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NURS 502 > Exam 1 - Non-painful red eye > Flashcards

Exam 1 - Non-painful red eye Flashcards

1
Q

What is conjunctivitis?

A

Inflammation of the bulbar and palpebral conjunctiva

  • Commonly referred to as “pink eye”
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2
Q

Symptoms of viral (adenoviral) conjunctivitis

A
  • Red eye with tearing
  • Watery discharge
  • Itching or irritation
  • Unilateral or bilateral
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3
Q

Can viral conjunctivitis present with viral URI?

A

Yes - recent or concurrent viral URI

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4
Q

How long does viral conjunctivitis last?

A

5-14 days

Highly contagious

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5
Q

What other physical exam findings could be seen with viral conjunctivitis?

A
  • Eyelid edema
  • Preauricular adenopathy
  • Follicles on palpebral conjunctiva
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6
Q

Viral conjunctivitis: management (both conservative and pharmacological)

A
  • Cool compresses
  • Good hand hygiene
  • Avoid touching eyes
  • Don’t share towels
  • Wash pillowcases
  • Lubricating drops
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7
Q

Viral conjunctivitis: patient education

  • When does it get better?
A

Prevent transmission (highly contagious)

  • Gets better in 1-2 weeks
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8
Q

Causative organisms of bacterial conjunctivitis (two groups)

  • Gradual or sudden onset?
A

Gradual onset

  • H. influenzae
  • Strep pneumoniae
  • S. aureus

Sudden onset

  • Gonorrhea
  • Chlamydia
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9
Q

Bacterial conjunctivitis symptoms

A
  • Unilateral or bilateral
  • Moderate or severe conjunctival injection
  • Thick, purulent discharge
  • Sticky eyes
  • Preauricular adenopathy
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10
Q

How would the provider manage bacterial conjunctivits in adults who are immunocompetent?

A

According to AAO, mild infection may resolve spontaneously –> observation

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11
Q

Is topical treatment warranted for bacterial conjunctivitis in adults?

A

Yes - topical treatment is empiric

  • Gentamicin
  • Ciprofloxacin
  • Azithromycin
  • Erythromycin
  • Sulfacetamide
  • Trimethoprim/polymyxin B
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12
Q

What is the usual duration of topical antibiotic treatment for bacterial conjunctivitis in adults?

A

One week

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13
Q

If the cause of the patients bacterial conjunctitivis is d/t CT/GC in adults, what should the provider do?

A

Refer to CDC treatment guidelines

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14
Q

If the cause of older children/adolescent bacterial conjunctivitis is d/t anything other than CT/GC, what should the provider do in terms of management?

A

Can be treated conservatively

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15
Q

What ophthalmic ointments can be prescribed to treat bacterial conjunctivitis in children?

A
  • Trimethoprim sulfate + polymyxin B sulfate ophthalmic solution
  • Erythromycin 0.5% ophthalmic ointment (all ages)
  • Fluoroquinolone or azithromycin over 12 months
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16
Q

How would the provider manage otitis conjunctivitis syndrome in children?

A

Treat with oral amoxicillin-clavulanate (if not allergic)

17
Q

Can bacterial conjunctivitis self resolve? When would the patient see improvement?

A

Typically self resolves by 1 week, regardless of antibiotic treatment

Improvement seen by day 3; if not, refer to ophthalmology

18
Q

Can patients with bacterial conjunctivitis return to school?

A

Return to school is controversial

19
Q

Allergic conjunctivitis symptoms

A

Seasonal and perennial

  • Bilateral
  • Pruritus
  • Clear or white stringy discharge
20
Q

Allergic conjunctivitis physical exam findings

A
  • Allergic shiners (dark circles under eyes)
  • Boggy conjunctiva
21
Q

When is allergic conjunctivitis usually diagnosed?

A

Usually diagnosed in late childhood

22
Q

Allergic conjunctivitis management: both conservative and pharmacological

A
  • Identify and avoid allergens
  • Cold compresses
  • Artificial tears
  • Oral antihistamines (if systemic allergy symptoms)
  • Ocular mast cell stabilizer, antihistamine, or dual therapy
    • Example: ketotifen (>3 years)
23
Q

What causes chemical conjunctivitis?

A

Exposure to fumes, smoke, liquids, chemicals such as chlorine

24
Q

Chemical conjunctivitis symptoms

A

Redness and irritation

25
Q

Chemical conjunctivitis treatment

A
  • Flush eyes immediately
  • Artificial tears as needed
26
Q

What should the provider do if the patient was exposed to a toxic substance that is causing severe pain and visual disturbance?

A

Refer immediately

27
Q

Vernal versus atopic conjunctivitis

A

Vernal - seen during childhood, spring time

Atopic - seen in adults over 50 years old with history of atopy

28
Q

Symptoms of vernal and atopic conjunctivitis

A
  • Bilateral itching
  • Burning
  • Tearing
29
Q

How would the provider treat vernal and atopic conjunctivitis? Is a referral warranted?

A

Treatment

  • Mass or cell stabilizer
  • Ophthalmic drops

Refer to ophthalmology (non emergent)

30
Q

What is the pathophysiology of dry eye syndrome?

A

Complex pathophysiology - most commonly due to lacrimal or meibomian gland dysfunction (like Sjogrens)

31
Q

Dry eye syndrome symptoms

A
  • Dryness
  • Foreign body sensation
  • Scratchy/grittiness
  • Burning
  • Stinging
  • Tearing
32
Q

What tests can the provider use to diagnose dry eye syndrome?

A
  • Schirmer test
    • Helps differentiate between evaporative dry eye versus lacrimal problem
  • Questionnaires
33
Q

How would the provider manage dry eye syndrome?

A

Educate the patient to avoid causative meds (e.g. anticholinergics, diuretics), air conditioning, fans

34
Q

What is the first line treatment (prescription) used for dry eye syndrome?

A

Preservative-free lubricants

  • Cyclosporin drops (restasis) can be prescribed by ophthalmologist
35
Q

What is subjunctival hemorrhage?

A

Bleeding between conjunctiva and sclera

36
Q

Are subconjuctival hemorrhages a medical emergency?

A

No - normally asymptomatic and benign

37
Q

What causes subjunctival hemorrhages? What are some risk factors?

A

Increased pressure in capillaries

  • Coughing
  • Sneezing
  • Straining

Other risk factors

  • Blood thinners
  • HTN
  • DM
38
Q

When do subjunctival hemorrhages normally resolve?

A

2 weeks

NURS 502 (43 decks)

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