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CMN 568 > Ch. 7 Adult Eye/Lid Disorders (E1) > Flashcards

Ch. 7 Adult Eye/Lid Disorders (E1) Flashcards

1
Q

Acute infection caused by staph aureus.
s/s: localized red, swollen, acutely tender are on the upper and lower lid

A

Hordeolum

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2
Q

Abscess of the gland of Zeis

A

External Hordeolum (stye)

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3
Q

How do you treat a hordeolum?

A

Warm compresses and antibiotic ointment (bacitracin or erythromycin) to the lid

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4
Q

Common granulomatous inflammation of the a meibomian gland that may follow an internal hordeolum

A

Chalazion

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5
Q

s/s: hard, nontender swelling on the upper and lower lid with redness and swelling of the adjacent conjunctiva

A

Chalazion

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6
Q

common chronic bilateral inflammatory condition of the lid margins, commonly caused by conjunctivitis

A

Blepharitis

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7
Q

s/s red-rimmed eyes and scales or collarette (dandruff) clinging to lashes
(often involves the lid skin, eyelashes, and associated glands. can be ulcerative or seborrheic)

A

Anterior blepharitis

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8
Q

anterior blepharitis treatment

A

eyelid hygiene (scrub w/ baby shampoo/massage)
Antibiotic ointment (bacitracin/erythromycin)
Warm compresses

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9
Q

s/s:
lid margins are rolled inward (mild entropion)
tear film may be frothy or abnormally greasy
hyperemic lid margins (inflammation of the eye lid)

A

posterior blepharitis

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10
Q

treatment of posterior blepharitis with inflammation of the conjunctiva and cornea

A

low-dose oral antibiotic therapy for 2-4 weeks
(tetracycline, doxycycline, minocycline, erythromycin, azithromycin)

Topical corticosteroids (prednisolone) and topical antibiotics (Ciprofloxacin) for 5-7 days

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11
Q

inward turning of the lower lid

A

Entropion

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12
Q

Outward turning of the lower lid

A

Extropion

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13
Q

Infection of the lacrimal sac usually due to congenital or acquired obstruction of the nasolacrimal system

A

Dacrocystitis

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14
Q

s/s
- pain, swelling, tenderness, and redness in the tear sac area
- purulent material can be expressed

A

Acute dacrocystitis

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15
Q

Acute dacrocystitis treatment

A

PO Augmentin, cephalexin, cipro, clindamycin, or triemethoprim-sulfamethoxazole

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16
Q

Inflammation of the mucois membrane that lines the surface of the eyeball and inner eyelids

A

Conjunctivitis

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17
Q

how is conjunctivitis transmitted

A

-direct contact of contaminated objects
-respiratory secretions
- contaminated eye drops

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18
Q

s/s
-watery eye discharge
- follicular conjunctivitis

A

Viral conjunctivitis

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19
Q

what treatment is DISCOURAGED with viral conjunctivitis

A

topical antibiotic and steroids

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20
Q

treatment of viral conjunctivitis

A

frequent hand and linen hygiene

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21
Q

s/s
-purulent eye discharge and eyelid matting
-blurring of vision and mild discomfort

A

bacterial conjunctivitis

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22
Q

why is gonococcal conjunctivitis an emergency

A

cornea perforation

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23
Q

treatment of gonococcal conjunctivitis

A
  • 500mg IM ceftriaxone (if pt weighs >150kg, give 1g)
  • topical antibiotics (bacitracin/erythromycin)
  • irrigate eye with saline
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24
Q

how is gonococcal conjunctivitis confirmed

A

gram stain and culture of discharge

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25
Q

treatment of Chlamydial keratoconjunctivitis – Trachoma

A

single dose of Azithromycin 1g

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26
Q

eye infection after contact with secretions infected with chlamydia

A

inclusion conjunctivitis

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27
Q

treatment of chlamydial keratoconjunctivitis – Inclusion conjunctivitis

A

Doxycycline 100 PO BID x 7days

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28
Q

test used to diagnose dry eyes

A

Schirmer test – measures the rate of production of the aqueous component of tears

