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year 2 > ophthalmology infections/trauma > Flashcards

ophthalmology infections/trauma Flashcards

(88 cards)

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1
Q

what is dacrocystitis

A

inflammation of the lacrimal sac // infection of stagnant tears

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2
Q

how does dacrocystitis usually present

A

a painful lump at the side of nose adjacent to the lower lid

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3
Q

what is the treatment of dacrocystitis

A

BSABs

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4
Q

where in the eye is redness most obvious in anterior blepharitis

A

lid margin more red than deeper part of lid

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5
Q

does anterior or posterior blepharitis involve the eye lashes/lash follicle?

A

anterior

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6
Q

what are the 2 types of anterior blepharitis

A

seborrhoeic (squamous) and staphylococcal (infection involving the lash follicle)

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7
Q

what are some symptoms of seborrhoeic (squamous) blepharitis

A

scales on lashes
gritty eye/foreign body sensation
mild discharge
no ulceration

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8
Q

what are some symptoms of staphylococcal blepharitis

A 
lashes distorted
teepee sign
loss of lashes
ingrowing of lashes (trichiasis)
styes
ulcers of lid margin
corneal staining
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9
Q

what is the teepee sign

A

lashes stuck together

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10
Q

what is a stye

A

acute purulent infection of a lash follicle

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11
Q

what causes the ulceration in staphylococcal anterior blepharitis

A

exotoxin

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12
Q

what is another name for posterior blepharitis

A

meibomian gland disease

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13
Q

what dermatology condition is associated with meibominan gland disease

A

acne rosacea

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14
Q

what are meibomian glands

A

specialised glands of eyelid which secrete an oily substance that prevents evaporation of tear film

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15
Q

what are chalazia

A

meibomian cysts

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16
Q

where is the eye most red in posterior blepharitis

A

redness is in deeper part of lid - lid margins often look normal

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17
Q

what is seen at the meibomian gland openings in MGD

A

pouting, swollen, dried secretion

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18
Q

what is the treatment for MGD

A 
lid hygiene (daily bathing/warm compress)
supplementary tear drops
fusidic acid
oral doxycycline for 2-3 months
steroid drops
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19
Q

