Eye problems Flashcards
Define Orbital cellulitis its cause, symptoms, and tx?
Infection of the fat and muscle contained within the boney orbit (usually Staph A, and Strep)
Cause: Infectious extension from sinuses, blood, or direct inoculation of the orbit from trauma or surgery.
Symptoms: Proptosis, increased IOP, Decreased acuity and EOM, diplopia.
Tx- aggressive antibiotic treatment, or surgery related to complications such as abscess formation, or involvement of the cavernous sinus, fungal infection, or failure to respond to tx.
Hordeolum aka? how do you get it? complications?
Acute purulent inflammation of the eyelid
Internal meibomian gland inflammation
external stye
stye tender red bump at base of eyelash, under or inside lid. 90% Staph A.
Comp-harden into a chalazion
What should you know about steroid use and the eyes?
avoid ocular steroid use in primary care
Chalazion? What is it how do you tx it?
chronic inflammatory lesion from an obstructed zeis or meibomian gland.
painless, rubbery nodule
tx incision and curettage, inject steroids, eval for meibomian gland carcinoma/sebaceous.
What eye condition presents in a similar manner to blepharitis but with decreased lacrimation?
keratoconjunctivitis sicca- on exam eyes may water more than usual don’t let this confuse you, these are reflex tears.
If you have keratoconjuctivitis sicca what’s the tx?
Artificial tears (or tear stimulation), eyelid cleansing, sweet glasses that cover the sides of your eyes, and avoiding infrequent blinking
Acute dacryocystitis?
blocked tear duct- tender and purulent
A 51 y/o f c/o loosing her lashes near an area with recurrent chalazion on her left eye should be evaluated for what?
Sebaceous carcinoma rare but highly malignant
whats the most common malignant tumor of the eyelid
basal cell carcinoma
This painful, destructive and potentially blinding disorder may involve the cornea, episclera, and uveal tract, and is commonly associated with RA, and Wegeners granulomatosis.
scleritis
How do patients with scleritis present Tx?
pain or deep aching in the eye that can radiate to the face. Reflex lacrimation and photophobia. PE reveals a diffuse nodular and necrotizing sclera, that could potentially lead to optic nerve edema with visual compromise.
Emergency!!!ould
tx NSAIDs and glucocorticoids, may need surgery or scleral grafts (thin necrotic sclera)
Keratitis can develop into what common complication, who is at risk and what will the cornea look like on PE; microscopically what’s happening at the cornea? Tx
corneal ulcer
contact lens wearer, those with foreign body in eye, herpetic, chemical exposure
Cornea looks opaque or hazy.
Microscopically loss of epithelial or sub epithelial tissue, stromal infiltrates of fibrin in the anterior chamber, or hypopyon from infection.
Tx eye shield and referal for deep ulcer or perforation, minor ulcer do not patch.
When you suspect a foreign body in the eye or are considering using fluorescein drops to visualize the eye what should you always do first?
r/o penetrating trauma before introducing a dye or analgesic eye drops
What does the uvea include and which type of uveitis is most common?
choroid, iris, or ciliary muscles
uveitis, iritis, or iridocyclitis
anterior uveitis is most common
deep eye pain (ciliary spasm), non reactive pupil, red eye, photophobia
maybe infectious or immune related
tx with antibiotics or glucocorticoids depending on cause
Explain how darkness exacerbates acute angle closure glaucoma?
Using a patch or blindfold or having the patient in a dark room will cause pupillary dilation and further decrease the angle between the iris and the cornea further the outflow tract block to the canal of schlemm.
