Opthalmology II Flashcards Preview

Nervous System: Unit III > Opthalmology II > Flashcards

Flashcards in Opthalmology II Deck (21)
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1

Ddx of unilateral red eye

  • viral or bacterial conjuctivitis
  • iritis
  • corneal abrasian
  • corneal ulcer
  • herpes simplex
  • herpes zoster opthalmicus
  • subconjuctival hemorrhage

2

DDx of bilateral red eyes

  • dry eyes
  • allergic conjuctivitis

3

Anatomic layers of cornea

  • superficial to deep:
  • epithelium
  • bowman's layer
  • stroma
  • descemet's membrane
    • endothelium

4

5

Indication for cataract surgey

  • When patient’s quality of life is diminished: trouble reading, driving, watching TV, trouble with glare
  • Newer surgeries not as "rough" for patients -- patients can help decide when they are ready for surgery

6

Indication for corneal transplant surgery

  • Pseudokaphic or aphakik bullous keratopathy
  • Endothelial dystrophy
  • Keratoconus
  • Trauma
  • Regraft
  • HSV/viral (2%)
  • Corneal dystrophy
  • Corneal degeneration
  • Chemical injuries

7

Basic step of cataract surgery

  • Topical anesthesia
  • Small incision (2.2 mm), circular tear made with laser
  • The cataract inside the capsular bag is gently broken up with ultrasound and removed with a tiny vacuum
    • CAREFULLY AVOID tearing the capsule, one cell layer thick
  • The IntraOcularLens is folded and inserted into the capsular bag, unfolds
  • Put on bandage contact lens

8

Sx and Dx: Blepharitis

  • Inflammation of lid
  • Crusting and symptoms worse in AM

 

9

Tx: blepharitis

  • Eye scrub
  • baby shampoo
  • bacitracin or erythromycin ointment

10

Sx and Dx: Bacterial conjunctivitis

  • Redness and mucopurulent discharge
  • minimal discomfort
  • vision minimally affected

11

Tx: bacterial conjunctivitis

  • Often will resolve without treatment
  • Polytrim (antimicrobial ophthalmic solution)

12

Sx and Dx: viral conjunctivitis (EKC)

  • Pink eye.
  • Photophobia, redness, watery discharge,
  • bilateral but asymmetric (first eye is worst)
  • preauricular lymphadenopathy
  • Swollen follicles, white spots on cornea

13

Tx: viral conjuctivitis

  • Cool Compresses and artificial tears
  • severe cases require topical steroid eye drops with pronounced inflammation
  • Most cases are self-limiting within a week

14

Sx and Dx: Allergic conjunctivitis

  • seasonal onset
  • bilateral
  • Itch
  • redness
  • chemosis = conjuctival swelling
  • mucopurulent discharge
  • no pre-auricular node

15

Tx: allergic conjunctivitis

  • Avoidance therapy
  • tears to flush antigen, cool compresses
  • antihistamine + mast cell stabilizer
  • Ointment of eye to lubricate cornea for chemosis.

16

Sx and Dx: Orbital cellulitis

  • Decreased vision
  • proptosis
  • abnormal pupillary response and motility
  • disc swelling
  • Dx: Blood culture, ENT consult

17

Tx: orbital cellulitis

  • systemic IV antibiotics/oral antibiotics
  • prompt drainage of orbital/sinus abcess

18

Sx and Dx/Tx: bacterial keratitis

  • Trauma from contact lense wearers
  • Sx:
    • pain, photophobia
    • decreased vision
    • white spot on cornea
  • Tx:
    • 4th gen. fluoroquinolones as topical antibiotic tx

19

Sx and Dx/Tx: HSV keratitis

  • HSV: vesicles around eye
  • Tx:
    • topical and oral antivirals
      • trifluridine
      • acyclovir
      • valtrex 
      • famvir

20

Sx and Dx: Narrow angle glaucoma

  • Sudden onset of pain
  • decreased vision
  • nausea, vomiting
  • haloes around lights
  • pupil mid-dilated
  • cornea is cloudy over time
  • eye is very hard to the touch

21

Tx: narrow angle glaucoma

  • Treat right away
    • optic nerve does not tolerate rapid rise in pressure well
  • β blocker, α agonist,
  • Systemic carbonic anhydrase inhibitor and mannitol
  • laser hole in iris