Eye Disorders

Question 1

Hordeoloa

• Types
• Causes
• Presentation
• Treatment

Answer 1

TYPES–internal and external (stye)
CAUSES–Staphylococcal abscess; Meibomian gland abscess (internal), Gland of Zies or Moll (external)
PRESENTATION–Painful red swelling with possible pustule (external); Localized, red, swollen, cyst (internal)
TREATMENT–Warm compresses, topical antibiotics, oral antibiotics, I&D

Question 2

Chalazion

• Causes
• Presentation
• Treatment

Answer 2

CAUSES–inflammation of meibomian gland (can follow internal hordeola)
PRESENTATION–hard nontender swelling on eye lid, redness and swelling of adjacent conjuctiva, blurred vision
TREATMENT–warm compress, I&D, corticosteroid
Refer to opthalmologist if persistent for serious trx

Question 3

Blepharitis

• Types
• Causes
• Presentation
• Treatment

Answer 3

TYPES–anterior and posterior
CAUSES–Styaphylococcal or seborrheic
PRESENTATION–chronic inflammation of glands around eyelashes, small pustules and crusty flakes, foreign body sensation, matting of eyelashes, burning sensation of lids
TREATMENT–proper lid hygiene, topical antibiotics for Staph

Question 4

Dacryocystitis

• Causes
• Presentation
• Treatment

Answer 4

CAUSES–bacteria blocking and infecting the nasolacrimal duct
PRESENTATION–over runny eye, redness and infections
TREATMENT–massage the area, probe duct (if infant after 12 months of age), treat infections with antibiotics (topical)

Question 5

Anterior (preseptal) Cellulitis

• Causes
• Presentation
• Treatment

Answer 5

CAUSES–Trauma, Upper Respiratory Infection, Sinusitis, otitis
PRESENTATION–red, swollen lids and skin, normal vision and conjunctiva
TREATMENT–cool compress, systemic antibiotics, hospitalization if child <3 yo

Question 6

Posterior (orbital) cellulitis

• Causes
• Presentation
• Treatment

Answer 6

CAUSES–Sinus infections (S. aurius, S. pneumoniae, H. influenzae)
PRESENTATION–Swollen, red lids and conjunctiva, proptosis, decreased vision, impaired ocular motility, optic disc edema
TREATMENT–hospitilization, ENT consult, blood cultures, IV antibiotics

Question 7

Bacterial Conjunctivitis

• Causes
• Presentation
• Treatment

Answer 7

CAUSES–Staph, strep, H. influenzae, N. Gonorrhea
PRESENTATION–purulent discharge and overall red “pink eye” conjunctiva; hyperpurulent if N. gonorrhea (treat emergently)
TREATMENT–antibiotic eye drops, warm compresses

Question 8

Viral Conjunctivitis

• Causes
• Presentation
• Treatment

Answer 8

CAUSES–Adenovirus
PRESENTATION–bilateral “bloodshot eye” apprearance, serous discharge, palpable pre-auricular lymph nodes
TREATMENT–self limiting (1-2 weeks)

Question 9

Allergic Conjunctivitis

• Causes
• Presentation
• Treatment

Answer 9

CAUSES–allergies
PRESENTATION–watery eyes, extremely itchy
TREATMENT–topical anti-histamines/mast cell stabalizers

Question 10

Neonatal conjunctivitis

• Causes
• Presentation
• Treatment

Answer 10

CAUSES–bacteria in mothers vagina at birth (N. gonorrhea, Chlamydia uncommon) Staph, strep, h. flu common
PRESENTATION–bacterial conjunctivitis in infants
TREATMENT–erythromycin at birth, systemic or topical antibiotics, referral to ophthalmologist if suspected N. gonorrhea