Eye disorders Flashcards
malposition of lid AWAY from eyeball–typically lower lid involved
ectropion
etiology of ectropion (5)
- involution–change in lid laxity
- cicatricial–scar
- paralytic–CN VII palsy
- Mechanical–space-occupying lesion
- Infection–HSV
Inward turning eyelid
Entropion
entropion etiology (5)
- cicatricial
- chemical burn
- trauma
- infection HSV
- laxity of lid
lid disorder that is chronic or acute; anterior or posterior, or both
blepharitis–usually Staph
Pathophys of blepharitis
- infections or seborrheic (Anterior blepharitis involves skin of external eyelid, eyelashes, and associated glands.
- inflammation of meibomian glands –secondary to seborrhea or acne rosacea
- infections (staph, demodex)
- Seborrheic (isolated to lid margins–ant or post)
- Acne rosacea–POSTERIOR blepharitis
burning, itching, redness, and mildly decreased vision
Seborrheic blepharitis
demodex Tx
metronidozole, tea-tree oil
chronic inflammatory skin disease which affects the MIDLINE skin of face and upper chest – persistent erythema, telangiectasis, papules, pustules, and sevaceous gland hypertrophy
Acne Rosacea – may be from Demodex
Tx of acne rasacea
- avoid triggers
- metronidazole gel to lids
- doxycycline
common acute infections abscess typically caused by staph.
hordeolum (stye)
types of Stye
- internal hordeolum–small staph abscess of meibomian glands
- external hordeolum–acute staph abscess of a lash follicle–associated w/ Zeis or Moll glands
TX for Stye and chalazion
- hygiene
- warm compress
- I&D if surrounding cellulitis
a form of blepharitis that is a localized nontender sterile granulomatous inflammation w/in a MEIBOMIAN gland
Chalazion
conjunctivitis usually always _____ etiology
viral (^adenovirus or HSV)
pink eye usually
acute viral conjunctivitis
bacterial conjunctivitis usually from (4)
- Staph aureus
- staph epidermidis
- Strep pneumoniae
- Haemophilus influenzae
H&P bacterial conjunctivitis (5)
- redness
- foreign body sensation
- purulent discharge
- itchy
- more likely unilateral
flat or elevated, cream-colored, white, or chalky lesion of conjunctiva adjacent to the limbus and w/in the palpebral fissure
Pinguecula
triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over the limbus ONTO CORNEA
Pterygium
changes in the retina due to hypertension
hypertensive retinopathy
Signs os hypertensive + diabetic retinopathy (3)
- “cotton wool spots”
- coper/silver wire (3D in appearance)
- punctate hemorrhages
TX for hypertensive retinopathy
lower blood pressure + ophthalmology exam
hypertensive retinopathy may predispose pt to
retinal detachment
diabetes causes vascular pathology to the retina
Diabetic retinopathy (proliferative or nonproliferative)
Tx for diabetic retinopathy (3)
- control diabetes
- laser for diabetic retinopathy
- ophthalmology exam and f/u
small, bright yellow DRUSEN (pigmentary changes–deposits under retina)
Age related macular degeneration Dry –> Wet
___ARMD most frequently progresses to blindness
wet
non-exudate ARMD
dry vs. exudate=wet
macular degeneration leads to loss of _____ ______ not ______ vision
20/20 vision not peripheral
Wet ARMD characterized by…
presence of choroidal neovascularization and associated exudation
opacity of lens of the eye, localized or diffuse, potentially causing problems w/ vision
Cataract
H&P cataract (6)
- decreased vision
- Glare esp at night
- alterations in color vision
- reduced acuity
- alteration in red reflex
- “crystalline lens”
Irreversible optic neuropathy typically associated w/ elevated intraocular pressure. If left untreated can lead to blindness
Open angle glaucoma
open angle glaucoma leads to
optic nerve damage–> vision loss
DDX of open angle glaucoma
Angle closure glaucoma
blockage of tear drainage may lead to
acute angle closure glaucoma
PE glaucoma
- visual field defects
- changes in cup:disk ratio CD
- raised intraocular pressure IOP
Misalignment of eyes, such that the two visual axes are not simultaneously directed at the same object
strabismus
main goal when treating glaucoma
lower IOP
etiology of strabismus (2)
- genetic
2. paralysis of ocular muscles
inward deviation of eye
esotropia
outward deviation of eye–may be observable when pt tired, unwell or daydreaming
exotropia
Tx for strapismus –refer ASAP, preferably before pt is 2 yo
- corrective lenses
- patching
- eye muscle surgery
inflammation of the lacrimal gland–acute or chronic
dacryoadenitis
etiology of dacroadenitis (4) – treat accordingly
- Staph
- Epstein-barr virus
- HSV
- N. gonorrhoeae
painful, tender swelling of the inferior medial canthal area, w/ surrounding cellulitis. infections obstrucion of nasolacrimal duct. INFRAMEDIAL region.
dacryocystitis
blood in the anterior chamber–traumatic typically from BLUNT TRAUMA
Hyphema
PE of hyphema (5)
- photophobia
- decreased visual acuity
- anisocoria (mydriasis or miosis)
- ^ IOP
- corneal blood staining
demyelinating optic neuropathy idiopathic or w/ MS
optic neuritis
W/ Hyphema don’t miss (2)
orbital fracture or globe rupture