Diseases with Treatments

Question 1

Treatment for breaking posterior synechiae induced by Anterior Uveitis

Answer 1

10% phenylephrine
1% Atropine

Question 2

Treatment for Anterior Uveitis (and describe dose/ what they do)

Answer 2

Topical Cycloplegic: 1 drop, every day, twice a day.
- for ocular comfort, reduces ciliary spasms

AND

Topical steroid (strong): Pred Acetate or Durezol, 1 drop, 4 times a day or every hour depending on severity.
-for inflammation. If persistent and severe, consider an oral steroid or subconj steroid injection.

Question 3

Treatment for Posner-Schlossman Syndrome

Answer 3

1) Topical Steroid during acute attacks (pred acetate 1%, 4 times a day or every hour)

2) IOP lowering meds with steroid

3) Self limiting (will resolve on own)

Question 4

Treatment for Fuch’s Heterochromic Iridocyclitis (FHIC)

Answer 4

No treatment. Unresponsive to steroids and topical IOP meds.

Posterior subcapsular cataract develops in 80% of patients so they will need cataract surgery

Question 5

Treatment of glaucoma secondary to Fuch’s heterochromic Iridocyclitis

Answer 5

Trabeculectomy or shunt surgeries
(Ahmed Glaucoma Valve - “Bleb”)

Question 6

Treatment of Uveitis-Glaucoma-Hyphema Syndrome (UGH)

Answer 6

Topical Cycloplegia + Topical Steroid + IOP lowering meds + surgery for IOL replacement.

Question 6

Treatment of Episcleritis

Answer 6

1) Mild topical steroid (Recommended)

2) Cold compress and topical lubricant

3) High dose of Oral NSAIDs
(ibuprofen or naproxen)

4) IF infectious, treat with anti-infective

Question 7

Treatment of Scleritis

Answer 7

1) NSAIDs (recommended!!)
-ibuprofen 400-600 mg qid
-Naproxen 250-500 mg bid
-Indomethacin 25 mg tid

2) Corticosteroids
-prednisone 60-100 mg daily, must taper

3) Immunosuppression therapy

Question 8

Treatment for Necrotizing Anterior Scleritis

Answer 8

1) Oral Steroids (IV for severe cases)

2) Oral immunosuppressants for long term therapy

Question 9

Treatment for Non-Infectious posterior scleritis

Answer 9

1) Oral NSAIDs (try many before considering failure)
2) Oral steroids
3) IV steroids if severe
4) Oral immunosupressants

Question 10

Treatment for Jaundice

Answer 10

Refer for systemic treatment meds

Question 11

Treatment for Orbital Cellulitis

Answer 11

1) IV antibiotic / antifungal

-Send to ER for Orbital CT or MRI

Question 12

Treatment/ Management for Dacyroadenitis

Answer 12

1) Antibiotic for 24 hrs, reassess if doesn’t get better.

Bacterial: Mild/Moderate Oral antibiotic
Viral: Cold compress and analgesic
Noninfectious: Oral steroid

Refer out for CT scan or MRI

Question 13

Treatment/ Management for Idiopathic Orbital Inflammatory Syndrome (IOIS) / Orbital Pseduotumor

Answer 13

1) Oral Steroid - Prednisone 80-100 mg daily as initial dose. Should show improvement quickly

Orbital CT / MRI

2) IV steroid for severe cases
3) Orbital Radiotherapy (refer out)

Question 14

Treatment/ Management for Orbital Cavernous Hemangioma

Answer 14

Orbital CT/ MRI

Refer out, surgical excision

Question 15

Treatment/ Management for Orbital Venous Varix (Orbital Varices)

Answer 15

Orbital CT/MRI
If complications, refer out for surgery or embolization

Question 16

Treatment/ Management for Lacrimal Gland Pleomorphic Adenoma (Benign Mixed cell tumor)

Answer 16

Orbital CT/MRI
Refer out for surgical excision

Question 17

Treatment/Management for Lacrimal Gland Carcinoma

Answer 17

Orbital CT/MRI
Refer out for surgical excision/ radiotherapy and chemotherapy

Question 18

Treatment/Management for Orbital Lymphoma

Answer 18

Orbital CT/MRI
Refer out for biopsy/ radiotherapy and chemotherapy

Question 19

Treatment for Rhabdomyosarcoma

Answer 19

Refer to Emergency department
Orbital CT/MRI
biopsy, radiotherapy, chemotherapy