Eyes Ears Mouth Flashcards
What is conjunctivitis?
Inflammation of the conjunctiva, the thin membrane covering the white of the eye and inside surface of the eyelids.
What are common symptoms of conjunctivitis?
Irritation, itching, grittiness in the eye, and watering or discharge.
What are the typical causes of conjunctivitis?
Viral, bacterial, or allergic; with Staphylococcus and Haemophilus influenzae as common bacterial causative organisms.
How can bacterial conjunctivitis be identified?
Yellow-white discharge, bilateral infection, and the absence of itching are suggestive; usually self-limiting.
What characterizes allergic conjunctivitis?
Bilateral, itching eyes with oedema and clear watery discharge; often associated with allergic rhinitis, eczema, or asthma.
What causes seasonal allergic conjunctivitis?
Mostly caused by pollen.
What causes perennial allergic conjunctivitis?
Allergens such as house dust mite.
What are danger symptoms in newborns with conjunctivitis?
Chronic conjunctivitis within 14 days after birth may indicate Chlamydia; profuse, purulent conjunctivitis within the first seven days may indicate gonorrhoea, requiring urgent medical treatment.
What complications can bacterial conjunctivitis in infants lead to?
Secondary infections like otitis media, meningitis, or septicaemia, especially in premature infants.
What should be considered in conjunctivitis differential diagnoses?
Any pain beyond discomfort, marked redness, or impaired vision requires further investigation for possible acute glaucoma, keratitis, or iritis.
How does bacterial conjunctivitis in infants differ from adults?
It can lead to more severe complications like otitis media, meningitis, or septicaemia.
What distinguishes allergic conjunctivitis from bacterial conjunctivitis in terms of discharge?
Bacterial conjunctivitis has a yellow-white discharge, while allergic conjunctivitis has a clear watery discharge.
What urgent medical treatment may be needed in newborns with conjunctivitis symptoms?
Symptoms in a baby under 28 days old need urgent medical attention to distinguish from a simple sticky eye and identify potential serious infections like Chlamydia or gonorrhoea.
What distinguishes bacterial conjunctivitis from viral conjunctivitis?
Bacterial conjunctivitis often has yellow-white discharge and may be self-limiting, while viral conjunctivitis is typically associated with clear watery discharge.
What is the role of the conjunctiva in the eye?
The conjunctiva is a thin protective membrane that covers the white of the eye and the inside surface of the eyelids.
How is allergic conjunctivitis linked to other allergic conditions?
Patients with allergic conjunctivitis often also suffer from allergic rhinitis, eczema, or asthma, indicating a systemic allergic response.
What is the distinction between seasonal and perennial allergic conjunctivitis?
Seasonal allergic conjunctivitis is mostly caused by pollen, while perennial allergic conjunctivitis is triggered by allergens like house dust mite throughout the year.
Why is conjunctivitis in newborns a cause for urgent medical attention?
Conjunctivitis symptoms in a baby under 28 days old may indicate serious infections like Chlamydia or gonorrhoea, requiring prompt medical treatment.
What potential complications may arise from bacterial conjunctivitis in infants?
Premature infants, particularly, are at risk of secondary infections such as otitis media, meningitis, or septicaemia.
When should further investigation be considered in conjunctivitis cases?
If there is more than discomfort, marked redness, or impaired vision, further investigation is needed to rule out serious conditions like acute glaucoma, keratitis, or iritis.
How does conjunctivitis in newborns due to Chlamydia present?
Chlamydia presents with chronic conjunctivitis within 14 days after birth and requires urgent medical attention.
What distinguishes gonorrhoea-related conjunctivitis in newborns?
Gonorrhoea may present with profuse, purulent conjunctivitis within the first seven days of life, necessitating urgent medical treatment.
What precautions should be taken with NSAIDs in conjunctivitis treatment?
NSAIDs may be considered for pain relief, but caution is advised due to potential adverse effects, especially in certain populations.
