Exam 2 Red eye Flashcards
Pt presents with an inflammed eyelid that they complain is really itchy/scaling/red in the morning. Dx, etiology, Tx, other associated condition?
dx: blepharitis
meibomian gland dysfunction
Tx: warm compresses, baby shampoo, antibiotics
may include a chalazion (pimple of eyelid) that can be drained from underside of eyelid or treated with hot compress. If untreated may develop cellulitis
pt comes (may or may not have vision affected) in and their entire eye is swollen, erythematous, warm to the touch and painful. What is your most likely dx, tx?
dx: cellulitis, an infection of periorbital
* often occurs from untreated chalazion/stye
tx: systemic antibiotics and REFERRAL to ophthalmologist
A patient complains of chronic tired eyes at night that itch and burn but may or may not affect vision. What is the likely dx and tx?
dx: Dry eyes, a deficiency in aqueous tear production
tx: artificial tears first*, topical cyclosporine, puntal plugs
distinguish bw the three types of conjunctivitis and how you would treat each
viral: acute bilateral, watery d/c, severe injections, URI sx –> tx: artificial tears, compresses, vasoconstrictor/visine
Bacterial: acute unilateral, mucopurulent d/c –> tx: topical or systemic antibiotics (systemic if GC or chlamydia suspected
ALlergic: ITCHY chronic bilateral, mucoid stringy d/c –> tx: artificial tears then topical antihistamines ie patanol
Acute onset of bloody appearing eye but no vision loss
Subconjunctival hemorrhage –> no treatment, just let heal
What conditions can result in a foreign body sensation and how do you distinguish them from each other. Tx?
Scleritis/epicleritis: subacute inflammaton of scleral tissue, focal injection stemming from nodule; tx: refer to ophth to prescribe steroids
corneal abrasion: acute onset, dx with fluorescein dye; tx: topical lubricant, topical antibiotic, ORAL pain med (no anesthetic drops!!)
foreign body: acute onset, mechanism of injury; tx: removal, irrigation, lubricant, antibiotic drops, possible referral
a chemical splashes into a students eye while in ochem lab. What should happen?
irrigation! then topical lubricants, antibiotics, REFER
a patient with a history of contact lens wear comes into the office complaining of vision loss, acute onset of pain, mucous d/c. Dx, Tx?
Dx: corneal ulcer aka keratitis (see white infiltrate with penlight)
tx: REFER, intensive topical antibiotics
* if HSV, dx by dendritic pattern under stain –> tx: antiviral
pt comes in complaining of photophobia and you notice a hypopyon and ciliary flush.. what is your dx? tx?
uveitis/iritis
tx: REFERRAL! topical steroids ASAP, cycloplegics/dilation drops to stabilize eye/pupils
patient has decreased vision, halos, nausea and pressure.. upon examination, you notice a steamy cornea, ciliary flush, circumlimbial injection, and a firm globe with narrow anterior chamber
dx: glaucoma ACUTE closure due to pupillary block
tx: REFER, anti ocular Hypertensives, oral/iv osmotic agents, laser peripheral iridotomy, surgical trabeculectomy
risks: older/thick lens, hyperopic eye. anticholinergics (cause pupil dilation/angle closure)
