Opthal emergencies & concepts Flashcards
(15 cards)
Chemical burn mx
copious irrigation 1-2 pints NS + opthal consult
pH litmus paper
remove FB
Pharm:
a. Cylcopleg - Cyclopentolate
b. Topical antibiotics - tetracyclines
c. Topical corticosteroids – dexamethasone 0.1% or
prednisolone 1%
d. Topical lubricants
eye patch
red eye approach
Painful
Glaucoma (AACG)
Scler
Uv
kerat
Corn abr/ulcer
Trauma/chemical
Painless
Conj
subconj hemorrhage
episcl
steps of v visual exam & adjuncts
Ac - snellen
field
pup - consensual photophobia (uveitis)
EOM
Lids & Ant segment - prop, ciliary flush (perilimbal injection), iridodonesis, evert lids, eclipse sign; circumciliary injection
Posterior - red reflex, c, cd ratio, ret vess, retina
slit lamp exam - hypopyon, keratitic precip
tonometry 21
fluorescein - cornea; seidel (ant chamber leak)
XR orbit
topical anes - relieves, FB, conj, corneal abrasion, keratitis
corneal ab
slit lamp FB removal; fluorescein coblat blue slit lamp
ANal, Cycl
Abx
Ref eye
eye shield
penetrating trauma
ABCs, TRO sight threatening injuries
CT head and thin cut CT orbit - FB
sterile eye shield
abx & tetanus
NBM
hyphema mx
shiled
head upright and rest
Cyclo, cortico, glaucoma meds
ddx for gradual vision loss
unilateral
Cat
AMD
Glaucoma
Dm ret & Mac
Refraction
Optic neuropathy (ischemic, compressive, inflammatory)
bilateral
Cat, amd, glauc, dm ret and mac, optic neuropathy
meds - hydroxy malaria, ethambutol
Papilloedema HTN or ICP
ddx for acute BOV
painless - posterior segment
vitreous hem
ret det
CRVO, CRAO,
Non arteritic anterior ishcemic optic neuropathy
painful
anterior, potentially red eye
corn abr/ulcer
AACG
uve
traumatic hyphema
orb cellulitis
keratitis
hx for BOV
site - onset; pain
trauma, chemical, FB, contact lens
pmhx - dm, high myopia, ret detachment, migrain
meds - steroids - cataracts, glaucoma
TB - etham, hydroxy
fmhx gluacoma, macular , retinal
welder
causes of leukocoria & mx
retblast
* CT and MRI
local - cryo laser; RT and CT; enucleation
gene and sibling counselling
cat
persis fetal vasc/ persis hyperplastic primary vit
ret of prematurity
opthal neonat
N gon, Chlam troch serov D-K
N: IM ceft + PO azi C+A
Chlam: PO eryt
treat mother and partner
DM ret severity classification
ret:
NProl DMR
1. aneur
mod: DB hem, flame, soft ex, cotton
hard exudates
ret edema
severe:
DB hem 4 quad
2 quad - vein bead loop
1 quad - IRMA
Proliferative:
VEGF production;
new vessel disc, new vessel elsewhere
rubeosis iridis - severe glaucoma
maculopathy
Clin sign mac edeam
ret thicken in 500um mac center
hard exudate
dx with OCT - optical coherence tomography
causes of dm visual loss
maculopathy
vit hem
trac ret detach
DM ret mx
medical
gly control <7
control comrbs
DRP
Pan ret photo - severe NPDR
