70 opth Flashcards
two testing can be useful in certain cases in the decision to recommend or not recommend cataract surgery.
Glare testing and potential acuity testing
Blepharitis
4 L’s to assess
tx for this? 3 abx 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
hordeulum aka? usually what bacteria?
stye - acute inflammation of eyelid - meibomian tear duct as well - s. aureus
Chalazion?
obstruction of meibomian tear gland - usually bigger than stye, usually not bacteria
preseptal cellulitis? tx? suspect which bact?
if under one year old?
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
orbital celluitis? seen in what pts? 3
causes?
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
Red flags for eye issues? 8
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
if severe headache and nausea with eye problems think what? 2, worry about what?
cluster or glaucoma
glaucoma
dry eye aka?
deratoconjunctivitis sicca
vitamin A deficiency can do what?
cause dry eyes
pinguecula? cause, tx?
pterygium
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
3 types of conjunctivitis - pink eye
infectious - which bacteria? vs non infectious
infectious - 1 bacterial and 2 viral
bacterial - s. pneumoia, s. aureas, h. influenza, gonorhea (refer)
viral - adenovirus
3 allergic/irritants, or think kawasaki
diff btwn viral and bacterial pink eye - tx?
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
is suspect gonorhea, do what, at risk for what?
send to ER for iv abx
risk of corneal perforation
episcleritis vs sceleritis
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
Keratisis? s/s? what to do with it
3 causes
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
2 eye conditions usually seen with auto immune issues?
s/s of the latter?
what to do for both?
sceleritis
uveitis - inflam of uveal tract (btwn retina and sclera)
cilary flush - redness around iris - lymbic system
pain or visual acuity change
refer
cataracts? dx? 2
tx? 4
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
which vision loss is associated with glaucoma vs macular dengeration
glaucoma - peripheral vision loss
mac d - central vision loss
2 types of glaucoma? which one more prevelant? more serious? look for and do what?
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
meds for glaucoma 4 types
bb - carteonol, timolol
a agonist - apracolidine, brimonidine
carbonic anhydrase inhibitors - brinzolamide
topical prostaglandin analouge - latanoprost
2 types of mac degen? more prevelant?
dry - 90% of cases, slow progress loss of visual function
wet - 10% but 80% end with sudden severe vision losss
amblyopia?
strabismus?
which one is common in retinoblastoma?
which one you can train? which one you cannot outgrow? gold standard to treat?
amblyopia - lazy eye, can be trained, gold standard - occlusion therapy
strabismus - misalignment - common in retinoblastoma, cannot outgrow, need sx
Central Retinal Artery Occulsion aka? see what, do what?
stroke of eye - acute, painless loss of monocular vision, retinal pallor ,cherry spot at fovea, positive RAPD, send to ER
which eye conditions common with MS, do what?
optic neuritis, - autoimmune- acute monocular vission loss, pain, worse with EOM, colour destatuation, send to ER