How can conjunctivitis symptoms be managed without medication?
Topical heat, such as warm compresses, can help alleviate symptoms, providing a non-pharmacological approach to relief.
What lifestyle factors can contribute to the severity of conjunctivitis symptoms?
Smoking and excess weight have been associated with more severe symptoms, emphasizing the importance of lifestyle modifications.
What should be considered in managing conjunctivitis in infants?
Conjunctivitis in infants, especially premature ones, should be closely monitored for potential complications like secondary infections.
What distinguishes the discharge in bacterial conjunctivitis from allergic conjunctivitis?
Bacterial conjunctivitis typically presents with a yellow-white discharge, while allergic conjunctivitis has a clear watery discharge.
What are the treatment options for infective conjunctivitis?
Chloramphenicol eye drops and eye ointment, available without prescription, are commonly used for their broad-spectrum activity against Gram-positive and Gram-negative bacteria.
What has clinical research shown about the efficacy of topical antibiotics in bacterial conjunctivitis?
Cure rates for suspected bacterial conjunctivitis are similar whether treated with a topical antibiotic or a placebo, but topical antibiotics can shorten the time taken to cure the infection.
When is the use of topical eye drops beneficial in bacterial conjunctivitis?
In culture-positive bacterial conjunctivitis, topical eye drops show a benefit in cure rate and duration, but this facility is not commonly available.
How should chloramphenicol eye drops be applied in the first two days of treatment for conjunctivitis?
Every two hours, and then every four hours thereafter, continuing treatment for a minimum of five days, even if symptoms improve.
What adverse effects are associated with chloramphenicol eye ointment?
Transient blurred vision, transient localized stinging, and burning sensations.
Are OTC chloramphenicol preparations suitable for pregnant or breastfeeding individuals and children under two?
No, they should not be used in these cases, and patients in these categories require routine referral to their GP.
What are other OTC preparations for conjunctivitis treatment?
Brolene® and Golden eye® brands containing propamidine isethionate for antibacterial, trypanocidal, and fungicidal activity against certain bacteria and fungi.
What is the antibacterial and antifungal property of dibromopropamidine isethionate found in ointment preparations?
It is active against pyogenic cocci, Staphylococcus aureus, certain Gram-negative bacteria, and fungi like Aspergillus niger and Candida albicans.
How often should Brolene® or Golden eye® drops be applied for conjunctivitis treatment?
Four times a day, although hourly use has been suggested for achieving the required antimicrobial levels.
How often should the ointment preparations containing dibromopropamidine isethionate be applied for conjunctivitis?
Once or twice daily, potentially used at night in combination with daytime drops.
What are rapid-acting and highly effective treatments for allergic conjunctivitis?
Topical antihistamines, such as Otrivine-antistin®, containing antazoline and xylometazoline to relieve redness.
Why is prolonged use of Otrivine-antistin® not advised?
Prolonged use is not recommended due to potential side effects; it’s important to follow usage guidelines.
How do topical mast cell stabilizers, like sodium cromoglicate (Opticrom®), work in allergic conjunctivitis?
They prevent the release of histamine and other inflammatory mediators from mast cells, providing relief.
What is the recommended frequency of use for topical mast cell stabilizers?
Regular use up to four times a day for up to 14 days is recommended for optimal benefit.
What special considerations should contact lens wearers be aware of?
Potential bacterial conjunctivitis can lead to bacterial keratitis, posing a threat to vision. Acanthamoeba infection, though rare, should also be considered. Contact lenses should not be worn during infection treatment.
How does benzalkonium chloride, a preservative in eye drops, affect contact lens wearers?
It can interact with soft contact lenses, so they should not be worn during treatment or for 24 hours after treatment.
What precautions should contact lens wearers take during eye infection treatment?
Thorough cleaning of lenses is imperative to prevent future infection, and lenses should not be worn in the presence of infection.
Why are eye infections highly contagious, and what precautions should be taken?
