Eye Conditions Flashcards
dt blood between conjunctiva and sclera – mb dt trauma, spontaneous, or secondary to illness (bleeding d/o, HTN, fever), asx and self-resolving. Can give artificial tears to help discomfort. Discourage use of NSAIDS or aspirin (it’s a hemorrhage)
Subconjunctival hemorrhage:
infxn of mucus membrane, usu dt adenovirus. Self-limited – shorter duration than bacterial and without d/c. sxs: itching, foreign body sensation, redness, photophobia, tearing. Tx: chamomile tea compress, artificial tears, good hand hygiene
Viral Conjunctivitis
purulent d/c, can last 2-4 wks without tx. Culture, esp if concerned about GC/CT. Good hand hygiene and avoidance of shared linens can prevent spread of infxn.
Bacterial conjunctivitis:
can be internal or external (aka stye). They are focal abscesses with pain, heat, swelling, and edema. Usu resolve in 1-2 wks. Tx: eyelid hygiene, warm compresses, and massage. Consider topical abx for assoc blepharoconjunctivitis or active drainage. Systemic abx for development of pre-septal cellulitis. Surgery indicated for very large hordeolums
Hordeolum:
granuloma of meiobian or Zeis glands dt lipid breakdown products that leak into surrounding tissue from either bacterial enzymes or retained sebaceous secretions. Appear as single, firm, non-tender nodules in eyelid. More common on upper lid.
Chalazion:
use blue light to visualize. Typically heal without serious complications. Support with ice compresses, NSAID eye drops, and prophylactic abx commonly given esp for traumatic or surgical abrasions. Close follow-up dt risk of developing corneal ulcer
Corneal abrasion:
full thickness epithelial loss, MC in pts who wear extended-wear contact lenses. Sxs: pain and occ blurry vision. Emergency – could cause loss of vision. They look like white or grey spots on the cornea, mb visible with naked eye. Occ abx injections in area of infxn or even surgery are needed. Discontinue contacts for 4 wks.
Corneal ulcers:
visual loss dt opacity of lens. Commonly have difficulty with colors, glare from bright lights, and reading. Often assoc with age. MC cause of blindness and treated with surgery.
Cataracts:
“halos forming around objects”, corneal cloudiness, and mid-dilated pupil. Dt increase in pressure
Acute angle-closure glaucoma:
black eye, from facial trauma, orbital surgery, or retrobulbar injection. Decreased acuity, painful proptosis (exophthalmos), ecchymosis, chemosis, mydriasis, afferent pupillary defect AND increased IOP. Tx: ice pack, pain control, bed rest
Retrobulbar hematoma:
injury to anterior chamber – blood makes a meniscus or layer over the iris of the eye. Sxs: pain, photophobia, blurred vision. Tx: rest with head sl elevated, shielded. Avoid anti-coagulants
Hyphema:
sudden painless loss of vision, usu dt emboli, atherosclerosis, vasculitis, vasospasm, or coagulopathy. Fundoscopic exam mb initially normal à “cherry red spot” on fovea. Tx: rebreathing expired CO2, sublingual nitro, gentle massage through eye lid may dislodge clot
Central retinal artery occlusion:
mb ischemic or non-ischemic. Non-ischemic mb asx. Ischemic may have marked decrease in vision – usu discovered upon waking. Both are painless. Funduscopic exam reveals retinal hemorrhages extending outward from optic disc “blood and thunder” appearance
Central retinal vein occlusion:
hazy vision, photophobia, perception of shadows, floaters, smoke signals, cobwebs, or lines in the visual field. Mb more noticeable with eye mvmts. Pain is uncommon. Mb secondary to trauma, diabetes, or retinal dz. Exam reveals blood in vitreous gel. Tx: head elevation and avoid measures that increase IOP.
Vitreous hemorrhages:
break or tear in neuronal layer and fluid leaks in. Sxs: flashes of light, floaters, a curtain or shadow moving over the field of vision, and peripheral or central visual loss. Exam reveals slightly opaque retina.
Retinal detachment:
