DO of the Eyes Flashcards
Associations of Leukocoria
– Retinoblastoma – Cataract – Retinopathy of prematurity – Retinal detachment – Larval granulomatosis
___________—instability or displacement of lens; edge of displaced lens may be visible in pupillary aperture
Ectopia lentis
Systemic causes of Ectopia lentis
Marfan syndrome (most with superior and temporal; bilateral), homocystinuria (inferior and nasal), Ehlers-Danlos
Misalignment of the eyes from abnormal innervation of muscles
Strabismus
What is the dx?
– Epicanthal folds and broad nasal bridge
– Caused by unique facial characteristics of infant
Pseudostrabismus
– Transient pseudostrabismus; common up to age_______
4 months
What condition?
A 12-hour-old newborn is noted to have bilateral conjunctival injection, tearing, and some swelling of the left eyelid. Physical examination is otherwise normal.
Ophthalmia neonatorum
° most common in first 24 hours of life
° From silver nitrate and erythromycin
Chemical conjunctivitis
2–5-day incubation;
may be delayed >5 days due to suppression from prophylactic eye treatment;
mild inflammatory and serosanguineous discharge, then thick and purulent
N. gonorrhea
Cx of N. gonorrhea—
corneal ulceration, perforation, iridocyclitis
5–14-day incubation;
most common; mild inflammation to severe swelling with purulent discharge;
mainly tarsal conjunctivae
C. trachomatis—
T or F
C. trachomatis—
cornea rarely affected
T
Treatment:
° N. gonorrhea: _______
° Chlamydia: __________
ceftriaxone × 1 dose IM + saline irrigation until clear
erythromycin PO × 2 weeks + saline irrigation until clear (may prevent subsequent pneumonia)
Organisms associated with Bacterial conjunctivitis
S. pneumonia, H. influenza (non-typable), S. aureus, other strep
Organisms associated with viral conj
Adenovirus, enterovirus
Epidemic keratoconjunctivitis =__________
adenovirus type 8
Common etilogy for Keratitis
H. simplex, adenovirus, S. pneumoniae, S. aureus, pseudomonas, chemicals
Etiology of ROP
Prematurity, hyperoxia, and general illness
Tx of ROP
Treatment—cryosurgery or laser photocoagulation
Most common primary malignant intraocular tumor
Retinoblastoma
Gene for Retinoblastoma
Recessive-suppressive gene—13q14 → family members need to be screened
– Initial sign in most = leucokoria
° Appears as white mass
° Second most common—strabismus
Retinoblastoma
DX of RB
Diagnosis—CT scan to confirm; no biopsy (spreads easily)
Tx of RB
consider _________—radiation, chemotherapy, laser therapy, cryotherapy
enucleation
RB Prognosis
Prognosis poor if extends into _______
orbit or optic nerve
Dx of Corneal abrasions
first anesthetize eye, then fluorescein and blue-filtered light (Wood’s lamp)
Inflammation of lids and periorbital tissue without signs of true orbital involvement; insidious onset; low-grade fever; no toxicity
Periorbital cellulitis
Causes of Periorbital cellulitis
trauma, infected wound, abscess of lid, sinusitis, bacteremia (H. influenza nontypable, S. pneumoniae, S. aureus)
Infection of orbital tissue including subperiosteal and retrobulbar abscesse
Orbital cellulitis
Causes of Orbital Cellulitis
paranasal sinusitis, direct infection from wound, bacteremia
Organisms of Orbital Cellulitis
nontypable H. influenza, S. aureus, beta hemolytic strep, S. pneumoniae
