Eye and Ear Flashcards
What are the features of Viral Conjunctivitis?
- Eyes affected?
- Discharge?
- Pain?
- Distribution of redness?
- Associated symptoms?
- Eyes affected? Both
- Discharge? Watery
- Pain? Gritty feeling
- Distribution of redness? Generalised
- Associated symptoms? Cough and cold
What are the features of Bacterial Conjunctivitis?
- Eyes affected?
- Discharge?
- Pain?
- Distribution of redness?
- Associated symptoms?
- Eyes affected? Both, but one eye affected a day or so before the other
- Discharge? Purulent (Pus)
- Pain? Gritty feeling
- Distribution of redness? Generalised and diffuse
- Associated symptoms? Generally none
What are the features of Allergic Conjunctivitis?
- Eyes affected?
- Discharge?
- Pain?
- Distribution of redness?
- Associated symptoms?
- Eyes affected? Both
- Discharge? Watery
- Pain? Itching
- Distribution of redness? Generalised but greatest in fornices
- Associated symptoms? Rhinitis
What are the red flag and referral symptoms of conjunctivitis?
- True eye pain
- Loss of visual acuity/vision
- Vomiting
- Limbal redness only
- Clouding of cornea
- Photophobia
- Foreign body
- Contact lenses
What are the risks of sub-conjunctival haemorrhages?
No risk.
- Check patient is not on warfarin or aspirin
How do you treat Episcleritis?
It is self limiting
What red-eye causes would you refer?
Keratitis (corneal trauma)
Uveitis
Glaucoma
Scleritis
What can you for allergic conjunctivitis?
Sodium Cromoglycate Eye Drops (mast cell stabiliser)
What can you give for Bacterial Conjunctivitis?
Chloramphenicol eye drops or ointment
What can you give for Viral Conjunctivitis?
Chloramphenicol eye drops or ointment
What preparations are no longer recommended for conjunctivitis?
Brolene and Golden Eye
What are the features of a Stye?
- Unilateral
- Swollen upper or lower lid
- Painful to touch
- Associated conjunctivitis
What are the features of Blepharitis?
- Bilateral
- Skin irritation, itching and burning
- Skin flakes around eyelashes
- Missing lashes
- Associated conjunctivitis
What OTC treatment would you suggest for Styes and Blepharitis?
OTC treatment usually not needed.
- Refer for antibiotics if an infection is suspected
What lifestyle advice would you give to a patient with a stye?
- Topical antibiotics will not speed up healing
- Warm compress 3-4 times a day (to bring the stye to a head)
What lifestyle advice would you give to a patient with blepharitis?
- Improved lid hygiene
- Warm compress bathing
- Mild shampoo
What are the symptoms of ‘dry eye’?
- Burning, tired, itchy, irritate or gritty eyes
- Lack of ocular redness
- Long standing history of symptoms
A patient is complaining of itchiness, pain, discharge and deafness regarding their ear. Which part is affected?
External ear
A patient is complaining of pain, discharge and deafness regarding their ear. Which part is affected?
Middle
A patient is complaining of deafness, dizziness and tinnitus regarding their ear. Which part is affected?
Inner ear
What would you suggest for a patient with excessive ear wax?
Olive oil if it is being syringed
Cerumol if not
What are the referral symptoms for conditions affecting the ear?
- Trauma related deafness
- Dizziness or tinnitus
- Foreign body
- OTC medication failure
- Pain originating from the middle ear
What is otitis externa?
- Generalised inflammation of the ear canal
- Characterised by irritation, pain, discharge and conductive hearing loss
What are referral symptoms for otitis externa?
- Ear pain in children (>6years)
- Generalised inflammation of the pinna-perichondritis
- Symptoms lasting >7days or longer
- Impaired hearing in children
- Mucopurulent discharge
- Pain on palpation
- Slow growing growths on the pinna of elderly patients
What can you give OTC for otitis externa?
Limited
- Antihistamines
- Analgesics
- Choline salicylates (Earex plus or Audax)
- Acetic acid 2% (for superficial infections of the ear)
