Clinical Care - Eyes Flashcards
1
Q
Posterior Blepharitis may be bacterial infection, particularly due to what?
A
- Staphylococci
- Acne Rosacea
2
Q
What jas “redrimmed” granulations?
A
Anterior Blepharitis
3
Q
What results from inflammation of the Meibomian Glands?
A
Posterior Blepharitis
4
Q
What diagnosis may be ulcerative or srborrheic?
A
Anterior Blepharitis
5
Q
What is defined as the lid margin frequently rolled inward?
A
Entropion
6
Q
Initial treatment of Blepharitis?
A
Scrub eyelid margins twice daily with commercial eyelid scrub (Ocusoft) or baby shampoo on a washcloth.
7
Q
After scrubbing/washing the eye with a washcloth, what treatment would be performed next when treating Blepharitis?
A
Warm compress 10-15 minutes 1-2x/day
8
Q
What antistaphylococcal antibiotic is used in the treatment for Blepharitis?
A
Bacitracin
9
Q
What long-term treatment is used for Blepharitis?
A
- Tetracycline
- Erythromycin (Ery-tab)
- Azithromycin
10
Q
What is an acute infection that usually involves Staphylococcus and is painful?
A
Hordeolum
11
Q
What is an abscess of the gland of Zeis?
A
External Hordeolum
12
Q
What is an abscess of the meibomian gland?
A
Internal Hordeolum
13
Q
What is a chronic focal granulomatous inflammation within the eyelid secondary to the obstruction of a meibomian gland or gland of Zeis?
A
Chalazion
14
Q
What presents with localized eyelid tenderness, swelling, erythema, and “pointing” of a mucopurulent material?
A
Hordeolum
15
Q
What diagnosis is associated with Blepharitis or Acne Rosacea?
A
Hordeolum
16
Q
What diagnosis has a hard and nontender nodule on the eyelid?
A
Chalazion
17
Q
Does the Hordeolum or Chalazion develop further back on the eyelid?
A
Chalazion
18
Q
What can result from leaving makeup on overnight, using old or expired cosmetics, or has Blepharitis?
A
Hordeolum or Chalazion
19
Q
Intial treatment for Hordeolum or Chalazion?
A
Warm compress x15 minutes four times a day
20
Q
If there is a concern of a patient developing periorbital cellulitis, what treatment is warranted?
A
- Antibiotic treatment
- Bactrim
21
Q
What is the initial care of a Hordeolum or Chalazion?
A
Warm compress x48 hours
22
Q
When treating a Hordeolum or Chalazion. What is the next step of treatment if a warm compress does not improve symptoms?
A
Antibiotic ointment
23
Q
What happens if after 48 hours of antibiotic ointment does not improve a sty?
A
Referral to Ophthalmology for I&D
24
Q
What complication is present with Hordeolum or Chalazion?
A
Periorbital Cellulitis
25
What conjunctiva coats the INSIDE of the eyelids?
Palpebral
26
What conjunctiva protects the ANTERIOR surface (except the cornea)?
Bulbar (or ocular)
27
Is there vision loss with Conjunctivitis?
No
28
What is the most common cause of VIRAL CONJUNCTIVITIS?
Adenovirus
29
What type of Conjunctivitis is bilateral?
Allergic
30
What type of Conjunctivitis is unilateral?
Bacterial (nongonococcal)
31
What are some common causes of Bacterial Conjunctivitis (nongonococcal)?
- Staphylococcus Aureus
- Staphylococcus Epidermidis
- Moraxella Catarrhalis
32
What is usually acquired through contact with infected genital secretions?
Bacterial Conjunctivitis (Gonococcal)
33
What type of Conjunctivitis is an ophthalmologic emergency because it may rapidly lead to perforation?
Bacterial Conjunctivitis (Gonococcal)
34
What presents with itching, burning, tearing, gritty or foreign body sensation; Hx of recent URI?
Viral Conjunctivitis
35
What presents with itching and WATERY DISCHARGE?
Allergic Conjunctivitis
36
What diagnosis has signs of chemosis (swollen conjunctiva)?
Allergic Conjunctivitis
37
What presents with discharge and complaints of having to wipe purulent exudate in the morning
Bacterial Conjunctivitis (Nongonococcal)
38
What has the critical signs of a purulent white-yellow discharge?
Bacterial Conjunctivitis (Nongonococcal)
39
What has the critical signs of severe purulent discharge and a hyperacute onset typically within 12-24 hours?
