Conditions Flashcards
what is considered lid and adnexal disorders?
Hordeolum/Chalazion
blepharitis
contact dermatitis
herpers zoster opthalmicus (HZO)
preseptal and orbital cellulitis
dacryocystitis
inflammatory nodules in the eyelid caused by blockage of sebaceous glands +/- infection
hordeolum/chalazion
treatment for hordeolum/chalazion?
warm compresses +/- topical antibiotic drops/ ointment
typically self-limited
chronic inflammation of eyelid margin- often caused by staph?
blepharitis
delayed hypersensitivity to agents that come in contact with skin (eye drops, cosmetics)
contact dermatitits
reactivation of varicella zoster virus in V1 dermatomal distribution
Herpes zoster opthalmicus
what is a sign you should look out for with herpes zoster?
Hutchinson’s sign- rash on tip of the nose
treatment for contact dermatitis?
stop the offending agent
treatment for herpes zoster?
oral acyclovir or valacyclovir- rarely IV
what is the difference between preseptal cellulitis vs orbital cellulitis?
preseptal celluitis is an infection of the eylids and he soft tissue ANTERIOR to the orbital septum (pts have normal motility)
Orbital Cellulitis is an infection posterior to orbital septum- may begin as preseptal and is known as a medical emergency impaired ocular motility
what are symptoms of preseptal cellulitis?
eyelid edema and erythema
normal motility, pupils, visual acuity
what is a treatment of preseptal cellulitis?
systemic antibiotics, admission to hospital if sever case or young patient
what are symptoms of orbital cellulitis?
Lid edema and erythema
impaired ocular motility, proptosis (eye bulging), chemosis (eye irritation),
decreased vision, RAPD
what is a treatment of orbital cellulitis?
admission to hospital
emergent opthalmology consult
blood cultures
CT orbits,
IV antibiotics, +/- abscess drainage
what are some complications of orbital cellulitis?
optic nerve damage
meningitis
cavernous sinus thrombosis
what syndrome is most common in infants (delayed opening of nasolacrimal passage)
dacryocystitis
when does dacyocystitis appear in adults?
occurs when nasal passage is blocked by trauma, neoplasm, or inflammation
what is the treatment for dacryocystitis?
NLD massage in infants +/- antibiotics
antibiotics in adults
what disorders or conjunctival and scleral disorders?
conjunctivitis
subconjunctival hemorrhage (hyposphagma)
scleritis/ episcleritits
pinguecula and pterygia
what causes conjunctivitis? which is the most common?
bacterial, viral, allergic, chemical, autoimmune
*viral most common
what are signs and symptoms of bacterial conjunctivitis?
chemosis (eye irritation)
redness
pus
what is the treatment of bacterial conjunctivitis?
swab/culture
broad antibiotic drops (polytrim, ocuflox, ciloxan
how do you treat bacterial conjunctivitis that is caused by gonococcal infection?
systemic antibiotics and possible hospitalization
* this requires immediate referral
what are the signs and symptoms of viral conjunctivitis?
watery or mucoid discharge
often spreads to the other eye
upper respiratory infection
enlarged lymph nodes
what is viral conjunctivitis caused by? How should it be treated?
commonly caused by adenovirus, enterovirus
treatment is self-limited (should resolve in 7-10 days)
but you can use artificial tears, cool compress
what are symptoms of allergic conjunctivitis?
itching, chemosis, tearing
what are some treatment options of allergic conjunctivitis
Topical antihistamines or oral agent if there is a respiratory component
what are some disorders autoimmune conjunctivitis is associated with?
Grave’s connective tissue disease, vasculitides, sarcoidosis
what are symptoms of autoimmune conjunctivitis?
diffuse redness, orbitopathy
which eye disorder is often a result of sneezing, nose blowing, eye rubbing. Its also associated with use of antiplatelet agents and anticoagulation?
Subconjunctival hemorrhage
signs and symptoms of subconjunctival hemorrahage?
mild foreign body sensation but no vision changes
if there is a recurrent subconjunctival hemorrhage what should you evaluate for?
blood dyscrasias, hypertension
what are the signs and symptoms of episcleritis?
focal tenderness, redness, swelling, mild pain
what are the signs and symptoms of scleritis? what is scleritis usually associated with?
deep aching pain; redness, +/- scleral thinning
associated with systemic connective tisse disease (RA, Lupus)
vision threatening
what treatment is available for scleritis and episcleritis?
oral or topical NSAIDs for episcleritis
systemic immunosuppressants for scleritis
what is pinguecula and pterygia? what are the differences between the two? what are these disorders assocaited with
dysplatic conjunctiva
its called pterygium when it grows onto cornea)
associated with excess sun and wind exposue
signs and symptoms of pinguecula and pterygia?
sudden eye pain and redness when inflamed
what are treatments for pinguecula and pterygia?
artificial tears for comfort
+/- surgical excision of pterygium if visually significant
what are disorders of the cornea?
corneal abrasion
corneal ulcer
herpes keratitis
chemical injuries
dry eye
what are signs and symptoms of corneal abrasion?
severe pain
redness
tearing
light sensitivity
+/- blurred vision
what are diagnostic evaluations of corneal abrasion?
pain improves with proparacaine
epithelial defect stains with fluorescein
what treatments are available for corneal abrasion?
time
antibiotic ointment for comfort and prophylaxis
signs and symptoms of corneal foreign bodies?
pain
tearing
redness
photophobia
foreign body that stains with fluorescein
treatment of corneal foreign body?
removal with wet cotton tip
30g needle or burr
antibiotic drops for prophylaxis
if high speed injury refer for dilated exam
what disorder is a serious infection of the cornea? Could be a history of FB, trauma etc.?
corneal ulcer
what are signs and symptoms of corneal ulcer?
sever pain
redness
tearing
light sensitivity
blurred vision
white corneal infiltrate that stains with fluorescein
treatment of corneal ulcer?
scrapings and culture
intensive medical management with drops
+/- surgical intervention
what disorder is a ocular infection with herpes simplex virus involving corneal epithelium?
herpetic keratitis