is MGD easy or difficult to treat

A

difficult to eradicate

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20
Q

what is sjogrens syndrome triad

A

keratoconjunctivitis sicca (dry eyes)
xerostomia
rheumatoid arthritis

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21
Q

what is the most common form of conjunctivitis

A

bacterial

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22
Q

what are the most common causes of bacterial conjunctivitis in older ages

A

staph aureus
strep pneumonia
H. influenza

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23
Q

what are the most common causes of bacterial conjunctivitis in neonates

A

staph aureus
neiserria gonorrhoea
chlamydia trachomatis

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24
Q

what are some symptoms of bacterial conjunctivitis

A 
almost always bilateral
sore or gritty eye
good vision
red and sticky eye
purulent thick yellow discharge/pus
presence of papillae (tiny bumps like bubble wrap with little red dot in centre - blood vessel)
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25
what is the treatment of bacterial conjunctivitis
topical chloramphenicol fusidic acid gentamicin
26
when should chloramphenicol be avoided
if history of allergy or asplastic anaemia
27
what can be given if someone is allergic to chloramphenicol
fucithalmic
28
what is the treatment for gonoccal conjunctivitis
oral and topical penicillin
29
what should you suspect in a young adult with bilateral conjunctivitis
chlamydial conjunctivitis
30
describe the course of disease with chlamydial conjunctivitis
slow/chronic onset of symptoms | mild discomfort for weeks and unresponsive to treatment
31
what are some symptoms of chlamydial conjunctivitis
watery discharge symblepharon assoc. hair follices + little wet rice grains (bumps in lower inside of eyelid)
32
what is symblepharon
palpebral conjunctiva gets stuck to bulbar conjunctiva causing turning in of eyelid
33
what is the treatment for chlamydial conjunctivitis
``` topical oxytetracycline topical erythromycin (also in neonates) ```
34
what organism causes trachoma
chlamydia trachomatis
35
where is trachoma seen and what does it cause
tropics and middle east | blindness
36
what may precede viral conjunctivitis
cold or flu
37
is viral conjunctivitis contagious?
yes very
38
what is the discharge like in viral conjunctivitis
watery
39
what are the 3 main causative viruses of viral conjunctivitis
adenovirus HSV HZV
40
what are some symptoms of viral conjunctivitis
chemosis lid oedema palpable pre-auricular lymph nodes assoc. follicles (little wet rice grains - bumps in lower inside of eyelid) - bigger bump with red around periphery
41
is HSV conjunctivitis usually unilateral or bilateral
unilateral
42
what cutaneous feature is seen in HSV conjunctivitis
cutaneous vesicles on eyelids and around skin of eye
43
what kind of ulcer is seen in HSV conjunctivitis
dendritic corneal ulcer
44
where does HSV sit and reactivate from
CN V ganglion
45
what is Hutchinson sign
tip of nose - means involvement of nasociliary branch of trigeminal nerve
46
what is the treatment of viral conjunctivitis
self limiting lubricants and cold compress strict hygiene topical steroids when corneal involvement HSV - aciclovir
47
how does molluscum contagiosum involve the eye
pearly umbillicated nodules filled with DNA pox virus can be seen on lid margin and red eye that generally goes unrecognised
48
what are some treatments for molluscum contagiosum conjunctivitis
curetting in central portion of lesion freezing the centre completely excising lesion short course of topical steroids (prednisolone or dexamethasone) if eye is very involved
49
what is the main feature of allergic conjunctivitis
itch
50
what are some features of allergic conjunctivitis
``` itch redness soreness watery, stringy discharge can cause chemosis ```
51
what is the treatment for allergi conjunctivitis
reduce allergen antihistamines (e.g. azelastine, emedastine) topical mast cell stabiliser (e.g. sodium chromoglicate, nedocromial) Olopatadine - dual action, very effective
52
how could unilateral orbital trauma cause diplopia
if it is associated with the zygomatic bone
53
what may be needed in order to examine an eye with a corneal abrasion
topical anaesthetic drops
54
give 2 examples of topical anaesthetic drug
oxybuprocaine or tetracaine
55
what s/s might indicate a corneal abrasion
``` severe pain lacrimation inability to open eye (blepharospasm) might be aggravated by blinking/moving eye foreign body sensation reduced visual acuity ```
56
what 3 investigations would be done for a suspected corneal abrasion
blue light + fluorescein eversion of upper eyelid if suspect IOFB - XRAY
57
what does a tear drop pupil indicate
corneal penetration
58
test to prove corneal penetration
Seidel's test (fluorescein)
59
what can be a complication of corneal penetration
retinal damage
60
what is worse an acid or alkali burn and why
alkali burn | acid coagulates causing little penetration
61
what is the treatment for a chemical injury of the eye
immediate irrigation with minimum 2L saline or until pH normal
62
what is sympathetic ophthalmia
penetrating injury to one eye causes inflammation of both eyes - exposure of intraocular antigens --> autoimmune reaction in both eyes
63
how can a corneal ulcer lead to permanent visual loss
healing occurs by collagen laying down in a haphazard fashion
64
give 4 causes of a central corneal ulcer
viral (HSV - dendritic ulcer) fungal bacterial acanthamoeba
65
what is the treatment of a dendritic ulcer
aciclovir
66
what is the treatment of a bacterial corneal ulcer
ofloxacin hourly
67
what are some cause of a peripheral corneal ulcer
RA GPA, polyarteriitis (rarely) hypersensitivity - marginal ulcers
68
what is the treatment of a peripheral corneal ulcer
oral/topical steroids
69
what are the 3 layers of the cornea
epithelium (10%) stroma (90%) endothelium
70
when should keratitis be suspected
if cornea stains with fluorescein
71
what are some s/s of keratitis
``` foreign body sensation pain photophobia lacrimation vision reduced (if ulcer which affects visual axis) ```
72
how does a dendritic ulcer form
HSV keratitis - epithelial cells undergo lysis and form a dendritic ulcer
73
how is a dendritic ulcer observed
blue light and fluorescein
74
true or false | HSV keratitis is not very painful and is recurrent
HSV keratitis is very painful | can be recurrent
75
where does HSV lie dormant
CN V ganglion
76
what is the treatment of HSV keratitis
aciclovir
77
what happens if steroids are used in HSV keratitis
can lead to spread of virus + ulcer increases in size and corneal melt and perforation DO NOT USE
78
what usually precedes adenoviral keratitis
URTI
79
is adenoviral keratitis usually unilateral or bilateral
bilateral
80
what may be seen in adenovrial keratitis
subepithelial infiltrates
81
what is the treatment of adenoviral keratitis
topical chloramphenicol - prevent secondary infection | steroids if chronic
82
what is usually seen with bacterial keratitis
hypopyon
83
what is the treatment for bacterial keratitis
hospital admission for hourly administration of drops - ofloxacin
84
what is bacterial keratitis usually assoc. with
other corneal pathology or contact lenses
85
when does acanthamoeba (fungal) cause keratitis
contact lens wearers | farmers
86
what is the treatment for acanthamoeba keratitis
chlorhexidene (every 30 mins for 6 days)
87
what is another cause of keratitis in contact lens wearers
pseudomonas aeruginosa
88
what is the treatment for keratitis caused by pseudomonas aeruginosa
gentamicin

year 2 (19 decks)

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