Eye Flashcards
Types of true strabismus
Esotropia(eye turned inward)
Exotropia(eye turned outward)
Hypertropia(eye turned superiorly)
Causes of strabismus
Refractive errors(most common)
Problems with extra ocular muscles
Problems with CN3,4,6
Problems with part of brain controlling extra ocular movements
Causes of leukocoria
Corneal opacification
Cataracts,congenital or acquired
Retinoblastoma
Retinopathy of prematurity
Causes of floaters(incomplete)
Retinal detachment, posterior vitreous detachment, vitreous hemorrhage,
Most common type of conjunctivitis and it’s causative pathogen
Viral conjunctivitis, caused by adenovirus
Symptoms of allergic conjunctivitis
Itching, conjunctival chemosis, eyelid edema and watery/mucoid discharge
Causative agents of allergic conjunctivitis
Dust, mold, pollen, spores and animal dander
Causative agents of hemorrhagic conjunctivitis
Coxsackie 24 and enterovirus
HSV viral conjunctivitis concerning complication
Involvement of the cornea(keratitis) which can lead to scarring and opacity
Treatment for a stye
Warm compress
Signs of HSV conjunctivitis
Skin lesions: herpetic skin vesicular eruption
Palpable pre auricular nose
Common causative pathogens for bacterial conjunctivitis
Staph aureus, staph epidermidis, strep pneumo, moraxella catarrhalis, pseudomonas
Treatment of bacterial conjunctivitis(excluding gonococcal)
Usually self limiting but topical floroquinolones/polymyxin B/trimethoprim can be used to reduce contagion and disease duration
Ophthalmia neonatorium definition and causative organisms
Conjunctivitis within 4 weeks after birth of infant
Dangerous: N gonorrhea,HSV
Less dangerous: Chlamydia Trachomatidis
Mx of chlamydial conjunctivitis
Oral erythromycin or clarythromycin
Mx of gonococcal conjunctivitis
Parenteral ceftriaxone 25-50/mg/kg
Mx of HSV conjunctivitis and ophthalmia neonatorium
Full assessment for disseminated HSV infection including PCR and Lumbar puncture to check for CNS involvement
Mx with IV acyclovir and topical antivirals regardless of absence of disseminated infection
How to administer eye drops to young children
Drop the eye drops onto the eyelid above the eye and let them drip in
Tool for measuring intraocular pressure for glaucoma
Goldmann tonometry
Mx of acute angle closure glaucoma
IV carbonic anhydrase inhibitor
Topical timolol
Topical pilocarpine
Topical brimonidine
Definitive:peripheral laser Iridotomy
Definitive management of Closed/Narrow angle glaucoma
PLI(Peripheral Laser Iridotomy)
Definitive Mx of open angle glaucoma
Laser Trabeculectoplasty
Interim mx of narrow angle glaucoma
Pilocarpine
Acetazolamide(carbonic anhydrase inhibitor)
Beta blockers
???
Red flags in a red eye case
1.Profound visual loss
2. Significant eye pain
3. Unilateral red eye
4. Purulent eye discharge
5. Positive RAPD
6. Hypopyon
7.Hazy or opaque cornea
8. Increased IOP
What do giant/cobblestone papillae suggest
Allergic conjunctivitis
Causes of Corneal staining
- Bacterial keratitis
- Herpes Simplex Keratitis
- Angle closure attack
Main pathogen that causes blepharitis
Staphylococcus
Causes of RAPD
- Acute angle closure
- Optic neuritis
- Orbital cellulitis
Mx of Orbital cellulitis
Immediate referral, admission of IV Abx, need CT scan and often surgical intervention
Cx of orbital cellulitis
Optic nerve compression
Subperiosteal or orbital abscess
Meningitis
Cavernous Sinus thrombosis
Conjunctivitis red flags
Contact lens user
painful
poor vision
purulent discharge
corneal changes
prolonged course >1 week
Common pathogens for bacterial conjunctivitis
staph aureus
staph epidermidis
strep pneumo
HIB
Are acid or alkali more dangerous in eye chemical injury
Alkali
RFs for fungal keratitis
Trauma, immunocompromise or topical steroid use
RFs for bacterial keratitis
Trauma, contact lens use
Sings of HSV keratitis
- Decreased corneal sensation
- Dendritic corneal ulcer
- Geographic amoeboid ulcer
Mx of HSV keratitis
Topical acyclovir for 10-14 days, 5x a day
common pathogens causing bacterial keratitis
staph aureus, strep pyogenes, strep pneumo and pseudomonas
RFs of bacterial keratitis
Contact lens, trauma, chronic corneal disease and prev ocular surgery
Signs and Sx of bacterial keratitis
Sx: Pain, discharge, decreased vision, photophobia
Signs: Conjunctival injection, edema, ulcers or hypopyon
Mx of bacterial keratitis
topical broad spectrum abx eg gentamicin and cefazolin, systemic abx if sclera involved
Common causative agent of fungal keratitis
Candida
Mx of fungal keratitis
Topical and systemic antifungals
RFs for endophthalmitis
Trauma, immunocompromise, ocular surgery
MX of endophthalmitis
Vitreous tap
Intra vitreal, topical and systemic Abx
KIV vitrectomy if vision is worse than HM
Causes of Anterior uveitis
- Idiopathic
- Local causes: Tumor, Infection, Trauma, Lens related
- Systemic inflammatory diseases eg IBD, Reiters, sarcoidosis, JIA, Ankylosing Spondylitis
Sx of Scleritis
Severe pain waking patient from sleep, watering, photophobia, violaceous appearance
Sight threatening
Etiology of scleritis
Often systemic connective tissue disease eg Rheumatoid arthritis
Mx of scleritis
Treat underlying systemic condition, nsaids, corticosteroids, immunomodulation
Mx of chemical injury to eye
Copious irrigation, lubricants, topical steroids, tertracycline abx, Vit C PO, +- surgical mx
Risk factors for Retinal Vein Occlusion
Same as usual VTE
Hypercoagulable state: Malignancy, Prothrombotic disorders, COCPs
Endothelial damage: Trauma or Iatrogenic
Stasis: surgery, immobility
Triad of ocular signs in chronic glaucoma
- Raised intra ocular pressure
- Visual field defect
- Optic disc cupping
