Ophtho

Question 1

TMS can cause

Answer 1

KCS

Meds should be discontinued and cyclosporine 0.2% ophtho solution started

Question 2

Anterior uveitis

Answer 2

Can arise from a primary ocular disorder or secondary to a patient’s systemic disorder

Clinical sign is aqueous flare but can also include corneal edema, low IOP, high fema, hypopyon

Question 3

Treatment for anterior uveitis

Answer 3

Topical corticosteroids
-Prednisolone acetate 1%
-Dexamethasone 0.1%

If steroids are not available, topical NSAIDs can be used
-Diclofenac 0.1%
-Ketorolac 0.5%

Question 4

Clinical signs of acute glaucoma

Answer 4

-episcaleral congestion
-corneal edema
-mydriasis
-vosion loss
-blepharospasm

Question 5

Drug of choice for glaucoma

Answer 5

Chronic anhydrase inhibitor
-dorzolamide 2%
-brinzolamide 1%

And use IV mannitol to treat patients with acute glaucoma secondary to uveitus

Question 7

Corneal ulcers

Answer 7

-superficial
-stromal
-desmetocele (conjunctival flap)
-corneal rupture/iris prolapse - sx disease

Question 8

Melting ulcers

Answer 8

If not surgical, treat with serum

Question 9

Treatment of uveitis

Answer 9

Topical myriadic/cyclopgic drugs (atropine SID-QID)

NO TOPICAL STEROIDS

Do not use if glaucoma present

Can use pain meds

Question 10

Anti-melting therapy

Answer 10

Can do hourly

-Serum or plasma
OR
-EDTA (Make by mixing sterile water in lavender tube to fill line)

-NAC 5%
-oral doxycycline or minocycline

Question 11

Partial thickness corneal lacerations

Answer 11

Treated with topical antibiotics 4 times a day with fluoroquinolone’s preferred

Atropine given every 12 to 24 hours

Question 13

Treatment of deep corneal ulcers

Answer 13

Topical antibiotics
Topical serum
Broad spectrum antibiotic

Question 14

How can you differentiate between full or partial thickness foreign body penetration into the cornea

Answer 14

Full thickness penetrations will usually be accompanied with blood and or fibrin in the anterior chamber

Question 15

Clinical signs of primary glaucoma

Answer 15

Blepharospasm, epiphora, episcleral injection, corneal edema, mydriasis, blindness

Primary glaucoma is caused by a collapse of the iridocorneal angle

Question 16

Emergency treatments for primary glaucoma

Answer 16

Manitol IV reduces IOP by dehydrating the vitreous

Last for about 6 hours

Carbonic anhydrase inhibitors should be started along with synthetic prostaglandins to reduce IOP

Synthetic prostaglandins (lantanoprost) increase aqueous outflow

Question 17

What is the cardinal sign of anterior uveitis?

Answer 17

Aqueous flare best scene using a slit beam

Question 18

Acute blindness

Answer 18

Most common causes of acute blindness are
-retinal detachment
-ivermectin toxicity in dogs
-enrofloxacin intoxicity in cats

Question 19

Reflex uveitis

Answer 19

Regardless of initial cause, all ulcers associated with some iridocyclitis

Can treat with atropine and systemic NSAIDs

Question 20

Patients with anterior uveitis should be miotic or mydriatic?

Answer 20

Miotic

Mydriasis indicates a pressure problem

Question 21

Treatment for anterior lens vacation

Answer 21

-remove the lens
-manual reduction
-medically managed for secondary glaucoma