Eye Part 1 Pharm

Question 1

what are the topical treatment options for anterior and posterior blepharitis?

Answer 1

azithromycin (4 week course)
erythromycin (cheap)
bacitracin

Question 2

what are the oral treatment options for anterior and posterior blepharitis?

Answer 2

doxycycline or tetracycline (2-4 week course)

erythromycin can be used as an alternative

Question 3

what is another treatment option for anterior and posterior blepharitis that you should you NEVER prescribe (unless you’re an ophthalmology PA)?

Answer 3

topical glucocorticoids

Question 4

what is the supportive treatment for anterior and posterior blepharitis?

Answer 4

warm compresses
lid massage
lid washing

Question 5

what is the mainstay of treatment for anterior and posterior blepharitis (seeing as it is a chronic condition)?

Answer 5

good lid hygiene

Question 6

is there a real cure for anterior and posterior blepharitis?

Answer 6

nope.

Question 7

what’s our goal of treatment for anterior and posterior blepharitis?

Answer 7

alleviate acute sx

develop a maintenance regimen to prevent or minimize future exacerbations

Question 8

what is the tx for bacterial conjunctivitis?

Answer 8

erythromycin ointment or trimethoprim-polymyxin B

Question 9

what is the tx for viral conjunctivitis?

Answer 9

antihistamine/decongestant drops (OTC)

Question 10

what is the tx for allergic conjunctivitis?

Answer 10

antihistamine/decongestant drops (OTC)

Question 11

what do we use for anesthesia of the eye for corneal abrasion?

Answer 11

proparacaine/tetracaine (after visual acuity if possible)

Question 12

what should you never send someone home with?

Answer 12

numbing drops! (PROLONGED USE MAY RESULT IN PERMANENT CORNEAL OPACIFICATION AND VISUAL LOSS)

Question 13

when does someone with a corneal abrasion need a same-day ophthalmology exam?

Answer 13

Corneal infiltrate, white spot, or opacity suggestion ulceration
Foreign body that cannot be removed
Hypopyon (pus in the anterior chamber)
A larger epithelial defect
Purulent discharge
A drop in vision of more than one to two lines on a Snellen chart
An infant or child with persistent discharge or unwillingness to keep the eye open
Corneal abrasion that has not healed after three to four days

Question 14

why do we use topical antibiotics in the treatment of corneal abrasions?

Answer 14

to prevent conjunctivitis

Question 15

what do we use for pain control for a SMALL corneal abrasion?

Answer 15

Ophthalmic NSAIDs, oral NSAIDS, Tylenol #3, Percocet (24h), Lacri-lube (OTC)

Question 16

what do we use for pain control for a LARGE corneal abrasion?

Answer 16

NSAIDs/narcotics (48h), cycloplegic drops like cyclopentolate or homatropine

Question 17

is eye patching more recommended for small or large corneal abrasions?

Answer 17

large. nor recommended for small ones.

Question 18

what are cycloplegic drops (used in large corneal abrasions)

Answer 18

Cycloplegics are parasympatholytic drops that inhibit the miotic (pupil-constricting) response to light; it is this response to light that causes the ache and photophobia of corneal abrasion. These drops do not relieve foreign-body sensation.

Question 19

when do you need to see ophthalmologist if you have a corneal abrasion from a contact lens?

Answer 19

THAT SAME DAY! examine for corneal opacity/white spot/ulcer

Question 20

what antibiotic drops do we use with corneal abrasions for pseudomonas coverage?

Answer 20

oxofloxacin, tobramycin, ciprofloxacin (cheapest)

Question 21

which antibiotics will not cover pseudomonas? (corneal abrasions)

Answer 21

macrolides

sulfas

Question 22

T/F: patients who got a corneal abrasion from wearing contacts should not get patched

Answer 22

true

Question 23

what treatment should be avoided with a corneal abrasion?

Answer 23

topical steroids (plussssssss these should be Rx by ophthalmologist or under their direction anyway)
repeated topical anesthesia
patching

Question 24

is treatment necessary for xanthelasma?

Answer 24

no. usually only done for cosmetic reasons

Question 25

what is the treatment for calazion?

Answer 25

most resolve without intervention in weeks or months..
warm compresses to help drain
ophthalmo - incision and cutterage or direct steroid injection.

Question 26

what should you check for if they have recurrent or persistent lesions (calazion)

Answer 26

cancer!

Question 27

what is the treatment for a hordeolum?

Answer 27

warm compresses, consider oral abx that cover staph aureus, if not better in 1-2 weeks, call ophthalmo for I&D

Question 28

what is the treatment for a pterygium?

Answer 28

artificial tears
vascular endothelial growth factor inhibitors?
NSAIDs/topical decongestants (potentially helpful)
obstructs vision/movement - surgical excision

Question 29

should you refer someone with cataracts to ophthalmo?

Answer 29

yes!

Question 30

when is surgery indicated for cataracts?

Answer 30

if it interferes with the pt’s ability to perform ADLs

Question 31

is surgery for cataracts done one eye at a time or both at once?

Answer 31

one eye at a time, outpatient

Question 32

what is initial treatment for ectropion?

Answer 32

artificial tears, lacri-lube

Question 33

what is the surgical intervention for ectropion

Answer 33

shorten/tighten lower lid

skin grafting

Question 34

what is the treatment for entropion?

Answer 34

surgical intervention! by an ophthalmologist trained in ophthal plastic surgery

Question 35

what are the various techniques of surgery for ectropion

Answer 35

tightening of the eyelid and attachements (restore to normal position)
several sutures placed - cause eversion of eyelid and hold it into place