Eyes and Vision Flashcards
Antibiotic of choice for pre septal cellulitis?
Co-amoxiclav
(Clindamycin if pen allergic)
If any systemic upset or signs of orbital cellulitis then urgent hospital admission.
Signs of orbital cellulitis distinguishing from pre septal?
Proptosis
Painful eye movements
Ophthalmoplegia
Diplopia
Who is able to certify a patient as severely sight impaired (blind) or sight impaired (partially sighted)?
Consultant ophthalmologist
visual acuity and visual fields will be measured
What form certifies patients as blind in the UK?
Certificate of Vision Impairment Form (CVI)
this is then sent to pt, GP and social services. Pt can then choose to be registered as severely sight impaired or sight impaired with their local social services.
Eye clinic liaison officer can follow through with support.
SEs of PG analogues e.g. bimatoprost, for tx of primary open angle glaucoma?
darkening of iris colour thickening and lengthening of eyelashes dry eye HTN headache
MOA: increases uveoscleral outflow
2nd line tx of primary open angle glaucoma?
topical beta blockers e.g. timolol-reduce aqueous humour production
for ocular HTN these should not be started 2nd line unless an alternative prostaglandin analogue has been tried first
3rd line-alpha agonists (topical sympathomimetic) e.g. brimonidine or carbonic anhydrase inhibitors or topical miotic e.g. pilocarpine
What name is given to infection of the lacrimal sac?
dacrocystitis
Tx-PO co-amoxiclav
When should PO Abx be considered in tx of blepharitis?
if associated meibomian gland dysfunction or acne rosacea-PO oxytetracycline or PO doxycycline
1st line tx of chronic (primary) open angle glaucoma?
topical prostaglandin analogues
should be used if intra ocular pressure of 24 or greater and are at risk of visual impairment within their lifetime
if patients are not at risk of visual impairment in their lifetime they should be monitored but tx not started
What are Argyll-Robertson pupils?
small bilaterally and accommodate but do not react to light (Accommodation Reflex Present)
associated with neuro syphilis, MS and diabetic neuropathy
What is Holmes-Adie syndrome?
typically an inflammatory condition causing inflammatory changes to ciliary ganglion
unilaterally enlarged pupil which is slow to react to light, slow and prolonged accommodation and associated with reduced lower limb reflexes
Most common bacterial pathogen causing contact lens associated keratitis in the UK?
pseudomonas aeurginosa
Emergency tx of acute angle closure glaucoma in primary care if immediate admission not possible?
- person should lie flat with their face up and head not supported by pillows
- pilocarpine 1 drop-2% if blue eyes, 4% if brown eyes (parasympathomimetic, constricts pupils)
- acetazolamide 500mg PO
Who should receive screening for glaucoma?
if positive family history patient should be screened annually from the age of 40
Drugs which may precipitate acute angle closure glaucoma?
TCAs
anticholinergics
topiramate
adrenergic drugs
