Eye problems

Question 1

Blepharitis S/T

Answer 1

bilateral red and swollen edge of eyelids . “itchy eyelid” associated with seborrhic dermatitis and rosacea

Scrub with warm water and baby shampoo

Question 2

Pterygium S/Cause

Answer 2

one-sided triangular shaped white to yellowish superficial growth on the nasal side , can be bilateral as well

Caused by long term UV damage, can surgically remove, use sunglasses

Question 3

Pinguecula S/Cause

Answer 3

white to yellowish small lesions on BOTH sides of the cornea ( ping pong)

caused by UV damage, wear sunglasses

Question 4

Chalazion

Answer 4

Small painless nodule on upper or lower eyelid , no tx can use warm compresses

Question 5

Senile arcus

Answer 5

white-gray ring on edge of cornea

common in elderly as it is due to lipid deposits

Age < 50 check lipid panel

Question 6

Xanthelasma

Answer 6

soft yellow flat plaques on the upper and lower lids by the inner cants

they are cholesterol plaques. order fasting lipid panel.

Question 7

Hordeolum or stye “ hurts”

Answer 7

Acute onset of localized lesion on eyelid. very painful

avoid eye makeup, use warm compresses, can use topical ophthalmic antibiotics

due to staph

Question 8

bacterial conjunctivitis

Answer 8

acute onset, red eye, dried crusty yellow-green crusting on awakening

topical ophthalmic flouroquinolones

Question 9

Viral conjunctivitis

Answer 9

acute onset of red eye, itchy, ***periauricular lymphadenopathy **, keep out of school for a week

Question 10

Allergic Conjunctivitis

Answer 10

bilateral itchy eyes, increased tearing with reddened / injected conjunctiva , may be seasonal

cool eyelid compress

Decongestant - Visine ( short term only)

Question 11

What does snellen 20/60 signify?

Answer 11

The patient can see at 20 ft what a normal person can see at 60 ft

** pt is always 20 **

Question 12

What is seen on eye exam with people with diabetic retinopathy ?

What are symptoms ?

Answer 12

Cotton wool spots
neovascularization
microaneurysms

blurred vision, floaters, scotoma ( blind spot)

Question 13

What is seen on eye exam with people with hypertensive retinopathy ?

Answer 13

copper wire arterioles
silver wire arterioles
av nicking, flamed shaped hemmorhages

Question 14

what is Herpes Keratitis? Classic presentation ? PE findings

Answer 14

caused by herpes virus of the trigeminal nerve affecting ophthalmic branch

complaining of acute onset blurred vision, tearing, and eye pain in one eye. Will see shingles on tip of nose

PE: fluorescein shows = fern like lesion, on the cornea on affected eye

TX: see optho stat

Question 15

what is an Cornea Abrasion? PE findings, TX?

Answer 15

acute onset of severe pain, foreign body sensation, tearing

“current closing” - type of vision loss

TX: topical antibiotic with erythromycin, no patching

PE: will see flouescein stain strips ( lower lid) ( should light up green)

Question 16

what type of bacteria are people who use contact lens most likely to get

and what antibiotic would you tx with?

Answer 16

higher risk for pseudomonas, if infected use topical antibiotics with fluoroquinolone

Question 17

What is Open Angle Glaucoma? PE findings? TX

Answer 17

increased ICP (>35), rarely symptomatic, causes ischemic damage to optic nerve

PE: disc cupping, and increased ICP

decreased peripheral vision

TX: beta-blocker eye drops

Question 18

What is Primary Acute Angle-Closure Glaucoma? PE findings? TX?

Answer 18

increased ICP, which caused ischemic damage to the retina.

Complains of severe, ocular/eye pain with decreased vision, n/v. halos around lights

PE: conjunctival erythema, fixed mid-dilated pupil, hazy cornea

TX: send to Ed

Question 19

What is Age-Related Macular Degeneration? PE findings? TX

Answer 19

painless loss of central vision, most common cause of vision loss.
Two types :
- dry AMD - tx w/ eye vitamins
- wet AMD - tx w/ injections of VEGF

Diet : increase w/ of lutien and zeaxanthin (cooked kale, cooked spinach)

Question 20

What is the red reflex test screening for?

Answer 20

cataracts,
normal: symmetrical round reddish-orange glow

abnormal : no glow, dull, white reflection are abnormal

Question 21

Classical presentation of cataracts ?

Answer 21

complains of blurred vision, increased sensitivity to glare, Poor night vision, sees halos around light