Assessment/DDx Cards (AED) - less obvious ones Flashcards
.Name, how would you assess? (2)
Naevus: Benign ocular pigmented lesion
FAT and photos for yearly review
Name, How would you assess? (3)
Congenital melanocytosis
FAT, photos, DFE check for choroidal melanoma
Name, Ax (4)
Primary Acquired Melanosis (PAM):
FAT, photos of small lesions - monitoring for change; Biopsy if indicated (e.g. at limbus, corneal involvement, overgrowth in one eye); Check motility (like with all lumps/bumps really, you get the point)
Name, Ax (1)
Kaposi’s sarcoma:
Look for multiple lesions, lid eversions/gazes
Name, Ax (5)
Sturge-Weber Syndrome
SL
Lid eversion
IOP
Gonio
DFE
.Name, Ax (1)
Cyst of Moll/sweat glands
Ax: direct slit lamp
Name, Ax (1)
Cyst of Zeis Gland - Opaque lesion
Ax: Direct slit lamp
Name, ax (5)
Stye/Hordeolum
Ax:
VA
Touch (tender, firm, mobile)
Slit lamp (lid eversion, NaFl)
Size
Photodocuments
Name, ax (1)
Chalazion
Ax:
Rule out sinister lesion (e.g. sebaceous gland carcinoma) (with biopsy presumably)
Name, ax (1)
Sebaceous gland carcinoma
Ax: biopsy to check for ddx
Name, ax (2)
Molluscum contagiosum
Check eyebrows
Ensure no lymphadenopathy
name, ax (1)
Keratoacanthoma
Biopsy of keratin core
Name, ax (1)
Xanthelasma
Ax: assess systemic lipid profile
Solar or Actinic Keratosis: how do you assess? (2)
Photos to look for change
Biopsy for signs of malignancy
Name, Ax (4)
Neurotrophic keratopathy
Ax:
Identify underlying cause
Hx, SL (incl. lids), NaFl, wratten filter
Tear workup
Corneal sensitivity test - poke eye with cotton bud (compare with good eye)
Name, Ax (3)
Bullous Keratopathy:
Identify underlying cause
Hx, SL (incl. lids), NaFl, wratten filter
Specular microscopy
Name, Ax (5)
Marginal Keratitis
Hx, SL, NaFl, Lids, Anterior Chamber
Name, ddx (4), Ax (1)
Mooren’s ulcer
ddx:
Other peripheral ulcerative change (RA, Wegener’s)
Microbial keratitis
HSV limbitis
HZV
Ax: Establish if peripheral cornea vascularisation is old, new or significant
What’s this? Ax (1)
Vortex Keratopathy
Determine cause (full ocular examination incl dilation, if suspected to be drug induced)
What is this? How do you assess? (6)
Ecchymosis
Hx for precipitating event (e.g. trauma, HTN, haemophillia, physical stress, drugs)
Slit lamp (AC and internal exam depending on hx)
Ensure there is an edge to the bleed
If no edge –> refer for scan
Worst case scenario = bleeding into cavernous sinus
Pupils, eye movements, IOP (depending on hx), BP
What’s this condition called? How can you assess? (6)
Superior limbic keratoconjunctivits
Hx (recurrent events, thyroid symptoms, CL wear)
Slit lamp (effron grading), incl. lid eversion + fluoroscein
Lid eversion will show inflamed superior limbus + changes to bulbar and palpebral conj
Can be diagnosing feature of thyroid disease
Dry eye workup
Document
What’s this? How can you assess? (3)
Bacterial conjunctivitis
Slit lamp + fluorescein, evert lids
Document
Conjunctival swab if severe
What’s this? How can you assess? (2)
Bacterial Conjunctivitis (gonococcal)
Slit lamp/lids
Conjunctival swab + lab analysis = ESSENTIAL (important to exclude for corneal involvement)
What’s this? What differential diagnosis exist for this? (4)
Pharynogoconjunctival fever (PCF)
DDx: EKC, Molluscum contagiosum conjunctivitis, Allergic conjunctivitis, Topical drug hypersensitivity
What’s all this? What differential diagnoses exist for this? (3)
Trachoma
DDx: AIC, Other causes of conjunctival cicatrisation, Other causes of superior corneal pannus
Name, What ddx exist for this? (3)
Adult inclusion conjunctivitis (AIC)
DDx: Adenoviral keratoconjunctivitis, Herpes simplex keratitis, Trachoma
Name, what ddx exist for this? (4)
Anterior blepharitis
DDx:
Posterior blepharitis
Trachoma - differentiate by no scarring on inner lid
Basal, squamous or sebaceous cell carcinoma
Dry eye syndrome
What’s this? How can you assess? (2)
Posterior blepharitis
Ax: as for anterior bleph (slit lamp incl. lid margins ocular surface with fluorescein, symptomalogy, skin assessment as well as gland expression
