Eye Inflammation Flashcards
What is the clinical presentation of episcleritis?
segmental eye redness, discomfort, no vision loss, pink color of the sclera
What is the population that episcleritis is more present in?
women
What is the causation of episcleritis?
connective tissue or vascular disease
often occurs alone in episcleritis
What is the treatment of episcleritis?
often resolves spontaneously, may improve with topical NSAIDs or artificial tears
What is the clinical presentation of scleritis?
overlying episcleritis, blue hue, painful SEVERE boring eye pain, worsens with eye movement, photophobia, vision loss
What is the most common population of scleritis?
women
What is the causation of scleritis?
Same as episcleritis with vascular disease; often occurs with systemic autoimmune diseases and infections
How can you diagnose scleritis?
labs and imaging!
What is the treatment of scleritis?
considered an EMERGENCY, refer to opthalmology
systemic NSAIDS, topical steroids
if no response to above, systemic steroids, subjunctival steroids, immune modulators
What is the clinical presentation of anterior blepharitis?
crusting, scaling, erythema of lid margins, “red-rimmed”, eyelashes, irritated, burning, itching
What is the cause of anterior blepharitis?
ulcerative from staph infection or inflammation of oil glands
What is the treatment of anterior blepharitis?
eyelid hygiene - massage, baby shampoo, warm compress
if constant issue; antibiotic eye ointment – bacitracin or erythromycin
What is the clinical presentation of posterior blepharitis?
spider veins in the eyelid, inflamed meibomian glands, lid margin rolled inward, tear film frothy or greasy
What is the causation of posterior blepharitis?
bacterial infection (staph), primary glandular dysfunction, ASS W/ ACNE ROASACEA
What is the treatment of posterior blepharitis?
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
What is the clinical presentation of internal hordeolum?
localized red, swollen, acutely tender, PAINFUL area on upper/lower lid ‘ points onto conjunctival surface
What is the causation of internal hordeolum?
acute = staph aureus, blockage/infection of Zeis (sebaceous) or Moll (sweat) glands
What is the causation of external hordeolum?
same as internal: staph aureus, blockage/infection of Zeis (sebaceous) or Moll (sweat) glands
What is the clinical presentation of chalazion?
hard, nontender swelling adjacent conjunctiva “painless, rubbery nodule”
What is the treatment of chalazion?
warm compress
2-3 weeks and no improvement requires I&D and maybe a corticosteroid injection
NO ABX
What is the clinical presentation of entropion?
inward turning of the lower eyelid
What are the risks for entropion and ectropion?
elderly
What is the causation of entropion?
loss of lid fascia, conjunctival scarring
What is treatment for entropion?
Usually not much, but if lashes are scratching the cornea, surgery is required; maybe botox would help?
What is the clinical presentation of ectropion?
outward turning of the lower eyelid
What is the treatment of ecotropion?
keep eyes moist, surgery for excessive tearing, exposure keratitis or cosmetic issue
What is the clinical presentation of dacryocystitis?
lacrimal SAC pain, unilateral swelling, tenderness, redness near sac area. Usually purulent; CHRONIC: tearing and discharge, mucus or pus may be expressed
In who is dacryocystitis most common?
infants and >40 years old
What is the causation of dacryocystitis?
acute: staph aureus
chronic: staph epidermidis
How do you treat dacryocystitis?
systemic oral abx with g+ coverage –> augmentin, cephs, cipro, clindamycin, bactrim
Follow up!
Chronic: keep latent with systemic, or relief of obstruction with surgery
How do you manage a congenital nasolacrimal duct obstruction?
usually resolves spontaneously
What is the clinical presentation for dacryadenitis?
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
What makes someone at risk for dacryadenitis?
inflammatory disorders
What is the causation of dacryoadenitis?
acute is mostly viral – EBV, mumps, coxsack, CMV, varicella
bacterial – staph aureus
chronic–non-infectious inflammatory disorders (thyroid disease, sjorgen’s, sarcoidosis)
How do you diagnose dacryoadenitis?
culture and drainage (optional)
chronic: requires lab workup for inflammatory etiology; biopsy
What is the treatment of dacryoadenitis?
systemic abx – oral cephalosporin (CEPHALEXIN)
sulfameth-trimethoprim or linezolid for MRSA, IV or PO
severe = IV naficillin or MRSA is IV vancomycin
What is treatment for severe dacryoadenitis?
IV naficillin or for MRSA vancomycin IV
What is the clinical presentation of dacryostenosis?
eyelash matting, tears that appear thicker and yellow in color
What is the causation of dacryostenosis?
nasolacrimal duct obstruction
What is the diagnosis process of dacryostenosis?
fluorescein applied to eye and left to check if cleared. Key=lack of accompanying symptoms
how do you manage dacryostenosis?
supportive care –> gentle massage to drain duct
how do you treat severe dacryoadenitis?
IV naficillin or MRSA-vancomycin
What is posterior blepharitis associated with?
acne rosacea
