617 the eyes Flashcards
Blepharitis- Inflammation of the eyelids
Anterior and posterior
Anterior cause by staphalococcus aurea
Posterior is mostly sebacious glands
Swollen eyelids, inflamed lid margins, scaling, crusting, ulceration, altered eyelash appearance
Blepharitis-Physical and treatment
PE-external eye structure: eyelids, eye lashes, maibomium glands, eyebrows, scalp, ears, base of the nose for seborrhea
TX: Careful cleansing of eyelids to remove oils
Q-tip and baby shampoo. warm, moist compresses, Antibiotic ointment such as erythromycin or bacitracin.
Avoid use of contact lenses and use good hand hygeine
Scrubs- 2-4 times per day
Hordeolum
inflamed area of eyelid where the eyelash meets the eyelid. Bacteria gets in the oil glands.Similar process of a pimple.
Hordeolum
swollen and red bump on the eyelid. gritty , scratchy sensation, sensitivity to light, tearing, tenderness on the eyelid
Hordeolum
PE: HEENT and eyelid and eye structures
TX: warm compresses to the eye 10 minutes 4x/day
Do not squeeze. Let drain on their own. daily lid scrubs
Antibiotics if infected.
Replace makeup
Chalazia
A gradually localized enlarging nodule caused by lipgranuloma blockage in the meibomian gland that lubricates the eye.
Usually painless
Chalazia-PE and TX
PE: HEENT, single or multiple, palpable, nontender, soft and usually fluctuant
TX: Warm compresses, daily lid scrubs with gentle massage.
Follow up with pain or swelling longer than 1 month or additional lumps or eyelash loss.
Antibiotics of no use
Viral conjunctivitis
inflammation or swelling of the membrane lining of the eyelid caused by a virus (adenovirus). Gritty feeling in the eyes, increased tearing, watery discharge, redness, itching, pain, blurred vision, sensitivity to light, HA, fever, nasal congestion, post nasal drip and cough
Conjuctivitis-viral
(eyes glued shut in the am)
one eye then the other
recent URI
PE: Eye structures, C&S, nose, thorat, mouth, CV, respiratory, cerical and preauricular lymph nodes
TX: cool compresses, hand hygiene, contact lense cleaning, or disposal. Change pillow case daily. Do not share towels or handkerchiefs
Come back in a week if not gone
Conjunctivitis-allergic
Inflammation or swelling of the eyelids due to an allergy causing substance. Histamine is released into the blood and the blood vessels in the conjunctiva become swollen
Conjunctivitis-Allergic
red, itchy, puffy eyes (both), tearing, stringy white discharge, Hx of seasonal allergies
Conjunctivitis-Allergic
PE: eye structures, red eyes, dilated bessels in conjunctiva, puffy eyelids, tears, nasal mucosa, throat, CV, respiratory.
Will have chiners under the eyes (dark circles), boggy nose
TX: no contacts- cool compresses-oral anti-histamines-artificial tears, naphcon A Vasocon (otc), Levocabastine
Conjunctivitis-bacterial
infection of the conjunctiva membrane lining the eyelid. Tears contain enzymes and antibodies that kill bacteria
Bacterial conjunctivitis
blurred vision, crust or matted discharge forming on eyelid overnight, thick mucoid discharge, early morning glued shut, absence of itching.
PE: HEENT, eye structures, swab for culture and sensitivity
TX: antibiotic drops or ointment.-Tobramycin, fluroquinolones, trimethoprim-polymixin B
Warm compresses, hand hygiene, contact lense dispose or clean, change pillowcases daily, dispose of eye cosmetics. Do not share towels, etc.
Corneal abrasion
A cut or scratch or abrading of the thin, clear, protective coat of the anterior portion of the ocular epithelium often the result of trauma
FNP can treat minor abrasion
Do not patch. Supportive care. May use a an antibiotic to lubricate. Do not rub. No topical anesthetics. Should be better in 24-72 hours
Corneal abrasion
Fluorescein staining
- put dye on the eye surface
- use cobalt blue light
- light causes the dye to glow green and you can see damage.
Iritis
swelling and irritation of the uvea, the middle part of the eye which provides the blood supply to the retina. Most common is the iritis. which affects the anterior portion of the meddle eye or the iris
Iritis
blurred vision, dark floating spots, pain, light sensitivity, hx of rheumatoid arthritis, ankylosing spondylitis, infections or toxin exposure.
PE: visual acuity, opthalmic exam
Labs-ESR, ANA
TX: underlying condition, dark glasses, steroid drops, refer for loss of vision or pain
Ciliary flush
Dilation of blood vessels immediately surrounding the cornea
Hx of angle closed glaucoma and uveitis, red eye, sudden pain, light sensitivity, n/v, ha, use of contacts
PE: Eye exam, nose, mouth, throat, CV, resp, conjunctival, blood vessels are dilated
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