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Ocular Disease > Disorders of the Episclera and Sclera > Flashcards

Disorders of the Episclera and Sclera Flashcards

1
Q

Episclera is connected to the sclera by what?

A

Fascia bulbi (Tenon’s capsule)

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2
Q

Blood is supply to the episclera through the _________ arteries.

A

anterior ciliary

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3
Q

Is episcleritis malignant or benign?

A

benign

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4
Q

T/F Typically, episcleritis is affecting one eye.

A

True

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5
Q

Which gender and age do we see more episcleritis cases?

A

female (2:1) between 20-40 years old

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6
Q

What causes episcleritis?

A

stress/hormonal changes

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7
Q

The two types of episcleritis are _____ and _____.

A

simple, nodular

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8
Q

T/F simple episcleritis is localized inflammation.

A

False, diffused. Nodular epicleritis is localized.

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9
Q

What is the test we use to rule out conjunctivitis, scleritis, pinguecula/pterygium and phlyctenular conjunctivitis from episcleritis?

A

2.5% phenylephrine test - cause blanching

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10
Q

What is the Naphcon-A medication?

A

vasoconstrictors/antihistamines

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11
Q

What are the Prolensa and Llevro medications?

A

NSAIDs use as anti-inflammatory drugs

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12
Q

What do you prescript to patients with moderate to severe episcleritis?

A 
Topical steroids (Alrex-Loteprednol or FML-Flourometholone) and oral NSAID's
need to monitor IOP because it's given steroids
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13
Q

T/F The dense nerve supply to the sclera is the short ciliary nerve.

A

False, long ciliary

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14
Q

What are the symptoms with episcleritis?

A

feels hot, tenderness upon palpation, photophobia, mild tearing, acute onset (min to hrs)

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15
Q

What are the symptoms with scleritis?

A
  1. Severe boring pain that radiates to forehead, brow, jaw and can wake the pt up at night.
  2. tearing/photophobia
  3. loss of vision
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16
Q

Scleritis is typically associated with ______ disease.

A

systemic

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17
Q

The onset of episcleritis is ________ and scleritis is ________.

A

acute, gradual

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18
Q

T/F Anterior uveitis can present in scleritis patient.

A

True

19
Q

T/F Anterior uveitis can present in episcleritis patient.

A

False

20
Q

T/F sclera becomes edmatous in scleritis patient.

A

True

21
Q

_____ scleritis is the most common scleritis.

A

Diffuse

22
Q

In Nodular scleritis, it can cause a rise in IOP if the nodule is located at the _______.

A

limbus

23
Q

T/F 2.5% phenylephrine can cause blanching in scleritis.

A

False. can cause blanching in episcleritis

24
Q

What other place you want to look at when suspect nodular scleritis in the eye?

A

look at the arms and fingers. It’s associated with rheumatoid nodules (1/3 of cases).

25
Q

Where is the most common place where nodules are growing in nodular scleritis?

A

superior region

26
Q

Which scleritis is most severe?

A

Necrotizing scleritis. This is almost always associated with systemic diseases.

27
Q

Which scleritis doesn’t have symptoms?

A

scleromalacia perforans. happens in elderly female with rheumatoid arthritis or rheumatoid disease

28
Q

How is posterior scleritis diagnose?

A

use ultrasound. you will see thickening of the posterior portion due to edema

29
Q

What is the ranking of likelyhood of systemic ideology in the different kind of scleritis.

A

Necrotizing > Scleromalacia > Diffuse Anterior > Nodular Anterior > Posterior

30
Q

Rheumatoid factor (RF) lab test is to rule out ___________.

A

Rheumatoid Arthritis

31
Q

Antibody antigen (ANA) lab test is to rule out ___________.

A

Systemic Lupus Erythematosus (LUPUS)

32
Q

HLA- B27 lab test is to rule out ________ and ________.

A

Ankylosing Spondylitis, Psoriatic arthritis

33
Q

Uric acid lab test is to rule out _______.

A

Gout disease

34
Q

Erythrocyte sedimentation rate (ESR) lab test is to rule out ________.

A

any inflammation conditions in the body

35
Q

RPR/FTA-ABS lab test is to rule out _______.

A

syphilis

36
Q

What is Wegener’s disease.

A

It’s a inflammation of the blood vessels that affects many organs in the body

37
Q

ANCA lab test is to rule out ________.

A

Wegener’s granulomatosis by presenting anti-neutrophil cytoplasmic antibodies in the blood.

38
Q

X-ray work up is to rule out _______, _______, and ______.

A

Wegener’s, Ankylosing Spondylitis, Rheumatoid Arthritis.

39
Q

What are the oral NSAID’s you can prescript to someone as a initial therapy to treat diffuse/nodular scleritis?

A
  1. Ibuptofen (800mg po TID)
  2. Indomethacin (75mg po BID)
  3. Naproxen (250-500mg po TID)
40
Q

Some contraindications for oral NSAID’s treatment in scleritis includes what?

A

peptic ulcer disease, recent GI bleed and renal insufficiency

41
Q

What is it if you see someone with a blue sclera?

A

you might think it’s osteogensis imperfecta or other connective tissue disorders or Nevus of Ota (increased melanin)

42
Q

Axenfield’s loops is associated with the _______ nerve.

A

posterior ciliary

43
Q

Should you give steroid to patient with an inflamed eye?

A

No because it will make it worst

Ocular Disease (12 decks)

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