Eye Flashcards
Pt is old* presents with eye lid away from eyeball (OD). Eye has a burning sensation, feels that there is something inside (FB), tearing, and irritated.
Ectropion
*Age related, bell palsy, space occupying lesion on the lower lid, infection (HSV).
Tx: tape lid, artificial tears, surgery - depending on the severity
Pt presents with eye lid towards the eye (OS) after baby hit his eye. Eye feels there is something in his eye, dry, and irritated. There are signs of keratisis.
Entropion.
Infection (HSV), space occupying lesion on the lower lid.
Tx: tape lid, artificial tears, surgery -depending on the severity.
Types of blepharitis
Chronic blepharitis Tx
1) anterior
2) Meibomian gland dysfunction (posterior)
3) Infectious demodex
4) Seborrheic
5) Acne Rosacea
chronic: staph –> topical bacitracin/erythromycin
Pt presents with inflammation on the eyelid w/ affected lashes
Anterior blepharitis
Tx: general hygiene - warm compress, lid scrub, mild shampoo
Pt presents with burning, irritation, tearing, and feeling that there is FB in the eye.
Upon examination, there a sign of hordeolum.
Meibomian gland dysfunction
dec or incr of secretion with pore occlusion –> prone to hordeolum/chazlion
Tx: general hygiene - warm compress, lid scrub, mild shampoo
Pt presents with burning, irritation, tearing, and feeling that there is a FB in the eye.
Upon examination, there are small mites hanging on the eyelashes.
Infectious (demodex) blepharitis
Tx: general hygiene - warm compress, lid scrub, mild shampoo and tea tree oil
Pt presents with burning and irritation only on the lid of the eye.
Upon examination, there are scrufs on the lashes.
Seborrheic blepharitis.
Tx: general hygiene - warm compress, lid scrub/mild shampoo.
Pt presents with redness in eye and face. There is keratisis on the eyelid.
Acne Rosacea
Idiopathic
Tx: Metronidazole and doxycycline, avoid spicy food and alcohol
Pt presents with painful abscess on eyelid.
Upon examination, pain increases upon palpation.
Prognosis:
Hordeolum
Tx: warm compress (w/ blepharitis: abx)
Problematic lesions: TMP-SMX (prophylactic abx)
Prognosis: Preseptal Cellulitis - infxn on ant eye lid
orbital cellulitis: hospitalization and IV abx
Pt presents a stye on eyelid and it doesn’t seem to go away. Stye is not tender.
Chalazion.
Tx: warm compress and I&D - if doesn’t get better in 3-4 wks needs surgery
Pt presents with pink eye complaining of burning sensation.
Upon examination, eyes are watery with edamtous lids.
Acute viral conjunctivitis.
Tx: supportive, artifical tears (4-8x daily), cool compress
Pt presents with itchy eye (OD) and complains of a FB sensation, irritated and watery discharge.
Upon examination, eyes are red w/ purulent discharge.
Bacterial conjunctivitis
d/t s. aureus, s. epidermidies, s. pneumonia, h. influenzae
Tx: fluroquinolone ointment, trimethroprimpolymyxin B drops
Pt presents with itchy, watery.
Upon examination both conjuctivitas are swollen w/puffy eyes and runny nose.
Allergic conjunctivitis
Tx: olopatadine (no steroids for eyes)
Pt presents with creamy, chalk appearance on conjunctiva.*
Pt lives in Hawaii.
Upon examination, lesion is flat/slightly elevated.
Pinguecula.
d/t to UV exposure and age
adjacent to limbus but does NOT affect cornea
Tx: prophylatic: avoid UV exposure
topical steroids can be used for mod to severe inflammation.
Pt presents with conjuctival tissue on cornea. Pt complains of visual loss and irritation and dry eye symptoms. Pt lives in Hawaii.
Upon examination, there is a mass on the cornea.
Pterygium
d/t UV exposure
Tx: prophylactic: avoid UV exposure
Topical steroids when inflamed; surgery
Pt has high blood pressure.
Upon examination:
Hypertensive retinopathy.
d/t high BP and necrosis of the smooth m.
Upon examination: cotton wool spots, punctuate hemorrhage, 4 diff stages
Tx: dec BP and opthalmo referral
Pt has diabetes. Pt has no symptoms of visual loss.
Upon examination:
Diabetic retinopathy. Nonproliferative: hemorrhages Proliferative: neurovascularization exudates, vascular occulsion Tx: control diabetes and opthalmo referral
Pt is recovering from CHF w/high BP. She is overweight and a chain smoker. She is complaining of vision loss.
Upon examination:
Age Related Macular Degeneration.
Dry: pigment changes, drusen (yellow pigments), gradual
Wet: acute, severe, curtain closing - neurovascularization
Tx: stop smoking, lose weight, dec BP, opthalmo referral
Pt is old and complains of seeing “glares” when she is driving and loss of visual acuity.
Upon examination, there is opacity in the eye ball and altered red reflex.
Cataract.
Idiopathic - underlying systemic dx (diabetes, HTN)
Tx: surgery to replace crystalline lens with artificial.
Pt presents with loss of peripheral vision.
Upon examination, there are changes to the optic disc ratio.
Open Angle Glaucoma
d/t the increase interocular pressure cx damage to the optic nerve (drain is fine)
Tx: opthalmo referral
Pt presents with N&V, loss of vision, headaches, and halos around lights.
Closed Angle Glaucoma
Pt is a child and tends to squint in one eye in bright eye. Parents noticed limited eye movement and moves head.
Upon examination, the eye is misaligned.
Strabismus
d/t paralysis of ocular m.
Tx: eye patch, corrective lens, surgery if needed, opthalmo referral
Pt presents with swelling and redness on upper lid.
Upon examination, there is inflammation of the lacrimal gland.
Dacryoadenitis
d/t dacryocystocele becoming infected.
Acute: + watery and discharge.
d/t staph, Epstein barr virus, HSV, N. gonorrheae
Chronic: globe displacement and enlarged lacrimal gland.
Tx: bacterial - agumentin; viral; acyclovir
Pt presents pain, tender, swelling of the eye. At birth it was a bluish mass.
Dacryocystitis
inflammation of the duct
d/t dacryocystocele becoming infected.
Tx: Clindamycoin, vancomyocin
