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eye > corneal disorders > Flashcards

corneal disorders Flashcards

1
Q

transparent outermost layer of the eye that covers the pupil and iris and allows light to enter the eye

A

cornea

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2
Q

opacities of the lens – usually bilateral

cloudy

leading cause of blindness worldwide

A

cataracts

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3
Q

cataracts MC cause

A

age related

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4
Q

cataracts other causes

A

congenital (from intrauterine infections such as rubella) (errors of metabolism)

topical, systemic, or inhaled corticosteroid treatment

radiation exposure

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5
Q

cataracts risk factors

A

> 60 years of age
cigarette smoking

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6
Q

progressive blurring of vision

glare (especially in bright light or with night driving)

change of focusing (development of nearsightedness)

can be seen on exam with dilated pupil even when it is small

as it progresses the funds loses its reflex and pupil appears white

A

cataracts clinical findings

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7
Q

cataracts treatment

A

refer to ophthalmology (not emergent)

lens replacement*

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8
Q

scratch or injury to the surface of the cornea

A

corneal abrasion

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9
Q

corneal abrasion causes

A

trauma
foreign bodies
contact lens (over worn, improperly fitting, improperly cleaned)

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10
Q

corneal abrasion presentation

A

severe pain
photophobia
foreign body sensation

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11
Q

what to do first on a corneal abrasion exam

A

check visual acuity before tetracaine or fluorescein

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12
Q

corneal abrasion: patient will be in severe pain. what to use to anesthetize

A

tetracaine

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13
Q

what exam to do with corneal abrasion

A

lid inversion with q tip to r/o foreign body

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14
Q

why should you be cautious with tetracaine

A

toxic to epithelium and can slow healing which increases risk of corneal infection and scarring

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15
Q

what exam to do with corneal abrasion if you are not certain

A

fluorescein stain
(defect will light up green)

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16
Q

corneal abrasion treatment

A

bacitracin- polymyxin/erythromycin ophthalmic ointment (antibiotic and lubricant)

oral NSAIDS/topical NSAIDS

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17
Q

corneal abrasion treatment for contact lenses (pseudomonas)

A

don’t wear contacts for 1 week

ciprofloxacin or other fluoroquinolone eye drops

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18
Q

what should you not use with corneal abrasion

A

antibiotic drops with steroids

reduce host resistance to superinfection and may make missed diagnosis of HSV, epithelial keratitis, or microbial keratitis worse

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19
Q

what should you not send the patient home with in corneal abrasion that they may ask for

A

tetracaine

causes delayed healing

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20
Q

treatment for large corneal abrasions > 50%

A

cycloplegic drops
(dilate eye to reduce pain)

patching

21
Q

defect in the corneal epithelium
crater, open sore

A

corneal ulcer

22
Q

corneal ulcer usually due to

A

infection
long term contact lens use

can be due to conditions that lead to persistent eye irritation

23
Q

corneal ulcer delay/ failure to treat can lead to

A

scarring or intraocular infection

24
Q

what can you expect to see with corneal ulcer

A

irregular border and hazy
pain
photophobia
tearing
reduced vision
corneal injection
may have discharge
corneal abnormality

25
Q

corneal ulcer treatment

A

refer emergently to ophthalmology

most likely will have you initiate antibiotics with close follow up

26
Q

what to do with foreign body on cornea

A

check vision *

remove with sterile wet cotton tipped applicator or with 25G needle

bacitracin-polymyxin/erythromycin opthalmic ointment

27
Q

what to do if foreign body cornea cannot be removed or corneal infection is suspected

A

send to ophthalmology right away

28
Q

foreign body intraocular usually affects those who

A

work with metal
high speed injury

28
Q

if no corneal FB is seen but there appears to be a wound

if there is visual loss or media opacity

deeper than cornea

A

foreign body intraocular

29
Q

what to do with foreign body intraocular

A

emergent referral to ophthalmology

30
Q

keratitis bacterial MC pathogens

A

staphylococci
streptococci
pseudomonas aeruginosa
moraxella species

30
Q

infection of the cornea

corneal opacity or infiltrate with red eye, photophobia, and foreign body sensation

agressive

often have purulent discharge

A

keratitis bacterial

31
Q

keratitis bacterial affects who

A

usually contact lens wearers

overnight use
sometimes after trauma

32
Q

how to make keratitis bacterial diagnosis

A

seeing the opacity (usually it is > 0.5 mm) with the other symptoms
- red eye
- photophobia
- foreign body sensation

hypopyon*

33
Q

keratitis bacterial treatment

A

needs to see ophthalmology emergently

topical antibiotic usually under direction of ophthalmology, usually fluoroquinolone given hourly

34
Q

what to avoid in keratitis bacterial

A

NO steroid drops
stop wearing contacts

35
Q

herpes simplex (HSV)

red eye, photophobia, foreign body sensation, and watery discharge

primary infection may affect lid, conjunctiva, and cornea

dendritic lesion is characteristic manifestation (seen with fluorescein)

A

keratitis viral

36
Q

keratitis viral treatment

A

self limited

antivirals and topical corticosteroids (to reduce duration of treatment)

refer to ophthalmologist

37
Q

the virus in keratitis viral recurrence can colonize the __________ and recur

A

trigeminal ganglion

  • fever
  • exposure to sunlight
  • immunodeficiency
38
Q

keratitis viral recurrence can be stroll risk for

A

corneal scarring

39
Q

occurs after corneal injury involving plant material or in an agricultural setting

occurs in eyes with chronic ocular surface disease and in contact lens wearers

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

A

keratitis fungal

40
Q

does pinguecula get larger

A

rarely, but may get pingueculitis

40
Q

keratitis viral diagnosis often ________ and treatment _________

A

delayed, difficult

41
Q

degenerative and benign lesion

yellow nodule on the conjunctiva, usually on nasal side (contain fat, protein, calcium)

common over the age of 35

usually bilateral

A

pinguecula

42
Q

pinguecula treatment

A

no treatment is required but artificial tears may help

topical anti-inflammatories may be needed

43
Q

fleshy triangular conjunctival tissue that grows on to the cornea, the nasal side

usually bilateral

A

pterygium

44
Q

what is pterygium associated with

A

long term exposure to wind, sun, sand, dust

45
Q

what do you have to watch for with pterygium

A

may get larger and/or inflamed

46
Q

pterygium treatment

A

artificial tears or topical NSAIDS

sometimes they are excised (growth that threatens vision, astigmatism, severe irritation)

eye (9 decks)

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