Eye Flashcards
Hordeolum
hordeolum is an acute infection and inflammation of one of the glands in the eyelid, painful
Treatment may be erthyromycin ointment or gentamicin; if refractory then oral cephalexin or dicloxacillin
Blepharitis
Inflammation of the eyelid
eyelids red, swollen, irritated, and itchy. It can cause crusty dandruff-like flakes on eyelashes.
Gentle washing and warm compresses
Chalazion
red bump on your eyelid. It is sometimes called an eyelid cyst or a meibomian cyst. It slowly forms when an oil gland (called a meibomian) becomes blocked
Warm compresses help, refer if remains for several weeks
Chalazion
red bump on your eyelid. It is sometimes called an eyelid cyst or a meibomian cyst. It slowly forms when an oil gland (called a meibomian) becomes blocked
Warm compresses help, refer if remains for several weeks
Chalazion v. Hordeolum
A chalazion is a less painful chronic infection on the INSIDE of the eyelid (conjunctival side) affecting the Zeis or meibomian (oil-secreting) glands.
Styes, or hordeola, are painful infected lesions on the EDGE of the eyelid (eyelash follicles) that come on quickly and eventually break open and drain
Describe clinical presentation, physical examination, and treatment of conjunctivitis.
A recent upper-respiratory infection or exposure to sick individuals can point to a diagnosis of adenoviral conjunctivitis.
Ocular symptoms include acute onset of a red eye with excessive watery discharge. Classically, it begins in one eye and then involves the fellow eye within days due to the phenomenon of autoinnoculation. Pink Eye.
Adenoviral conjunctivitis can occur in three different forms: adenoviral conjunctivitis, pharyngoconjunctival fever, and epidemic keratoconjunctivitis
Treatment is with antibiotic eye drops if bacterial, but most are viral or allergic.
Corneal Surface Defect or Foreign Body
Contact lens = high risk
Corneal ulcer = defect with infiltrate of white area into cornea
Sudden onset of eye pain = foreign body
Treat abrasions with antibiotic prophylaxis and lubricating drops, a ointment help give a barrier
Flush eye for FB, espeailly chemicals and measure pH of eye after fliush (7-7.5 goal)
Abrasion on F. Dye Stain
An abrasion will appear bright green, often polygonal
If pattern changes with blinking = herpetic infection
If pattern doesn’t change with blinking = corneal lacerations
Eye Drops or Cream?
Adults get eye drops
Peds get eye creams
Describe the components of a general eye examination.
Record visual acuity in the right and left eye and both eyes together whenever possible, and ask the patient if vision has been affected
Examine and compare each eye to one another
Pupil responses, reactivity, accommodation
Check visual fields
Fundoscopic exam
Which eye conditions warrant referral to an ophthalmologist?
Abrasions at 3 and 9 o'clock position Metallic or chemical foreign body Infectious keratitis Full thickness corneal laceration Elevated eye pressure (>30) Lesion in central vision
Bacterial v. Viral conjunctivitis
Bacterial has gritty or sticky sensation, yellow-green discharge, cornea is clear
Viral usually has recent history of URI, rhinitis, clear discharge
Pinguecula v. Pteryglum
Pinguecula is a small raised growth on conjunctiva. Presents with dryness, irritation
Pteryglum is a raised wedge shaped growth of conjunctiva into the cornea. Presents with irritation, redness, may affect vision
Both are from UV exposure, treat both with artificial tears
Open Angle Glaucoma
Most common
Drainage angle is open but the mesh is blocked
Eye pressure increases and vision is slowly decreased
Acute Closure Glaucoma
Iris bulges forward and blocks the drainage angle
Occurs suddenly, eye pressure spikes
Medical emergency - immediate referral
Subconjunctival hemorrhage
Subconjunctival hemorrhage (collection of blood occurring under the conjunctiva but not into iris/pupil)
- Caused by trauma, excessive straining (Valsalva) with vomiting or coughing, HTN, or rubbing of eyes
- Signs and symptoms
a) No change in visual acuity and no foreign sensation
b) No photophobia
c) May have felt a mild “stinging” sensation when it occurred - Treatment
a) Rule out HTN, trauma, or bleeding disorders, and treat if needed
b) No treatment needed, except reassurance that it will resolve in approximately 2 wk
dacryostenosis
nasolacrimal duct obstruction in infants
- Signs and symptoms
a) Persistent tearing (most common complaint)
b) Debris on eye lashes
c) No conjunctival redness, unless from rubbing
d) May see enlargement of tear duct opening
e) Gentle palpation may elicit tears or mucus into inner canthus - Treatment
a) Gentle massage to inner canthus 2 to 3 ×d
b) Warm moist compresses
Xanthelasma
harmless yellow bump on or near your eyelid skin
Usually result of lipoprotein or biliary problem, may indicate cholesterol problem
More common in elderly
Only treated if cosmetic concernes
Dry Eye Syndrome
Symmetrical irritation or redness
Blurred vision that resolves with blinking
Light sensitive
Treat with artificial tears, humidifier at night
Iritis / Uvelitis
Caused by inflammation of anterior uveal tract and ciliary body often involved
Signs and symptoms
a) Ciliary flush (red ring around the iris)
b) Photophobia with aversion to penlight in both eyes
c) No discharge and minimal tearing
Treatment is immediate referral to ED or ophthalmologist