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29
Q

s/s –EYES
itching, tearing, redness, stringy discharge, and ocassional photophobia

A

allergic eye disease

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30
Q

s/s EYES
-conjunctival hyperemia
-chemosis (edema)

A

Allergic conjunctivitis

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31
Q
  • occurs late in childhood and early adulthood
  • more common in the spring
  • s/s: large “cobblestone” papillae and possible follicles at the lumbus
A

Vernal conjunctivitis

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32
Q
  • chronic disorder of adulthood
  • s/s: upper and lower tarsal conjunctivas exhibit a papillary conjunctivitis
A

atopic keratoconjunctivitis

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33
Q

treatment for mild to moderately severe allergic eye disease

A

Mast cell stabilizers (Cromolyn)
Antihistamines (topical/systemic)

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34
Q

Yellowish, elevated conjunctival nodule in the area of the palpeable fissure

A

pinguecula

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35
Q

fleshy, triangular encroachment of the conjunctiva onto the cornea

A

Pterygium

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36
Q

pterygium is typically associated with __

A

prolonged exposure to wind, sun, sand, or dust

37
Q

corneal ulcers are most commonly due to

A

infections by bacteria, fungi, viruses, or amoebas

38
Q

delayed or ineffective treatment of corneal ulceration may lead to

A

corneal scarring and possible intraocular infection

39
Q

s/s
eye pain, photophobia, tearing and reduced vision, purulent or watery discharge

A

corneal ulcer

40
Q

acute painful red eye and corneal abnormality requires ___

A

emergent referral

41
Q

contact lens wearers with acute eye pain, redness, and decreased vision require ___

A

prompt referral

42
Q

s/s white spot on direct visualization

A

bacterial keratitis

43
Q

Tx of bacterial keratitis

A

emergent referral and topical fluroquinolones (levofloxacin, ofloxacin, norfloxacin, ciprofloxacin)

44
Q

Treatment of herpes simplex keratitis

A

topical antiviral (ganciclovir)
oral antiviral (acyclovir / valacyclovir)

45
Q

herpes zoster ophthalmicus– what predicts involvement of the eye

A

involvement of the tip of the nose or the lid margin

46
Q

s/s
- malaise, fever, headache, and periorbital burning or itching
- vesicular rash
- conjunctivitis, keratitis, episcleritis, and anterior uveitis
- possible elevated intraocular pressure

A

Herpes zoster ophthalmicus

47
Q

tx of herpes zoster ophthalmicus

A

acyclovir 800mg 5times/day
valacyclovir 1g TID x7-10 days
Famciclovir 500 TID x7-10 days

48
Q

s/s
corneal infiltrate that may have feathery edges and multiple “satellite lesions”

A

fungal keratitis

49
Q

treatment of fungal keratitis

A

Topical: Natamycin, amphoteracin, voriconazole

50
Q

s/s
- rapid onset of extreme pain and blurred vision (halos around lights)
- red eye, cloudy cornea, dilated pupil
- Nausea and abdominal pain
- hard eye on palpation – elevated intraocular pressure >50

A

Acute Angle-Closure Glaucoma

51
Q

Tx of acute angle-closure glaucoma

A

Emergent referral
Acetazolamide 500mg IV x1, then 250PO QID with topical timolol (to lower intraocular pressure)

52
Q

tx of chronic glaucoma

A

Prostaglandin analog gttps

53
Q

intraocular inflammation

54
Q

sudden redness and blurry vision often with photophobia

A

Acute anterior Uveitis

55
Q

gradual loos of vision, commonly with floaters and retinal lesions

A

posterior uveitis

56
Q

pupil is small, poorly reactive, and irregularly shaped with development of posterior synechiae

