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Flashcards in Special Senses Deck (70)
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1

Causes of dry eyes

Causes:
• Excess tear loss - blepharitis, contact lens wear, drugs
• Insufficient production - sjogrens, allergic conjunctivitis
Abnormalities of eyelids and blinking - parkinsons

2

S&S of dry eyes

S&S:
• Gritty irritation and FB sensation
• Mild pain aggravated by reading, dry air, PC work
• Worse at end of day

3

Tx of dry eyes

Tx:
• Review meds
• Tear substitutes
• Avoid contact lenses where possible

4

Differentials of a red eye

Differentials:
• Conjunctivitis
• Corneal ulcer
• Iritis
Foreign body
• Episcleritis
• Scleritis
• Acute angle closure glaucoma
• Age related macular degeneration
• Diabetic Retinopathy

5

S&S of conjunctivitis

S&S:
• Mucopurulent discharge on eyelashes
• Dilated red blood vessels on sclera
• Acute onset often bilateral red eyes

6

Tx of conjunctivitis

Tx:
• Topical chloramphenicol or topical fusidic acid
• Don’t wear contacts
• Don’t share towels

7

Allergic conjunctivitis S&S and tx

Allergic conjunctivitis:
• Bilateral sx
• Prominent itch
• History of atopy
• Tx - Antihistamines or sodium cromoglicate

8

corneal ulcer S&S

S&S:
• Pain
• Photophobia
• Blurred vision
• Sensation of foreign body
• Signs - Red eye, corneal stain with fluorescein, hypopyon

9

Causes of corneal ulcer

Aetiology:
• Infections - herpes, streptococcus
• Contact lens wear
• Blepharitis

10

Tx of corneal ulcer

Tx:
• Herpes - aciclovir ointment
• Bacterial - topical abx
• Topical steroids

11

Tx of corneal FB

Tx:
• Topical NSAID
• Topical abx
• Tetanus ppx to prevent secondary infection if rust
• Refer if not healed in 72 hrs or worsening sx

12

Open angle glaucoma S&S

Open angle Glaucoma:
• Develops slowly over time, no pain
• Side vision begins to decrease followed by central
• Optic disc cupping (see pic)

13

Tx of closed angle glaucoma

Tx:
• Urgent admission
• Acetazolamide (reduces aqueous secretions) and topical pilocarpine (pupillary constriction)

14

S&S of acute angle closed glaucoma

S&S:
• Female over 50 usually
• Unilateral eye pain
• Eye watering
• Headache
• Progresses to N&V
• May collapse
• Reduced vision
• Red eye
• Fixed mid dilated pupil

15

Causes of homonymous Quadrantanopia

Homonymous quadrantanopia:
• Lesion of temporal lobe - superior
• Lesion of Parietal lobe - Inferior
PITS - Parietal Inferior Temporal Superior

16

Wet AMD tx

Anti-VEGF injection

17

S&S of cataracts

S&S:
• Slowly progressive visual loss or blurring
• Glare
• Reduced colour sensitivity
• Reduced night vision
• Double vision
• No red reflex with opthalmoscope

18

Tx of cataracts

Tx:
• Lens extraction and intraocular lens implant surgery

19

Classification of diabetic retinopathy

Background - microaneurysms, blot hemorrhages <3, hard exudates

Pre-proliferative - cotton wool spots, >3 blot hem, cluster hemorrhages

Proliferative - Fibrous tissue anterior to retinal disc, retinal neovascularisation

20

Tx of diabetic retinopathy

Tx:
• Preproliferative - Laser photocoagulation
• Proliferative - Anti VEGF injection
• Glycemic control, lower BP, lower lipids

21

S&S of HTN retinopathy

S&S:
• Headache
• +/- visual disturbance
• Underlying causes may be present eg pain
BP >200/130

22

Tx of HTN retinopathy

Management:
• Use oral therapy with short half life so you can monitor the drop in BP without taking ages
• Reduce BP by not more than 25% to avoid stroke risk

23

Optic neuritis S&S

S&S:
• Unilateral decrease in visual acuity over hours or days
• Red desaturation
• Pain worse on eye movement
• Central scotoma (blindness)

24

Causes of optic neuritis

Causes:
• MS
• Diabetes
• Syphilis

25

Patho of stye and tx

Infection of glands of eyelids

Tx:
• Hot compress
• Analgesia
• Abx if associated conjunctivitis

26

Differentials of sudden painless loss of vision. S&S of each

Central retinal artery occlusion:
• Sudden painless loss of vision
• Cherry red spot on a pale retina

Central retinal vein occlusion:
• Causes - glaucoma, polycythemia, HTN
• Severe retinal hemorrhages on fundoscopy

Retinal detachment:
• Flashes of light
• Floaters
• Curtain being drawn, tunnel vision to central vision.

27

Blepharitis patho and S&S and tx

Inflammation of eyelid margins

S&S:
• Bilateral
• Discomfort around eyelid margins
• Eyes sticky in morning
• Eyelid margins red
• Secondary conjunctivitis may occur

Tx:
• Hot compresses
• Mechanical removal of debris from lid margins with cotton wool buds dipped in hot water

28

Tx of pinna haematoma

urgent drainage and pressure dressing

29

S&S of otitis externa

S&S:
• Painful discharging ear
• History of itchy ear
• Hearing muffled by discharge

30

Tx of otitis externa

Tx:
• Topical eardrops empirically - gentamicin
• Swab discharge in resistant cases
• Microsuction of pus to enable drops to get to source