicative of...



High risk group for corneal ulceration

Contact lens wearers


Common cause of dendritic keratitis is ____, could also be herpes opthalmacus which presents with ____

Herpes simplex I viral infection often from contact lens use, associated vesicles near the eye


Epischleritis shows up only in ____ ulcerative colitis or IBS while iritis can show up in ______

active, active or not