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Clinical Medicine I > Eye Inflammation > Flashcards

Eye Inflammation Flashcards

1
Q

What is the clinical presentation of episcleritis?

A

segmental eye redness, discomfort, no vision loss, pink color of the sclera

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2
Q

What is the population that episcleritis is more present in?

A

women

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3
Q

What is the causation of episcleritis?

A

connective tissue or vascular disease
often occurs alone in episcleritis

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4
Q

What is the treatment of episcleritis?

A

often resolves spontaneously, may improve with topical NSAIDs or artificial tears

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5
Q

What is the clinical presentation of scleritis?

A

overlying episcleritis, blue hue, painful SEVERE boring eye pain, worsens with eye movement, photophobia, vision loss

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6
Q

What is the most common population of scleritis?

A

women

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7
Q

What is the causation of scleritis?

A

Same as episcleritis with vascular disease; often occurs with systemic autoimmune diseases and infections

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8
Q

How can you diagnose scleritis?

A

labs and imaging!

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9
Q

What is the treatment of scleritis?

A

considered an EMERGENCY, refer to opthalmology
systemic NSAIDS, topical steroids
if no response to above, systemic steroids, subjunctival steroids, immune modulators

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10
Q

What is the clinical presentation of anterior blepharitis?

A

crusting, scaling, erythema of lid margins, “red-rimmed”, eyelashes, irritated, burning, itching

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11
Q

What is the cause of anterior blepharitis?

A

ulcerative from staph infection or inflammation of oil glands

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12
Q

What is the treatment of anterior blepharitis?

A

eyelid hygiene - massage, baby shampoo, warm compress
if constant issue; antibiotic eye ointment – bacitracin or erythromycin

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13
Q

What is the clinical presentation of posterior blepharitis?

A

spider veins in the eyelid, inflamed meibomian glands, lid margin rolled inward, tear film frothy or greasy

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14
Q

What is the causation of posterior blepharitis?

A

bacterial infection (staph), primary glandular dysfunction, ASS W/ ACNE ROASACEA

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15
Q

What is the treatment of posterior blepharitis?

A

warm compress and gland expression
if conjunctiva/cornea are inflamed,
long term low dose oral abx:
tetracycline, doxycycline, minocycline, erythromycin, azithromycin

short term topical corticosteroids: prednisolone

topical abx: ciprofloxacin

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16
Q

What is the clinical presentation of internal hordeolum?

A

localized red, swollen, acutely tender, PAINFUL area on upper/lower lid ‘ points onto conjunctival surface

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17
Q

What is the causation of internal hordeolum?

A

acute = staph aureus, blockage/infection of Zeis (sebaceous) or Moll (sweat) glands

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18
Q

What is the causation of external hordeolum?

A

same as internal: staph aureus, blockage/infection of Zeis (sebaceous) or Moll (sweat) glands

19
Q

What is the clinical presentation of chalazion?

A

hard, nontender swelling adjacent conjunctiva “painless, rubbery nodule”

20
Q

What is the treatment of chalazion?

A

warm compress
2-3 weeks and no improvement requires I&D and maybe a corticosteroid injection

NO ABX

21
Q

What is the clinical presentation of entropion?

A

inward turning of the lower eyelid

22
Q

What are the risks for entropion and ectropion?

A

elderly

23
Q

What is the causation of entropion?

A

loss of lid fascia, conjunctival scarring

24
Q

What is treatment for entropion?

A

Usually not much, but if lashes are scratching the cornea, surgery is required; maybe botox would help?

25
Q

What is the clinical presentation of ectropion?

A

outward turning of the lower eyelid

26
Q

What is the treatment of ecotropion?

A

keep eyes moist, surgery for excessive tearing, exposure keratitis or cosmetic issue

27
Q

What is the clinical presentation of dacryocystitis?

A

lacrimal SAC pain, unilateral swelling, tenderness, redness near sac area. Usually purulent; CHRONIC: tearing and discharge, mucus or pus may be expressed

28
Q

In who is dacryocystitis most common?

A

infants and >40 years old

29
Q

What is the causation of dacryocystitis?

A

acute: staph aureus
chronic: staph epidermidis

30
Q

How do you treat dacryocystitis?

A

systemic oral abx with g+ coverage –> augmentin, cephs, cipro, clindamycin, bactrim
Follow up!

Chronic: keep latent with systemic, or relief of obstruction with surgery

31
Q

How do you manage a congenital nasolacrimal duct obstruction?

A

usually resolves spontaneously

32
Q

What is the clinical presentation for dacryadenitis?

A

lacrimal GLAND inflammation. Acute within hours or days with pain swelling, redness of outer portion of upper lid. Includes purulence, fever, malaise
CHRONIC: bilateral, painless, soft tissue swelling

33
Q

What makes someone at risk for dacryadenitis?

A

inflammatory disorders

34
Q

What is the causation of dacryoadenitis?

A

acute is mostly viral – EBV, mumps, coxsack, CMV, varicella
bacterial – staph aureus
chronic–non-infectious inflammatory disorders (thyroid disease, sjorgen’s, sarcoidosis)

35
Q

How do you diagnose dacryoadenitis?

A

culture and drainage (optional)
chronic: requires lab workup for inflammatory etiology; biopsy

36
Q

What is the treatment of dacryoadenitis?

A

systemic abx – oral cephalosporin (CEPHALEXIN)
sulfameth-trimethoprim or linezolid for MRSA, IV or PO

severe = IV naficillin or MRSA is IV vancomycin

37
Q

What is treatment for severe dacryoadenitis?

A

IV naficillin or for MRSA vancomycin IV

38
Q

What is the clinical presentation of dacryostenosis?

A

eyelash matting, tears that appear thicker and yellow in color

39
Q

What is the causation of dacryostenosis?

A

nasolacrimal duct obstruction

40
Q

What is the diagnosis process of dacryostenosis?

A

fluorescein applied to eye and left to check if cleared. Key=lack of accompanying symptoms

41
Q

how do you manage dacryostenosis?

A

supportive care –> gentle massage to drain duct

42
Q

how do you treat severe dacryoadenitis?

A

IV naficillin or MRSA-vancomycin

43
Q

What is posterior blepharitis associated with?

A

acne rosacea

Clinical Medicine I (33 decks)

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