Eyes Flashcards
most likely Dx of red eye? and TX?
Allergic conjunctivitis. Cold compression, Oral and Drops Antihistamine
Blepharitis definition, causes, PE, Tx
Chronic inflammation of the meibomian (posterior) glands or S. aureus infection.
PE: Red eyes, gritty, FB, excess tears, photophobia, diplobia, collarettes (crust).
Tx: Warm compression, Lip massage and hygiene, topical antibiotic (omega 3 oil)
Blepharitis Complications
Periorbital cellulitis: infection of soft tissue not extending to orbit.
Orbital Cellulitis: emergency, infection of fat and EOMs
Periorbital cellulitis definition, causes, PE, Dx, Tx
Blepharitis, insect, FB.
PE: No ptosis, vision change, fever, pain with movement or opthalmoplegia. Eye pain and swelling.
Dx: CBC, blood/ discharge cultures, CT of orbit.
Tx: outpatient, empiric (S. aureus, S. pneumoniae, MRSA). If not MRSA = amox-clavulanic acid
If MRSA = Bactrim, Clindamycin,
Orbital Cellulitis definition, causes, PE, Tx
extension of infection from paranasal sinuese (ethmoid).
PE: Eye pain, swelling, vision change, fever, pain with movement, proptosis (eye bulging), ophthalmoplegia, conjuctivitis
Dx: CBC, blood/ discharge cultures, CT of orbit
Tx: Hospitalization, consult, IV vanco, ceftriaxone
Dacryocystitis definition, causes, PE, Tx
Lacrimal sac infection from 2nd nasolacrimal duct obstruction.
Tx: agressive antibiotics
Subconjuctival hemorrage definition, causes, PE, Tx
non emergent: blood under conjuctiva due to vessel rupture. couge, sneeze, valsalva. 2-4 weeks self resolve.
Hyphema definition, causes, PE, Tx
anterior chamber bleed. Increase IOP, Acute onset pain, photophobia N/V.
Tx: referal, bed rest, control IOP, oral diuretic. t
Corneal FB definition, causes, PE, Tx
FB on Cornea, something in my eye.
PE: pain, inability to open eye, irrigation.
Dx: stain with Fluorescein
viral conjunctivitis & Tx
Adenovirus = pharyngitis
Tx: cold compression
Bacterial Conjunctivitis Dx Tx
S. penumoniae, H. flu, pseudomonas. coppious disharge, Eyes Matted Shut.
Tx: Erythromucin, Fluoroquinolones
Allergic conjunctivitis
Tx
Bilateral, seasonal, chemosis
Tx: cold compression, antihistamines
Entropion
Ectropion
Pingueculum
pterygium
lid falling in
lid flopping
non emergency growth
wedge growth impeding iris, surgery requi
Chemical conjunctivitis
Acute burning/ pain. corneal abrasion
Tx: Irrigate
Perforating Globe
From penetrating trauma, look for anterior chamber depth, misshaped pupil. Emergency referral
Corneal abrasion definition, causes, PE, Tx
corneal epithelial tissue. Feels like something is present. Acute onset pain, Tearing, light sensitivity, inability to open eyelids. use fluorescein dye.
Tx: topical antibiotics (1-2 day heals)
Never leave anesthesia around = Anesthetic Keratitis, corneal transplant.
Corneal ulcer (Keratitis) definition, causes, PE, Tx
Lens abuse or infection.
Eye pain, photophobia, tearing, decreased vision.
Conjuctival injection at limbus, hazy with Hypopyon = Herpes Simplex
Tx: referal, antibactrial, Acyclovir (HSV)
Blow out fracture
trauma of orbit. Enopthalmos. Pain, diplopia, contricted EOM, Step off, Dx: CT Tx: refer, empiric augmentin.
uveitis/iritis TX, PE
Systemic Inflammation.
Low IOP, iris inflammation, decrease vision, unilateral. Hazy, Tx: Dilate pupil for synichae, Prednosome, PE: cells and flare (proteins and WBC). HSV, Ankulosping spondilities, IBD, arthritis.
AACG
increased IOP. Tx: control IOP IV Azet & miotic drop & beta blocker. Laser
Emergency, common on boards.
Dark is worse (pupils dark) contiunous aq humor productoin. extreme eye pain, halos, N/V, headache photophobia. PE: descreased vision, steamy cornea and cresent shadow. Acute onset
COAG
Gradual nerve damage = loss of vision. Increasing IOP mechanical obstruction. Pt exam over 40 (2-5 years), diabetic = yearly exam.
Cup to disk ratio increase.
PE: asympt to bilateral
Dx: 2/3 parameter, IOP increase, visual field, optic disk.
Tx: refer, Timodol (decrease IOP), Laser Trabeculoplasty
.
