DO of the Eyes

Question 1

Associations of Leukocoria

Answer 1

– Retinoblastoma
– Cataract
– Retinopathy of prematurity
– Retinal detachment
– Larval granulomatosis

Question 2

___________—instability or displacement of lens; edge of displaced lens may be visible in pupillary aperture

Answer 2

Ectopia lentis

Question 3

Systemic causes of Ectopia lentis

Answer 3

Marfan syndrome (most with superior and temporal; bilateral), homocystinuria (inferior and nasal), Ehlers-Danlos

Question 4

Misalignment of the eyes from abnormal innervation of muscles

Answer 4

Strabismus

Question 5

What is the dx?

– Epicanthal folds and broad nasal bridge
– Caused by unique facial characteristics of infant

Answer 5

Pseudostrabismus

Question 6

– Transient pseudostrabismus; common up to age_______

Answer 6

4 months

Question 7

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.

Answer 7

Ophthalmia neonatorum

Question 8

° most common in first 24 hours of life

° From silver nitrate and erythromycin

Answer 8

Chemical conjunctivitis

Question 9

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

Answer 9

N. gonorrhea

Question 10

Cx of N. gonorrhea—

Answer 10

corneal ulceration, perforation, iridocyclitis

Question 11

5–14-day incubation;

most common; mild inflammation to severe swelling with purulent discharge;

mainly tarsal conjunctivae

Answer 11

C. trachomatis—

Question 12

T or F

C. trachomatis—

cornea rarely affected

Answer 12

T

Question 13

Treatment:

° N. gonorrhea: _______
° Chlamydia: __________

Answer 13

ceftriaxone × 1 dose IM + saline irrigation until clear

erythromycin PO × 2 weeks + saline irrigation until clear (may prevent subsequent pneumonia)

Question 14

Organisms associated with Bacterial conjunctivitis

Answer 14

S. pneumonia, H. influenza (non-typable), S. aureus, other strep

Question 15

Organisms associated with viral conj

Answer 15

Adenovirus, enterovirus

Question 16

Epidemic keratoconjunctivitis =__________

Answer 16

adenovirus type 8

Question 17

Common etilogy for Keratitis

Answer 17

H. simplex, adenovirus, S. pneumoniae, S. aureus, pseudomonas, chemicals

Question 18

Etiology of ROP

Answer 18

Prematurity, hyperoxia, and general illness

Question 19

Tx of ROP

Answer 19

Treatment—cryosurgery or laser photocoagulation

Question 20

Most common primary malignant intraocular tumor

Answer 20

Retinoblastoma

Question 21

Gene for Retinoblastoma

Answer 21

Recessive-suppressive gene—13q14 → family members need to be screened

Question 22

– Initial sign in most = leucokoria
° Appears as white mass
° Second most common—strabismus

Answer 22

Retinoblastoma

Question 23

DX of RB

Answer 23

Diagnosis—CT scan to confirm; no biopsy (spreads easily)

Question 24

Tx of RB

consider _________—radiation, chemotherapy, laser therapy, cryotherapy

Answer 24

enucleation

Question 25

RB Prognosis

Prognosis poor if extends into _______

Answer 25

orbit or optic nerve

Question 26

Dx of Corneal abrasions

Answer 26

first anesthetize eye, then fluorescein and blue-filtered light (Wood’s lamp)

Question 27

Inflammation of lids and periorbital tissue without signs of true orbital involvement; insidious onset; low-grade fever; no toxicity

Answer 27

Periorbital cellulitis

Question 28

Causes of Periorbital cellulitis

Answer 28

trauma, infected wound, abscess of lid, sinusitis, bacteremia (H. influenza nontypable, S. pneumoniae, S. aureus)

Question 29

Infection of orbital tissue including subperiosteal and retrobulbar abscesse

Answer 29

Orbital cellulitis

Question 30

Causes of Orbital Cellulitis

Answer 30

paranasal sinusitis, direct infection from wound, bacteremia

Question 31

Organisms of Orbital Cellulitis

Answer 31

nontypable H. influenza, S. aureus, beta hemolytic strep, S. pneumoniae