70 opth

Question 1

two testing can be useful in certain cases in the decision to recommend or not recommend cataract surgery.

Answer 1

Glare testing and potential acuity testing

Question 2

Blepharitis

4 L’s to assess

tx for this? 3 abx 2?

Answer 2

eyelid margin inflammation, more localized to eyelids and lashes

lymphnodes
lids
lashes
lacrimal systems

tx - hot compress 15 mins x QID
lid massage, wash with baby shampoo
azythromycin 1% to lid margin QID x 4 weeks
oral doxycycline 500mg BID

Question 3

hordeulum aka? usually what bacteria?

Answer 3

stye - acute inflammation of eyelid - meibomian tear duct as well - s. aureus

Question 4

Chalazion?

Answer 4

obstruction of meibomian tear gland - usually bigger than stye, usually not bacteria

Question 5

preseptal cellulitis? tx? suspect which bact?

if under one year old?

Answer 5

soft tissue infx anterior to orbital septum

tx with big gun - systemic - amox clav

h. infu in children
s. aureous or strep in adults

if <1 year, tx as orbital cellulitis, send to ER

Question 6

orbital celluitis? seen in what pts? 3

causes?

Answer 6

ocular medical emergency - these pts look sick - ER for IV tx
inflammation of orbital posterior septum -

seen in children, elderly, immonocompromised

cause - 2ndary to sinus/facial/tooth inf or trauma

Question 7

Red flags for eye issues? 8

Answer 7

sudden reduction in visual acuity
severe pain
fixed pupil
photophobia
severe foreign body sensation (cant open eyes)
ciliary flush (around iris)
severe headache and nausea
corneal opacity

Question 8

if severe headache and nausea with eye problems think what? 2, worry about what?

Answer 8

cluster or glaucoma

glaucoma

Question 9

dry eye aka?

Answer 9

deratoconjunctivitis sicca

Question 10

vitamin A deficiency can do what?

Answer 10

cause dry eyes

Question 11

pinguecula? cause, tx?

pterygium

Answer 11

yellow, slightly raised growth on the conjunctiva, nasal side - usually from sun exposure, welding

tx - benign unless affect vision - need sx

pterygium- benign, triangular wedge of conjunctiva, nasal side, but extends laterally to cornea,

similar tx to pinguecula

Question 12

3 types of conjunctivitis - pink eye

infectious - which bacteria? vs non infectious

Answer 12

infectious - 1 bacterial and 2 viral
bacterial - s. pneumoia, s. aureas, h. influenza, gonorhea (refer)

viral - adenovirus

3 allergic/irritants, or think kawasaki

Question 13

diff btwn viral and bacterial pink eye - tx?

Answer 13

bacterial usually unilateral, crusting in AM, purulent, tender - erythromycin pointment QID 5-7days or polytrim drops QID 5-7 days

viral can progress to bilat within 48 hours, more tearing, usually clear mucous, burning, usually with URTI

Question 14

is suspect gonorhea, do what, at risk for what?

Answer 14

send to ER for iv abx

risk of corneal perforation

Question 15

episcleritis vs sceleritis

Answer 15

epi - resolves on own 3 weeks - topical nsaids, artificial tears - localized redness, no visual changes

scleritis - auto immune causing desctruction of sclera - usually with inflam of other organs - photophobia, pain, HA, edema, visual acuity changes

Question 16

Keratisis? s/s? what to do with it

3 causes

Answer 16

cornea inflammation - can lead to scarring and vision loss

similar s/s as sceleritis - refer

bacterial, viral - hvs and photokeratitis - uv exposure/ snow blindness/welders eye

Question 17

2 eye conditions usually seen with auto immune issues?

s/s of the latter?

what to do for both?

Answer 17

sceleritis

uveitis - inflam of uveal tract (btwn retina and sclera)
cilary flush - redness around iris - lymbic system
pain or visual acuity change

refer

Question 18

cataracts? dx? 2

tx? 4

Answer 18

lens dehydration and protein denaturation causes lense opacity, leading to partial or total blindness

dx slit lamp and reduce or absent red reflex

tx - glasses, illumination, sx, stop smoking, limit steroid use

Question 19

which vision loss is associated with glaucoma vs macular dengeration

Answer 19

glaucoma - peripheral vision loss

mac d - central vision loss

Question 20

2 types of glaucoma? which one more prevelant? more serious? look for and do what?

Answer 20

primary open angle - more prevelant

acute angle closure - more serious - pain, red eye, visaual changes, fixed dilated pupil, n/v- send to er or opthomology

Question 21

meds for glaucoma 4 types

Answer 21

bb - carteonol, timolol

a agonist - apracolidine, brimonidine

carbonic anhydrase inhibitors - brinzolamide

topical prostaglandin analouge - latanoprost

Question 22

2 types of mac degen? more prevelant?

Answer 22

dry - 90% of cases, slow progress loss of visual function

wet - 10% but 80% end with sudden severe vision losss

Question 23

amblyopia?
strabismus?

which one is common in retinoblastoma?
which one you can train? which one you cannot outgrow? gold standard to treat?

Answer 23

amblyopia - lazy eye, can be trained, gold standard - occlusion therapy

strabismus - misalignment - common in retinoblastoma, cannot outgrow, need sx

Question 24

Central Retinal Artery Occulsion aka? see what, do what?

Answer 24

stroke of eye - acute, painless loss of monocular vision, retinal pallor ,cherry spot at fovea, positive RAPD, send to ER

Question 25

which eye conditions common with MS, do what?

Answer 25

optic neuritis, - autoimmune- acute monocular vission loss, pain, worse with EOM, colour destatuation, send to ER