EYELIDS AND ANTERIOR SEGMENT

Question 1

Red Eye: inflammatory etiologies

Answer 1

blepharitis
chalazion/hordeolum
cellulitis
conjunctivitis 
dacryoadenitis/dacryocystitis
corneal ulcer (keratitis)
uveitis

Question 2

Red Eye: traumatic etiologies

Answer 2

subconjunctival hemhorrhage
corneal abrasion
foreign body
hyphema

Question 3

Red Eye: other etiologies

Answer 3

glaucoma

tumor

Question 4

Vital Signs of Ophthalmology

Answer 4

vision
pupils
pressure

Question 5

Blepharitis

Answer 5

chronic condition

inflammation of the eyelids, typically with intermittent exacerbations

dry eye

Question 6

Anterior Blepharitis

Answer 6

infectious (S. aureus) or seborrheic component

Question 7

Posterior Blepharitis

Answer 7

results from meibomian gland dysfunction

Question 8

Blepharitis: clinical presentation

Answer 8

red eyes
gritty or foreign body sensation
burning sensation
excessive tearing 
crustiness in lashes
light sensitivity
\+/- blurry vision

Question 9

Blepharitis: physical exam

Answer 9

diffuse conjunctival injection 
inflamed/red eyelid margins
crusting/matting of eyelashes
plugged glands
collarettes

Question 10

Blepharitis: treatment

Answer 10

warm compress
lid massage
lid hygiene
topical antibiotics (severe)
oral antibiotics (really severe)

Question 11

Blepharitis: prevention

Answer 11

omega 3 supplements

Question 12

Chalazion

Answer 12

blepharitis complication

painless
rubbery
nodular

Question 13

Hordeolum

Answer 13

blepharitis complication

painful
infected
purulent

Question 14

Periorbital Cellulitis

Answer 14

infection of the soft tissues around the eye

does not extend into the orbit

more common

Question 15

Orbital cellulitis

Answer 15

infection of the fat and muscles surrounding the globe

more dangerous (close to cavernous sinus)

Question 16

Periorbital Cellulitis: etiology

Answer 16

external sources
(blepharitis, insect bites, FB)
sometimes sinusitis

Question 17

Orbital Cellulitis: etiology

Answer 17

extension of infection from paranasal sinuses (ethmoid sinuses)

Question 18

Periorbital Cellulitis: clinical presentation

Answer 18

eye pain
eyelid swelling and erythema

NO

• vision change
• fever
• pain with eye movements

Question 19

Periorbital Cellulitis: physical exam

Answer 19

NO

• proptosis
• ophthalmoplegia

Question 20

Orbital Cellulitis: clinical presentation

Answer 20

eye pain
eyelid swelling and erythema
vision changes (diplopia)
fever
pain with eye movements

Question 21

Orbital Cellulitis: physical exam

Answer 21

proptosis
ophthalmoplegia
conjunctivitis
+/- discharge

Question 22

Periorbital and Orbital Cellulitis: diagnosis

Answer 22

CBC
blood culture
culture of any discharge
CT scan of orbits and sinuses

Question 23

Periorbital Cellulitis: treatment

Answer 23

< 1 yo: hospitalize

> 1 yo: empiric antibiotic therapy (S.aureus, S.pneumoniae, MRSA)

Question 24

Orbital Cellulitis: treatment

Answer 24

hospitalization+ophthalmologist consult

• IV antibiotics (broad spectrum)
• surgical drainage if abscess

Question 25

Conjunctivitis

Answer 25

Inflammation of the white of the eye (conjunctiva) most common eye disease viral = most common also: bacterial, allergies, chemical transmission: direct contact

Question 26

Viral Conjunctivitis: etiology

Answer 26

most common agent: adenovirus

Question 27

Viral Conjunctivitis: signs and symptoms

Answer 27

``` pharyngitis fever malaise watery discharge preauricular adenopathy ```

Question 28

Viral Conjunctivitis: treatment

Answer 28

cold compress | resolves on its own

Question 29

Bacterial Conjunctivitis: etiology

Answer 29

most common organisms: - S. pneumoniae - H. influenzae - Pseudomonas

Question 30

Bacterial Conjunctivitis: clinical presentation

Answer 30

copious discharge | "eyes matted shut" in morning

Question 31

Bacterial Conjunctivitis: treatment

Answer 31

antibiotic eye drops or ointment

Question 32

Allergic Conjunctivitis

Answer 32

bilateral | seasonal

Question 33

Allergic Conjunctivitis: clinical presentation

Answer 33

itchiness | conjunctival injection and swelling

Question 34

Allergic Conjunctivitis: treatment

Answer 34

cold compress topical antihistamines oral antihistamines

Question 35

Dacryocystitis

Answer 35

infection in the lacrimal sac usually secondary to a nasolacrimal duct obstruction children > adults treatment: - aggressive antibiotics - surgery (NLD probing)

Question 36

Entropion

Answer 36

lid disorder inward turning of the eyelids - occur with age (degeneration of lid tissues) - due to childhood facial structure treatment: lubrication

Question 37

Ectropion

Answer 37

lid disorder outward turning of the eyelids - occur with age (degeneration of lid tissues) treatment: surgery

Question 38

Pingueculum

Answer 38

conjunctival disorder yellow, elevated nodule most common: - located on nasal side of conjunctiva - persons > 35 yo no treatment (rarely grow)

Question 39

Pterygium

Answer 39

conjunctival disorder fleshy, triangular growth of the conjunctiva spreads --> threatens cornea shape and visual axis associated with wind, sun, dust exposure treatment: - artificial tears - anti-inflammatories - excision