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Foundations II (Jess) > Eyelids & Anterior Segment > Flashcards

Eyelids & Anterior Segment Flashcards

1
Q

3 most important things to check when doing an eye exam?

A

Vision
pupils
tonometry

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2
Q

What is Blepharitis?

A

chronic condition

inflammation of the eyelids w/ intermittent exacerbations

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3
Q

Anterior blepharitis is caused by? (2)

A

infectious (S. aureus)
or
seborrheic component

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4
Q

Posterior blepharitis is caused by?

A

meibomian gland dysfunction

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5
Q

Clinical presentation of Blepharitis?

A 
red eyes
gritty/foreign body sensation
burning
excessive tearing
crustiness in lashes
light sensitivity
\+/- blurry vision
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6
Q

What might you see in a PE in a pt with Blepharitis?

A 
diffuse conjunctival injection
eyelid magins=inflamed and red
crusting or matting of lashes
plugged glands w/ magnification
Collarettes (flakes on eyelashes)`
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7
Q

Tx of Blepharitis

A 
warm compress
lid massage
lid hygiene
topical abx (erythromycin ointment)
oral abx in severe cases
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8
Q

describe Chalazion vs Hordeolum

A

Chalazion- painless, rubbery, nodular

Hordeolum- painful, infected, purulent

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9
Q

Does periorbital cellulitis extend into the orbit?

A

No!

it is an infection of soft tissue AROUND the eye

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10
Q

What types of tissue does orbital cellulitis involve?

A

the fat and muscle tissue surrounding the globe

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11
Q

Do either periorbital or orbital cellulitis involve the globe?

A

NAHHH

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12
Q

Is periorbital or orbital cellulitis more common? Who gets it the most?

A

periorbital

childrens

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13
Q

What causes periorbital cellulitis?

A

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

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14
Q

Most common cause of orbital cellulitis?

A

An extension of infection from the paranasal sinuses (ethmoid sinuses)

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15
Q

What might you see on clinical presentation of a patient with periorbital cellulitis?

A

Eye pain
eyelide swelling/erythema
(No vision change, fever, or pain with eye movement)

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16
Q

What might you see on clinical presentation of a patient with orbital cellulitis?

A 
eye pain
eyelid swelling/erythema
vision changes (possible diplopia)
fever
pain with eye movement
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17
Q

What might you see on PE of a patient with orbital cellulitis that you would not see in pt with periorbital cellulitis?

A

Proptosis
Ophthalmoplegia (paralysis of the muscles within or surrounding the eye)

You would also see:
conjunctivitis
+/- discharge

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18
Q

If in doubt if periorbital vs orbital cellulitis what should you treat it as?

A

ORBITAL!

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19
Q

Tx of periorbital cellulitis (outpt or hospital)

A

outpatient

20
Q

What pathogens do you need to cover with empiric tx of periorbital cellulitis?

A

S. aureus
S. pneumoniae
MRSA

21
Q

Abx for periorbital cellulitis for non MRSA? MRSA?

A

Non MRSA:
oral clindamycin or amocicillin-clavulanic acid

MRSA:
oral trimethoprim-sulfamethoxazole (Bactrim)
PLUS either:
Amoxicillin, Amoxicillin-Clavulanic acid, Cefdinir, Cefpodoxime

22
Q

Tx of orbital cellulitis:
outpatient vs inpatient?
Abx?

A

Hospitalization w/ ophthalmologist consult

start IV abx immediately
(broad spectrum- vancomycin + ceftriaxone)

Surgical drainage is abscess formation

23
Q

What is the most common eye disease?

A

Conjunctivitis

24
Q

what is conjunctivitis? What is it caused by?

A

inflammation of the white of the eye

Viral infection is most common (others= bacterial, allergies, chemical)

25
Q

How is conjunctivitis spread?

A

Direct contact

26
Q

Most common cause of viral conjunctivitis?

A

Adenovirus

27
Q

Usual symptoms of viral conjunctivitis?

A 
bilateral
pharyngitis
fever
malaise
watery discharge
preauricular adenopathy
28
Q

How do you treat viral conjunctivitis?

A

Give cold compress for discomfort

It’s viral- obvi NOT with abx

29
Q

Most common cause organisms in bacterial conjunctivitis? (3)

A

S. pneumoniae
H. influenzae
Pseudomonas

30
Q

Characteristic findings in bacterial conjunctivitis

A

unilateral
Copious dischage
“eye matted shut” in the morning

31
Q

Tx for bacterial conjunctivitis

A

Abx eye drops or ointment

  • Erythromycin ointment
  • Fluoroquinolone drops
32
Q

Is allergic conjunctivitis usually unilateral or bilateral?

A

Bilateral

33
Q

Characteristics of Allergic conjunctivitis

A

chronic (seasonal)

itchiness
conjunctival injection
swelling (chemosis)

34
Q

Tx of allergic conjunctivitis

A

cold compress
oral antihistamines
drops

35
Q

What do you want to educate your patient about in regards to conjunctivitis?

A

handwashing
no sharing eye drops
throw away eye makeup

36
Q

What is dacryocystitis and who is it more common in?

A

infection in the lacrimal sac, usually 2/2 a nasolacrimal duct obstruction

children

37
Q

Tx of Dacrocystitis

A 
agressive abx (clindamycin, IV vancomycin)
may require surgery
38
Q

What is entropion vs ectropion?

A

Entropion- inward turning of eyelids (especially lower lid)

Ectropion- outward turning of the eyelids (especially the lower lid)

39
Q

Cause of entropion vs ectropion

A

Entropion- may occur w/ age as result of degeneration of lid tissue, or due to childhood facial structure

ectropion- may occur w/ age as result of degeneration of tissue

40
Q

How do you treat entropion?

A

lubrication

because damage may occur w/ rubbing of lashes on eye

41
Q

How do you treat ectropion?

A

May require surgery of excessive tearing or exposure keratitis

42
Q

Describe a pingueculum (shape, color, nasal or temporal side)

A

yellow
elevated nodule
mostly on the nasal side

43
Q

What age are pingueculums most common and what is the treatment?

A

over age 35

trick question:
they rarely grow, don’t require treatment

44
Q

Describe pterygiums (color, shape, complications)

A

fleshy
triangular

growth of the conjunctiva that typically spreads and may threaten cornea and visual axis

45
Q

What are pterygiums caused by?

A

associated with wind, sun, dust exposure

46
Q

Tx of pterygium

A

artificial tears, anti-inflammatories may be helpful

47
Q

pingueculum vs pterygium, which one is serious?!

A

Pterygium!!

Foundations II (Jess) (8 decks)

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