A

Nongranulomatous anterior uveitis

57
Q

presents acutely with unilateral pain, redness, photophobia, and Vision loss

A

Nongranulomatous anterior uveitis

58
Q
  • sometimes presents with iris nodules
  • large “mutton fat” keratic precipitates
A

granulomatosis anterior uveitis

59
Q

treatment of anterior uveitis

A

topical corticosteroids

60
Q

when do you refer a patient with uveitis

A

acute uveitis: visual loss or severe pain
chronic: more than mild visual loss

61
Q

gradually progressive blurred vision
no pain or redness
lens opacities

62
Q

when do you refer a patient with cataracts

A

ADLS are affected by vision impairment

63
Q

rapid loss of vision– “curtain” spreading across visual field
No pain or tenderness
increase of floaters and photopsia (flashes of light)

A

Retinal detachment

64
Q

c/o sudden visual loss, abrupt onset of floaters that may progressively increase in severity or occasionally “bleeding into the eye”

A

Vitreous hemorrhage

65
Q

Hallmark sign of age-related macular degeneration

A

Drusen – hard discrete yellow subretinal deposits

66
Q

Gradual progressive bilateral visual loss due to decreased blood supply to both the outer retina and the retinal pigment epithelium

A

Dry age-related macular degeneration

67
Q

-rapid onset of visual loss
- both eyes can be equally affected over a few years
- Cased by choroidal new vessels growing under either the retina or the retinal pigment epithelial cells –> accumulation of exudative fluid, hemorrhage, and fibrosis.

A

Wet age-related macular degeneration

68
Q

Sudden monocular loss of vision
no pain or redness
widespread or sectoral retinal hemorrhages

A

retinal vein occlusions

69
Q

sudden monocular loss of vision
no pain or redness
“island of vision” in the temporal field
pale retinal swelling w/ cherry-red spot at the fovea

A

central retinal artery occlusion

70
Q

sudden loss of vision
sudden loss of a discrete area in the visual field in one eye
fundus signs of retinal swelling

A

branch retinal artery occlusion

71
Q

which diabetic patients require urgent referrals

A

sudden loss of vision or retinal detachment
proliferative retinopathy or macular involvement
severe nonproliferative retinopathy
unexplained reduction of visual acuity

72
Q

__ are the hallmark of hypertensive crisis with retinopathy that requires emergency treatment

A

fundus amormalities

73
Q

sudden visual loss, usually with an altitudinal field defect and optic disk swelling with pallor

A

anterior ischemic optic neuropathy

74
Q

may occur with severe blood loss, nonocular surgeries, severe burns, HD (severe HoTN and anemia)

does not cause optic swelling

A

Posterior ischemic optic neuropathy

75
Q
  • Subacute, usually unilateral, visiual loss
  • pain exacerbated by eye movements (pain behind eye)
  • optic disk swelling is usually normal in acute stage but develops pallor
  • color vision loss
A

Optic neuritis

76
Q

__ is strongly associated with demyelinating disease

A

optic neuritis

77
Q

optic disk swelling due to raised intracranial pressur

A

papilledema

78
Q

treatment for papilledema in patients with with idiopathic intracranial hypertension or transverse venous sinus stenting

A

Acetazolamide

79
Q

palsy of any of the 3 cranial nerves can cause

A

double vision

80
Q
  • ptosis with a divergent and slightly depressed eye
  • lateral extraocular movements only
  • dilated pupil that doesn’t restrict to light
A

third nerve palsy

81
Q

-upward deviation of the eye with failure of decompression on adduction
- vertical and torsional diplopia that is most apparent when looking down

A

fourth nerve palsy

82
Q
  • Convergent squint in the primary position with failure of abduction of the affected eye, producing horizontal diplopia that increases on gaze to the affected side and n looking into the distance
  • important sign of Increased ICP
A

sixth nerve palsy

83
Q

s/s
fever
proptosis
restriction of extraocular movements
swelling with redness of the lids

A

Orbital cellulitis

84
Q

Corneal abrasion treatment

A

bacitracin-polymyxin ointment or drops
Fluoroquinolone topical ointment for contact wearers

85
Q

treatment for moderate to severe chemical conjunctivitits

A

topical corticosteroids and topical and systemic vitamic C

86
Q

pupillary dilation can potentially precipitate

A

acute glaucoma

87
Q

what is a potential complication of treating infectious keratitis with corticosteroids

A

possible perforation of the cornea

CMN 568 (3 decks)

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