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Ophthalmology > Treatments > Flashcards

Treatments Flashcards

(47 cards)

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1
Q

Tx: Warm compresses, Lid scrubs, Johnson’s baby shampoo/Q-tips, Ocusoft lid scrubs
Antibiotics: Bacitracin or E-mycin ointment, Tobradex (abx/steriod) combo, Oral abx, Doxycycline or minocycline or aladox, Anti-inflammatories

A

Blepharitis and meibomianitis

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2
Q

Tx: Warm compresses, Steroid/abx combo, Oral abx

A

Hordeolum

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3
Q

Tx: Warm compresses, Surgical excision, Occasionally steroid injection into lesion

A

Chalazion

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4
Q

Oral or IV abx

A

Dacrocystitis

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5
Q

Lubrication, Surgical repair (blepharoplasty)

A

Ectropion

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6
Q

Epilation (physically removing the eyelashes), Surgical repair, Bandage contact lens

A

Entropion

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7
Q

OTC anti-histamines (mild), Mast cell inhibitors and stabilizers (EXPENSIVE!!), Lastacaft, Pataday, Alomide, Bepreve, Mild steroids, FML, Lotemax, Pred Mild, Alrex; Oral antihistamines helpful; Cool compresses

A

Allergic Conjunctivitis

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8
Q

Floroquinolones, Vigamox, Zymaxid, Besivance, Always ask about contacts and whether extended wear

A

Bacterial conjunctivitis

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9
Q

Cold compresses, decongestants, Steroids, supportive rx

A

Viral conjunctivitis

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10
Q

Lubrication (artificial tears), Low dose steroids if more severe

A

Pinguecula

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11
Q

Lubrication (artificial tears), Steroids, Surgery (VERY hard; regrowth possible)

A

Pterygium

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12
Q

Determining the cause

Surgical intervention if indicated

A

Ptosis

Horner’s Syndrome - with miosis and anhidrosis

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13
Q

HSV; Send to eye provider; They’ll prescribe antivirals: Viroptic, Zirgan, Avoid steroids with epithelial ds! They make viruses get worse

A

HSV keratitis

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14
Q

Treat aggresively: Vigamox Zymaxid (Consider loading dose); Ask about contact lenses

A

Bacterial keratitis

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15
Q

Dx with fluorescin staining

Acute Tx: Artifical tears, Optive, Systane
Chronic Tx: Non-preservative tears
Severe Tx:, Restasis (cyclosporine), Punctal plugs (plug the puncta)

A

Keratitis (keratoconjunctivitis sicca)

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16
Q

Debridement, Abx, Cycloplegic drops (dilates pupil > helps w/ discomfort and healing), Patch (no longer used?), Use bandage contact lens

Recurrent corneal erosion
Surface has pulled away
Happens based on the way some things scratch it

A

Corneal abrasion

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17
Q

Remove with spud, Rust removed with Alger brush, Treat like corneal abrasion, Can heal the spot with drops and ointments

A

Corneal foreign body

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18
Q

Txt agressively: Vigamox, Zymaxid

Never patch!

A

Corneal abrasion

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19
Q

IV antibiotics

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A

Orbital cellulitis

20
Q

Oral Acetazolamide 500mg
–> If sulfa allergy, then Isosorbide
–> Add BetaBlocker for 20 mins unless C/I (asthma, COPD)
Also Apraclonidine or Brimonidine
–> Once pressure is normalized, add Pilocarpine QID (makes pupils smaller)

Goal is to get pressure down ASAP
Immd. referral to glaucoma expert
Ultimately, laser surgery (YAG) done to each eye
Makes a hole in the iris (iridotomy)

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A

Closed angle glaucoma

21
Q

Mostly pharmacology agents first

Surgery when the above is no longer effective

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A

Open angle glaucoma

22
Q

Prostaglandins for glaucoma treatment (start with these)

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A

Xalatan, travatan, lumigan

SE: longer lashes, iris darkening

23
Q

Beta blockers for glaucoma treatment

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A

Timolol

Be careful with asthma/COPD

24
Q

Alpha andregenic agonist for glaucoma treatment

25
Timolol and dorzolamide combo for glaucoma treatment
Cosopt
26
Timolol and brimonidine combo for glaucoma treatment
Combigan
27
brinzolamide/brimonidine combo for glaucoma treamtent
Simbrizna
28
Which treaments are seldom used for glaucoma?
Pilocarpine(miotics), epinephrine, and systemic CAI’s
29
Pulses of laser to the trabecular meshwork to create scar tissue, which then expands the pores, causing them to open up wider to get better flow
Argon Laser Trabeculoplasy (ALT) for glaucoma
30
Lower energy and less damage to area May be able to retreat but not proven Can last about 5 years
Selective LT (SLT) for glaucoma
31
Creates surgical tunnels in the eye to let the fluid flow out differently; Dramatic drop in pressure; More risk for infection, etc.
Filtering Surgery Trabeculectomy for glaucoma
32
Very aggressive; Cycloplegia (paralyze the ciliary body) 2-5% Homatropine bid-qid; Avoid Atropine - duration is too long; Topical steroids for inflammation **Gold standard is Pred Forte** Loading dose - every hour for 1st day or so Wean off over time Durezol
Anterior uvetitis
33
Retinal specialist needed Oral agents Localized retinal lasers Intraocular injections
Posterior uvetitis
34
Steroids | IOP lowering meds
Iritis
35
Bedrest until surgery **Scleral buckle (*Gold Standard. Place "buckle" around the outside of eye to squeeze eye and force reattachment. Problem: you create a different anatomy to the eye)**
Retinal detachment
36
Laser photocoagulation (can seal up at detachment) Cryotherapy (inject gas into eye to locate detachment Pneumatic retinopexy Victrectomy (remove vitreous)
Retinal detachment alternatives
37
No tx, poor recovery Ocular massage and palaption have been tried Breathing into a bag to create acidosis and vasodilation
Central retinal artery occlusion
38
``` Treat underlying med condition If neovascularization, retinal specialist PRP IO steroids, Anti VEGF, ASA therapy Most mild cases resolve on own ```
Central retinal vein occlusion
39
Treat underlying conditions
Branch retinal vein occlusion
40
Mild/early stages: monitor closely For macular edema: Focal retinal laser Anti-VEGF injections
Diabetic retinopathy
41
For advanced Nonproliferative & Proliferative: Panretinal photocoagulation (PRP) Laser tx Sometimes intraocular steroids
Diabetic retinopathy
42
Treat underlying HTN
Hypertensive retinopathy
43
Currently no ocular tx | AREDS trial using high dose anti-oxidant + Zn supplements
Dry macular degeneration
44
Anti-VEGF Ab injections: Lucentis, Avastin, Eylea Reduces blood vessel growth, reduces blood that is present; Occasionally lasers and IO injections; Continue with Amsler Grid
Wet macular degeneration
45
Involves placement of an intraocular lens in the posterior capsule (behind the iris); Anterior chamber lens seldom used, higher risk for Uveitis Glaucoma, Hyphema; Bifocal lenses can be used (accommodating IOLs)
Cataract surgery
46
Limited lifting for 1st month | Abx, NSAIDS, steroid drops for first month
Post op cataract instruction
47
Intraocular lens is placed just behind the iris The nucleus and cortex is removed, but the post capsule is left intact; This creates an envelope for the lens to sit in, and keeps vitreous in back of eye; "Foldable" lens is placed in the bag and zonules hold it in place Pts are safe to dilate
Cataract surgery

Ophthalmology (2 decks)

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