Bacterial Conjunctivitis (Gonococcal)
40
What differential diagnoses are associated with Conjunctivitis?
- Acute uveitis
- Foreign Body
- Chlamydial Keratoconjunctivitis
41
How do you treat MILD VIRAL CONJUNCTIVITIS?
ARTIFICIAL TEARS
42
How do you treat MODERATE VIRAL CONJUNCTIVITIS?
EPINASTINE (elestat)
43
What is the first thing you do for SEVERE VIRAL CONJUNCTIVITIS?
Consult ophthalmology BEFORE giving steroids.
44
What is the treatment for MILD ALLERGIC CONJUNCTIVITIS?
Artificial tears
45
What is the treatment for MODERATE ALLERGIC CONJUNCTIVITIS?
Antihistamine
46
What is the treatment for BACTERIAL CONJUNCTIVITIS (non-contact AND non-gonococcal)?
Erythromycin
47
What is the treatment for BACTERIAL CONJUNCTIVITIS (non-gonococcal) for a topical antibiotic?
Trimethoprim
48
What is the treatment for BACTERIAL CONJUNCTIVITIS contact wearers (non-gonococcal)?
Ciproflaxacin
49
What is the treatment for associated dacryocystitis using system antibiotics?
- Amoxicillin/Clavulanate (Augmentin)
- Cephalexin
50
What is the treatment for BACTERIAL CONJUNCTIVITIS (gonococcal)?
Ceftriaxone PLUS Azithromycin
51
What is used if a patient being treated for BACTERIAL CONJUNCTIVITIS (gonococcal) has a penicilin/cephalosporin allergy?
Gentamicin
52
There's a high risk of developing what ?with BACTERIAL CONJUNCTIVITIS (gonococcal)
Corneal perforation
53
A cool compress is the initial care of what type of CONJUNCTIVITIS?
Viral
54
What presents with red eye, foreign body sensation, is usually asymptomatic, and has blood often in one sector of the eye?
Conjunctival Hemorrhage
55
What labs/studies are ordered for Conjunctival Hemorrhage?
- Complete eye exam
- Lab bleeding studies (if recurrent)
- CT/MRI (IF ORBITAL SIGNS ARE PRESENT)
56
What is the treatment for a Conjunctival Hemorrhage?
- None required (clears spontaneously)
- Artificial Tears (for irritation)
57
What diagnosis is related to sunlight exposure, chronic inflammation, and oxidative stress?
Pterygium
58
What is a degeneration of fibrovascular, deep conjunctival layers resulting in vascular tissue proliferation?
Pterygium
59
What presents with irritation, redness, descreased vision, and may be asymptomatic?
Pterygium
60
What has the critical sign of a wing-shaped fold of fibrovascular tissue?
Pterygium
61
What lab/studies are used for Pterygium?
Slit Lamp
62
What is the treatment for Pterygium?
- Protect eyes (UV blocking)
- Artificial tears
63
What is the treatment for MILD Pterygium?
Artificial tears
64
What is the treatment for MODERATE to SEVERE Pterygium?
- Corticosteroids
- NSAID
65
When is a surgical removal indicated for Pterygium?
- The Pterygium threatens the visual axis or induces significant astigmatism.
- Prior to cataract or refractive surgery.
66
How can a ocular foreign body present?
Superficially or Partially embedded
67
What presents with the symptoms of a foreign body sensation, tearing, and a history of trauma?
Ocular Foreign Body
68
What has the signs of a conjunctival injection, eyelid edema, mild AC reaction, and SPK?
Ocular Foreign Body
69
What CRITICAL SIGN presents with Ocular Foreign Body?
Rust Ring
70
What may present with or without a "Rust Ring?"
Ocular Foreign Body
71
What lab/study is performed for a Ocular Foreign Body after open globe is ruled out?
Fluorescein Staining
72
What lab/studies are performed for Ocular Foreign Body?
- History
- Fluorescein Staining
- Slit Lamp
- Dilate + Examine
- US or CT
73
How should a Ocular Foreign Body be removed?
- Saline Irrigation
- Foreign Body Spud
- Cotton-tipped Applicator
- Fine Forceps
74
What medication is used to treat Non-contact lens wearers with an Ocular Foreign Body?
Erythromycin
75
What medication is used to treat Contact lens wearers with an Ocular Foreign Body?
