D1 - Ocular Conditions Flashcards
Coloboma:
Signs (3)
Irregular key hole shaped pupil
‘Hole’ in lower region of iris
Can be unilateral or bilateral
Colomoba:
Symptoms (3)
Photophobia
Reduced VA
Loss of field
Colomoba:
History (1)
Congential
Colomoba:
Treatment (3)
Cosmetic contact lenses with opaque iris
Large specs to protect orbital area from UV
Photochromatic lenses to provide UV protection in all light conditions
Colomoba:
Referral
Manage in practice
Meibomian Gland Dysfunction (MGD):
Signs (3)
Red eyes
Small lumps along lid margin
Sometimes crusty appearance
Meibomian Gland Dysfunction (MGD):
Symptoms (4)
Discomfort - gritty feeling
Itchy eyes
Blurred vision
Similar to dry eyes
Meibomian Gland Dysfunction (MGD):
History
Associated with dry eye syndrome and blepharitis
Meibomian Gland Dysfunction (MGD):
Treatment (3)
Massage lids to promote secretion of oils
Use hot compress or warm eye-pads
Defer contact lens wear
Meibomian Gland Dysfunction (MGD):
Referral
GP if antibiotics required
Blepharitis:
Signs (3)
Dandruff of the eyelashes
Inflamed lid margin
Lids appear swollen
Blepharitis:
Symptoms (2)
Discomfort - sore/itchy
Sticky lids
Blepharitis:
History (7)
Scalp disorder
Poor health
Poor lid hygiene
Dry eyes
Bacterial or fungal infection
MGD
Parasites
Blepharitis:
Treatment (3)
Improve lid hygiene
Warm eye pads with wheat germ
Defer contact lens wear
Blepharitis:
Referral
GP if antibiotics required
Ectropian:
Signs (3)
Lower lid margin rolls out
Drooping lower lids
Conjunctiva becomes dry & red
Ectropian:
Symptoms (2)
Dry eye (epiphoria)
Soreness of facial skin
Ectropian:
History (3)
Possibly trauma
Usually senile
Cause by loss of muscle tone or shrinking of scar tissue
Ectropian:
Treatment (2)
Surgery
Dispense large frame and side shields
Ectropian:
Referral
GP - non urgent
Entropian:
Signs (2)
Lower lid margin rolls in
Inflammation & corneal scarring
Entropian:
Symptoms (4)
Painful
Lacrimation
Corneal scarring
May lead to reduced VAs
Entropian:
History (1)
Eyelashes abrading cornea
Entropian:
Treatment (2)
Removal of eye lashes
Bandage contact lenses
Surgery may be required
Entropian:
Referral
GP
Ptosis:
Signs (1)
Drooping upper lids
Ptosis:
Symptoms (1)
Poor VA if pupil obscures
Ptosis:
History (3)
Paralysis of levator muscle
Congential
Senile
Due to stroke
Ptosis:
Treatment (2)
Ptosis prop
Surgery
Ptosis:
Referral
GP - Non urgent
Stye (Hordeleum Externam):
Signs (1)
Inflammation and swelling of lid margin
Stye (Hordeleum Externam):
Symptoms (1)
Discomfort
Stye (Hordeleum Externam):
History (4)
Blockage or tarsal gland, causing meibomian cyst
Bacterial infection of lash follicle
Dirty makeup brushes
Possible reoccurrence
Stye (Hordeleum Externam):
Treatment (2)
Hot compress
Eyelash removal
Stye (Hordeleum Externam):
Referral
Manage in practice
Chalazion (Meibomian Cyst):
Signs (1)
Hard swelling which gradually enlarges
Chalazion (Meibomian Cyst):
Symptoms (2)
No pain
Growth may induce pressure causing blurred vision
Chalazion (Meibomian Cyst):
History ()
Swelling of tarsal gland
Can be due to blockage or infection
May be associated with blepharitis or other skin conditions
Chalazion (Meibomian Cyst):
Treatment (2)
May disappear
Longstanding requires surgical removal through tarsal conjunctiva
Chalazion (Meibomian Cyst):
Referral (1)
Non urgent unless abrading the cornea
Xanthalasma:
Signs (1)
Flat yellow lumps of fat on lids
Xanthalasma:
Symptoms (1)
Cosmetic appearance
Xanthalasma:
History (1)
Raised cholesterol
Possibly diabetes
Xanthalasma:
Treatment (1)
Removal by laser
Reduce fat intake
Xanthalasma:
Referral (2)
GP - non urgent
Attend GP for cholesterol check
Conjunctivitis:
Signs (4)
Inflamed conjunctiva
Blood shot eye
Mucous discharge
Often bilateral
Conjunctivitis:
Symptoms (3)
Lids sticky in morning
Eyes feel gritty and hot
Photophobia
Conjunctivitis:
History (1)
Possible previous occurrence
Conjunctivitis:
Types (3)
Bacterial
Viral
Allergic
Conjunctivitis:
Treatment (4)
Bathe lids
Boil towels and pillowcases
Antibiotic eye drops may be required
Defer contact lens wear
Conjunctivitis:
Referral (1)
GP if antibiotics required
Pinguecula:
Signs (2)
Raised yellow area on conjunctiva
Most common in elderly
Pinguecula:
Symptoms (1)
Possible irritation with contact lenses
Pinguecula:
History (4)
Exposure to UV
Dry and hot climate
Hardening of bulbar conjunctiva
Degeneration of conjunctiva
Pinguecula:
Treatment (1)
Cosmetic appearance
Pinguecula:
Referral (1)
GP - non urgent
Pterygium:
Signs (3)
Raised triangular growth on conjunctiva
Invades epithelium
Often bilateral
Pterygium:
Symptoms (2)
Possible irritation with contact lenses
Reduced VAs
Pterygium:
History (4)
Living in hot climate
Excessive UV
Dusty conditions
Possible previous occurrence
Pterygium:
Treatment (1)
Surgical removal before pupil invasion
Pterygium:
Referral (3)
GP - non urgent
Sub-conjunctiva Haemorrhage:
Signs (1)
Burst blood vessel between conjunctiva and Tenon’s capsule
Sub-conjunctiva Haemorrhage:
Symptoms (2)
Possible discomfort
No pain
Sub-conjunctiva Haemorrhage:
History (3)
Exertion
Possible previous occurrence
High blood pressure
Sub-conjunctiva Haemorrhage:
Treatment (1)
None
Sub-conjunctiva Haemorrhage:
Referral (1)
GP if reoccurring as blood pressure check is required
A&E if trauma
Arcus:
Signs (1)
Opaque white/grey band at periphery of iris
Arcus:
Symptoms (1)
None
Arcus:
History (2)
Raised cholesterol
Caused by fat deposited in the cornea
Arcus:
Treatment (1)
Reduce cholesterol intake
Arcus:
Referral (1)
GP for cholesterol check
Epicanthal Folds:
Signs (3)
Commonly seen in young children as their nose is not fully developed
Usually bilateral
Gives appearance of esotropia
Epicanthal Folds:
Symptoms (2)
None
Kids with condition often brought for sight test
Epicanthal Folds:
History (2)
Examination carried out to ensure heterotropia is not present
Use a pen torch to check light reflex
Epicanthal Folds:
Treatment (1)
Surgery if required
Epicanthal Folds:
Referral (3)
GP if surgery required for cosmesis
