Eyes Flashcards
What is Reiter’s syndrome?
- A type of reactive arthritis
- Can’t see, can’t pee, can’t climb a tree
What is anisocoria?
Unequal pupil size
-Not necessarily pathological
What anesthetic is typically used on the eye?
Tetracaine 0.4%
What warrants an emergent referral to an eye specialist?
- Red eye with pain or visual disturbance
- Red eye with corneal damage
- Acute glaucoma
- Foreign body?
- Never prescribe topical steroids
What does bilateral angioedema of the eyes indicate?
Systemic allergens:
-Food
What does unilateral angioedema of the eyes indicate?
Local allergen:
- Poison ivy
- Topical chemical
- Insect bites
What is the most common cause of a “red eye”?
Conjunctivitis
Major manifestations of conjunctivitis?
- Discharge
- Injection
- Lack of photophobia
- Lids stuck together
- Normal vision
Most common cause of bacterial conjunctivitis in temperate zones?
Pneumococcus
Most common cause of conjunctivitis in tropical zones?
H. aegyptius
What does gross purulence w/ conjunctivitis suggest?
Neisseria infection
Organisms usually causing chronic conjunctivitis?
- Staph. aureus
- Moraxella lacunata
What does conjunctivitis with unilateral mucopurulent discharge, absent pre-auricular adenopathy, and thick crusts on eyelids suggest?
-Bacterial conjunctivitis
What does bilateral conjunctivitis w/ pre-auricular nodes and profuse exudate suggest?
Chlamydial conjunctivitis from GU tract
What does conjunctivitis that starts unilaterally and quickly spreads, has watery discharge, pre-auricular adenopathy, fever and pharyngitis suggest?
Viral infection
Most common viral cause of conjunctivitis?
Adenovirus
What is bilateral sterile conjunctivitis associated with?
Reactive arthritis:
- Reiter’s syndrome
- Steven-Johnson syndrome
- Acne rosacea
What are yellow nodules on conjunctival sclera commonly found on nasal side?
-Pinguecula
Usual cause of subconjunctival hemorrhage?
Trauma
- Anti-coagulants
- Self-limiting
What does massive hemorrhage with proptosis and limited EOMs indicate?
Orbital hemorrhage
-Can compromise optic nerve and retinal circulation
What is episcleritis associated with?
- Gout
- Allergies
- Psoriasis
- Collagen disease
Most common complaint in episcleritis?
Tender, irritated eyes
What eye condition is associated with perilimbal ciliary flush, photophobia, tearing, and possibly ulcers?
Keratitis (corneal disease)
What eye condition is characterized by photophobia, a painful eye, and pain that precedes a HSV rash?
Herpes Simplex Keratoconjunctivitis
Treatment for corneal damage from FB?
- Vigorous irrigation
- Refer to specialist
What is a hyphema?
Layering of blood in anterior chamber
-emergency
Is a corneal laceration or perforation a medical emergency?
Yes
What is uveitis?
Disease of the iris, ciliary body, or choroid.
Usual cause of uveitis?
Idiopathic
-Associated with Ankylosing spondylitis, JRA, colitis, sprue, TB, sarcoidosis
Secondary causes of uveitis?
- Trauma
- Corneal inflammation
What bacteria often causes blepharitis?
Staph.
What eye condition is characterized by greasy lid scaling and Meibomian gland dysfunction?
Seborrheic blepharitis
What is a hordeolum?
Acute staph. infection of Meibomian gland (internal) or glands of Zeis or Moll around lashes (sty)
What is acute dacryocystitis?
Infection of tear duct near nose
-Purulent matter may be expressed
Do infections cause chalazions?
Nope; sterile
What is orbital cellulitis?
- Infection of orbit by Staph.
- Can lead to paresis of 3rd, 4th, 6th, and ocular portion of 5th cranial nerves: cavernous sinus thrombosis
What pressure indicates acute glaucoma?
IOP over 20 mmHg
Most common cause of impaired vision?
Refractive error
What drugs can cause vision loss?
- Sulfonamides
- Thiazides
- Anti-cholinergics
Most common cause of vitreous opacity?
Hemorrhage:
- DM
- Trauma
- HTN
- Clots
What can cause retinal inflammation?
- Histoplasmosis
- Toxoplasmosis
- HSV
- Cytomegalovirus
What conditions can cause vascular disease of the eyes?
- Central retinal artery occlusion (clot from atrium or carotid)
- Giant cell arteritis
What manifestations will you often see with central retinal artery occlusion?
- Cherry red spot
- Boxcar veins
What manifestations can you see with giant cell arteritis?
- Elevated ESR
- Enlarged or normal disc
- Central retinal artery occlusion
- Associated with Polymyalgia rheumatica
Leading cause of blindness over the age of 50?
Age-related macular degeneration
What systemic diseases are associated with retinal disease?
- DM
- HTN
- SLE
20-50% of individuals with optic neuritis develop what disease?
MS
What disorder is associated with the following: stare, lid lag, lid retraction, and mild proptosis?
Grave’s disease (autoimmune)
What are risk factors for developing Grave’s disease?
- Smoking
- Hyperthyroidism
What is the leading cause of blindness in those under 65?
Diabetic retinopathy
What is intraretinal vascular damage also known as?
Non-proliferative
Clinical signs of non-proliferative diabetic retinopathy?
- Microaneurysms
- Cotton wool patches
- Lipid and serous exudate
What is it called when vascular damage extends into vitreous cavity?
Proliferative retinopathy
-Much worse
What clinical signs are associated with hypertensive retinopathy?
- Flame hemorrhages
- A/V nicking
- Arteriolar narrowing
Do we prescribe topical steroids for eye conditions?
Never.
What condition is associated with giant cell arteritis?
Polymyalgia rheumatica
