treatments

Question 1

presbyopia
(aging eyes)

Answer 1

corrective lenses

Question 2

chronic glaucoma
progressive optic nerve damage

Answer 2

prostaglandin analog drops (latanoprost, travoprost)
topical beta blockers
laser treatment/surgery: trabeculoplasty

Question 3

acute angle glaucoma
(damage to optic nerve from pressure)

Answer 3

emergent optho referral
reduce IOP
- IV acetazolamide
- oral acetazolomide
- timolol maleate (topical)
- topic pilocarpine (once pressure begins to fall)

Question 4

amblyopia
brain can’t mesh two images so it turns off one

Answer 4

occlusion therapy
atropine

Question 5

amaurosis fugax
transient emboli to retinal artery

Answer 5

treat like stroke until proven otherwise

Question 6

retinoblastoma
retinal tumor of childhood

Answer 6

opthalmology and oncology

Question 6

optic neuritis
inflammatory demyelination of optic nerve

Answer 6

IV steroids and refer

Question 7

papilledema
optic disk swelling

Answer 7

reduce ICP
weight loss and acetazolamide
shunting

Question 8

viral conjunctivitis
inflammation of mucous membrane that line surface of eyeball and inner eyelids

Answer 8

cold compress and artificial tears

Question 9

HSV, shingles, chickenpox viral conjunctivitis

Answer 9

topical ganciclovir 0.15 gel
and or oral acyclovir
optho consult/ follow up

Question 9

bacterial conjunctivitis

Answer 9

trimethoprim with polymyxin B, azithromycin

contact wearers: ciprofloxacin

Question 10

gonoccocal conjunctivitis

Answer 10

IM cefrtiaxone 1g as single dose
erythromycin/ bacitracin may be added

Question 11

chlamydia conjunctivitis: inclusion

Answer 11

doxycycline

Question 12

chlamydia conjunctivitis: trachoma

Answer 12

oral azithromycin single 1 g dose
improve hygiene living conditions

Question 13

allergic conjunctivitis

Answer 13

antihistamine: levacobastine, emedastine
mast cell stabilizer: cromolyn
combined antihistamine and mast cell stabilizer: olopatadine

systemic antihistamine: loratadine

avoid triggers

Question 14

keratoconjuncivitis sicca
dry eyes

Answer 14

artificial tears
preservatives can mimic dry eyes
stop trying medications
use humidifier

Question 15

cataracts
opacities of lens

Answer 15

refer to opthalmology
lens replacement

Question 16

corneal ulcer

Answer 16

refer emergently to optho
initiate antibiotics with close follow up

Question 16

corneal abrasion
scratch to cornea

Answer 16

bacitracin-polymyxin/erythromycin ophthalmic ointment

contact lens wearers: ciprofloxacin and don’t wear contacts for 1 week

Question 16

large corneal abrasions

Answer 16

cycloplegic drops

Question 17

foreign body cornea

Answer 17

bacitracin-polymyxin/erythromycin ophthalmic ointment

Question 18

keratitis bacterial
infection of cornea

Answer 18

see optho emergently
topical antibiotic under direction of optho
fluoroquinolone given hourly

Question 19

keratitis viral
(HSV)

Answer 19

self limited
reduce symptom duration with antivirals and topical corticosteroids
refer

Question 19

keratitis fungal

Answer 19

diagnosis often delayed and treatment difficult

Question 20

pinguecula

Answer 20

no treatment required artificial tears may help

Question 21

pterygium

Answer 21

artificial tears and topical NSAIDs

Question 22

episcleritis

Answer 22

resolves spontaneously

Question 22

uveitis inflammation of any component of uveal tract

Answer 22

refer

Question 23

scleritis

Answer 23

REFER systemic NSAIDS and or topical steroids

Question 24

anterior blepharitis

Answer 24

eyelid hygiene, massage with baby shampoo

Question 25

posterior blepharitis

Answer 25

regular meibomian gland expression and warm compress if conjunctiva and cornea inflamed: long term low dose oral antibiotic therapy

Question 26

hordeolum

Answer 26

warm compress incision erythromycin/bacitracin

Question 27

chalazion

Answer 27

initial: warm compress incision and curettage

Question 28

entropian

Answer 28

can monitor if lashes scratch Cornea; surgery botulinum toxin injections

Question 29

ectropion

Answer 29

keep eyes moist OTC

Question 30

acute dacryocystitis

Answer 30

systemic oral antibiotics with gram pos coverage: amoxicillin- clavulanate, cephalexin, ciproflox follow up with optho

Question 31

chronic dacryocystitis

Answer 31

latent with systemic antibiotics dacryocystorhinostomy

Question 32

dacryostenosis

Answer 32

supportive treatment gentle massage with downward motion 3-4x daily

Question 32

congenital dacryocystitis

Answer 32

resolves spontaneously balloon dilation

Question 33

dacryoadentitis

Answer 33

cephalexin severe: IV nafcillin

Question 34

macular degeneration

Answer 34

vitamins and stop smoking

Question 35

dry ARMD

Answer 35

pegcetocoplan and avancincaptad pegol injections

Question 36

wet ARMD

Answer 36

VEGF injections - ranibizumab

Question 37

retinal detachment

Answer 37

close retinal holes and tears - laser photocoagulation - cryopexy - pneumatic retinopathy

Question 38

diabetic retinopathy

Answer 38

get control of blood glucose and examine every 3-4 months macular edema: VEGF

Question 38

hypertensive retinopathy

Answer 38

control HTN

Question 39

central/branch retinal artery occlusion

Answer 39

urgent referral to ER for stroke workup lay patient flat, ocular massage, high concentrations of inhaled oxygen, IV acetazolamide, anterior chamber paracentesis

Question 40

retinal vein occlusion

Answer 40

macular edema: VEGF neovasculariaztion: pan retinal laser photocoagulation

Question 41

periorbital cellulitis

Answer 41

oral antibiotics - amox/clavulanic acid or 1st gen cephalosporin hot packs

Question 42

orbital cellulitis

Answer 42

nafcillin plus: metronidazole or clindamycin MRSA: vancomycin

Question 43

globe rupture

Answer 43

bandage eye and cover with shield that rests on face not eye HOB elevated to 30-45 degrees remain still and don't move eye IV antibiotics: vancomycin + ceftazidimide surgey= NPO

Question 44

hyphema

Answer 44

prevent rebleed and intraocular hypertension elevate HOB to 30-45 consult optho - antifibrinolytic agents - corticosteroids (systemic and topical)

Question 45

subconjunctival hemorrhage

Answer 45

monitor reassurance resolves in 2 weeks

Question 46

orbital fracture

Answer 46

optho or plastic surgery orbital fracture into sinus: cephalexin oral corticosteroids for swelling

Question 46

bullous subconjunctival hemorrhage

Answer 46

monitor reassurance resolves in 2 weeks