5: Eyes Flashcards
Itchy, burning, swollen red lid margin. May have flakes/heavy crusting on the lashes, lid redness and swelling, foam along lid margin.
Blepharitis/Meibomian Gland Disease
Blocked glands, thickened and telangiactatic lid margin.
Blepharitis/Meibomian Gland Disease
T/F Blepharitis/Meibomian Gland Disease can be associated with acne rosacea.
True
_____ is the main cause of bacterial conjunctivitis in adults.
Blepharitis (Blepharonconjunctivitis)
What is the treatment for blepharitis (4)?
- Wash lashes with baby shampoor or lid scrubs.
- Warm compresses.
- Artificial tears.
- ABX/steroid combo if lid is very inflamed.
When treating blepharitis with ocular topical steroids, what do you need to monitor?
Intraocular pressures
Internal or external “stye.”
Hordeolum
Infection of glands around the eyelid that is painful to palpation.
Hordeolum
Inflammation of glands around the eyelid that is not painful to palpation.
Chalazion
Which usually comes first, a hordeolum or a chalazion?
Hordeolum. Chalazaions often begin as hordeolums.
What is the treatment for hordeolum or chalazion (4)?
- Warm compresses for 10 min with lid massage.
- If large and painful, consider oral ABX.
- If chronic, oral doxy 100 mg BID.
- If no resolution within 2 weeks, refer (may need excision).
Lid turning inward.
Entropion
Lid turning outward.
Ectropion
Entropion and ectropion can be involutional or cicatricial (related to _____).
Alopecia
Entropion/Ectropion results in _____ and/or _____.
Dry eyes
Excessive tearing
Inability to close the eyelid completely.
Lagopthalmos
Lagopthalmos can be associated with _____.
Exopthalmos (hyperthyroidism)
What is the treatment for lagopthalmos (the inability to close the eyelids completely) (3)?
- Evert the lash line.
- Thick ocular ointment (Refresh PM).
- Refer to oculoplastic surgeon.
_____ is the most common cause of eyelid dermatitis, especially if bilateral.
Contact dermatitis
Itchy red eyelids that can be caused by preservatives in topical agents, cosmetics, hair products, etc.
Contact dermatitis
Management of contact dermatitis (4)?
- Stop causative agent.
- Cold compresses.
- Preservative-free tears.
- Topical/oral antihistamines.
T/F Most causes of adult conjunctivitis are bacterial (“pink eye”).
False. Most causes of adult conjunctivitis are viral or allergic.
Itchy with mild injection. Happens mostly in kids and young adults. Look for papillae on palpebral conjunctiva.
Allergic conjunctivitis
What is the management for allergic conjunctivitis (1)?
Topical antihistamine (Alaway, Zaditor, or Patanol BID).
“Pink” eye with possible mucus. Mostly follicles on palpebral conjunctiva. Tearing and burning. Usually starts in 1 eye and spreads to the other.
Viral conjunctivitis
With viral conjunctivitis, the patient may have inflamed PAN (polyarteritis nodosa). Often associated with _____.
URI
Management for viral conjunctivitis (3)?
- Highly contagious: change pillow cases, towels, cosmetics, etc.
- Preservative-free tears.
- Cold compresses (self-resolving in 2-3 weeks).
When should viral conjunctivitis be referred?
If vision is affected or there is pain with blinking.
Beefy red conjunctiva, major discharge, itching/irritation.
Bacterial conjunctivitis
Management for uncomplicated cases of bacterial conjunctivitis (1)?
Topical ABX.
What is a cause of newborn bacterial conjunctivitis and how is it treated?
Ophthalmia neonatorum d/t N. Gonorrhea. Needs IV fortified ABX.
In kids, if bacterial conjunctivitis is hyperacute, what might be the cause?
N. Gonorrhea. Treat with oral/IM ABX.
This type of bacterial conjunctivitis is typically recurrent and does not respond to treatment.
Chlamydia (oral ABX).
Hemorrhage of the eye.
Subconjunctival hemorrhage
What should you r/o with subconjunctival hemorrhage?
HTN (check BP)
Management of subconjunctival hemorrhage (3)?
- Avoid blood thinners, if possible.
- Avoid heavy lifting/strenuous activity.
- If recurrent, do blood work.