- Ciprofloxacin (ointment or ophthalmic)
- Artificial Tears
76
What is the next step if unable to remove a foreign body with irrigation or swab?
Consult MO, Optometry, or Ophthalmology
77
What SHOULD NOT be attempted when treatment Ocular Foreign Body?
Removal with a needle
78
When can a contact lens wearer reutrn to wearing their contacts after being treated for Ocular Foreign Body?
After the eye feels normal for a week
79
What is a complication of Ocular Foreign Body?
Corneal Ulcer
80
What is the healing time for corneal abrasions?
24 to 48 hours
81
What presents with severe pain, tearing, and photophobia?
Corneal Abrasion
82
What may present with a history of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens)?
Corneal Ulcer
83
What labs/studies are performed for a Corneal Abrasion?
Slit Lamp
84
What is the treatment for Non-Contact Lens Wearers with a Corneal Abrasion?
- Antibiotic ointment (ERYTHROMYCIN)
- Antibiotic drops
85
What is the treatment for Contact Lens Wearers with a Corneal Abrasion?
Fluoroquinolone drops (CIPROFLOXACIN)
86
What other treatment is performed for a Corneal Abrasion aside from antibiotics?
- Topical (NSAID) drops
- Pain Management (Tylenol +/or NSAIDS)
- Debride loose or hanging epithelium
87
What should a contact lens wearer with a Corneal Abrasion NOT DO?
Wear contacts for 1 week
88
When should Non-Contact Lens Wearers follow up?
In 24 hours
89
When can a patient with a Corneal Abrasion continue wearing their contacts?
After the eye feels normal for a week
90
Corneal Ulcer is also known as what?
Infectious Keratitis
91
What is the biggest risk factor for a Corneal Ulcer?
Improper contact lens use
92
What are 3 types of causative organisms for a Corneal Ulcer?
- Bacteria
- Virus
- Fungi
93
What bacteria can cause a Corneal Ulcer?
- Pseudomonas
- Strep
- Staph
- Moraxella
94
What virus can cause a Corneal Ulcer?
- Herpes Simplex
- Varicella Zoster
95
What fungi can cause a Corneal Ulcer?
- Penicillium
- Cephalosporium
96
What presents with erythema and edema of lids, conjunctivae, discharge, OCULAR PAIN or FOREIGN BODY SENSATION, PHOTOPHOBIA, and bluerred vision?
Corneal Ulcer
97
What may present with decreased visual acuity, cornea that is round or ireggular opacity or infiltrate, and is central in location?
Corneal Ulcer
98
What can a Corneal Ulcer present with in severe cases?
Hypopyon
99
What is a hypopyon?
A white and hazy base that is due to WBC infiltration
100
What will a fluorescein stain reveal for a Corneal Ulcer?
Epithelial defects
101
What topical antibiotic is used to treat a Corneal Ulcer?
- Ciprofloxacin drops
- Fluoroquinolone
102
After giving topical antibiotics to a patient with a Corneal Ulcer, what is done next?
- Refer to ophthalmologist within 12-24 hours
- MEDEVAC
103
What instructions are provided to a patient with a Corneal Ulcer?
Stop wearing contacts until cleared by optometry or ophthalmology
104
What complication is present with a Corneal Ulcer?
Corneal Scarring / Perforation
105
Aqueous Humor is completed replaced every how often?
90 minutes
106
What is an accumulation of RBC's within the anterior chamber?
Hyphema
107
Where does a Hyphema occur?
Between the cornea and the iris
108
What is the MOST COMMON risk factor for a Hyphema?
- Trauma
- Recent Ocular Surgery
109
What would present with pain, light sensitivity, blurred clouded or blocked vision, and a history of blunt trauma?
Hyphema
110
What has a differential of inflammatory / infectious hypehmia (herpetic uveitis)?
Hyphema
111
What has a differential diagnosis of a ruptured globe and penetrating ocular injury?
Hyphema
112
What lab/studies are performed for a patient diagnosed with a Hyphema?
- Complete eye exam
- CT scan
113
What immediate action is taken for a patient with a Hyphema?
Referral to Ophthalmology or Optometry
114
What is the treatment for a patient with a Hyphema after a consult has been placed?
- Bed rest
- RIGID SHIELD
- Avoid anti platelet/coagulents
- Mild analgesic (Tylenol)
115
After a Hyphema patient has their initial follow-up, what may be used to maintain a long-acting treatment?
Cycloplegic agent (Atropine)
116