Patients should wash hands thoroughly after touching the eyes and avoid sharing towels or pillows to prevent the spread of infection.
How can cold compresses help in conjunctivitis, and why are they recommended?
Cold compresses may soothe the eye in any form of conjunctivitis, providing relief from symptoms.
What practical tips can help manage allergic conjunctivitis triggered by pollen?
Avoidance of trigger factors, such as pollen, is key. Some people find that wearing sunglasses helps reduce symptoms.
What should be questioned during a patient history to determine the need for urgent referral?
Question the patient on a history of foreign body presence or eye injury, as it may indicate the need for urgent GP referral or a visit to an accident and emergency department.
What produces tears in the eyes?
Lacrimal glands, ocular surface epithelium, conjunctival goblet cells, and meibomian glands.
How are tears distributed and drained?
Tears are distributed by blinking and drain via the lacrimal ducts.
What is dry eye syndrome, and what can aggravate it?
Dry eye syndrome (keratoconjunctivitis sicca) is a tear deficiency causing eye discomfort, aggravated by factors such as dry air, dust, wind, and smoke.
What factors can cause decreased tear production?
Drugs, Sjögren’s syndrome, allergy, dehydration, trauma (e.g., surgery, radiation), abnormal ocular surface, disruption of trigeminal sensory nerves, and decreased lipid production by meibomian glands.
What is the relationship between blepharitis and dry eye syndrome?
Dry eye syndrome is associated with, a complication of, and may be exacerbated by chronic blepharitis. Low tear film phospholipids in blepharitis can lead to increased tear film evaporation and dry eyes.
What are common symptoms of dry eye?
Feeling of irritation or grittiness, transient blurring of vision, and excessive tearing (watery eyes). Patients may not complain of ‘dryness.’
How can dry eye symptoms be managed?
Removal of exacerbating factors (e.g., adverse drug reactions, environmental conditions) and treating underlying conditions such as blepharitis.
What complications can arise from dry eye?
Complications include filamentary keratitis (fine filaments of epithelium and mucus attached to the cornea) and epithelial damage leading to corneal ulceration.
How does a viral or bacterial infection in the eyes present?
Described as grittiness or foreign body sensation, with red and inflamed conjunctiva, discharge making eyelids stick together.
What are danger symptoms of dry eye?
Complications such as filamentary keratitis or epithelial damage leading to corneal ulceration.
What is the differential diagnosis for grittiness in the eyes?
Viral or bacterial infection, presenting with red and inflamed conjunctiva and discharge causing eyelids to stick together.
What is the first-line choice for treating dry eye syndrome?
Artificial tear preparations, with Hypromellose being the most widely available and cost-effective treatment.
Are there significant differences among artificial tear preparations?
There is no evidence to suggest superiority among artificial tear preparations, although carbomer-based ones may cling to the eye surface more readily, allowing reduced frequency of application.
How frequently should artificial tear preparations be used?
As frequently as necessary to relieve symptoms.
What are potential adverse effects of artificial tear preparations?
Ocular irritation, especially due to preservatives, may occur if used very frequently. Preservative-free drops could be considered to minimize this, although they are a more expensive option.
What should patients be reminded of regarding artificial tear drops?
Preserved drops should be discarded after 28 days, and single-application packs (Minims®) should be discarded immediately after use.
What are the components of lubricant eye ointments like Lacri-lube®?
They contain liquid paraffin, white soft paraffin, and wool alcohols, providing prolonged lubrication, and are suitable for bedtime use due to transient blurring of vision.
Can lubricant eye ointments be used during contact lens wear?
No, ointments should not be used during contact lens wear.
What is the astringent found in some eye preparations, and what is its value?
Witch hazel is found in products like Optrex® and Eye dew®, but its value is doubtful.
What is essential for managing blepharitis in terms of eye care?
Good eye care, including using boiled and cooled water to soak cotton wool for gentle cleaning of eyelids, and occasionally using antibiotic ointments if bacterial debris infiltrates the conjunctiva.
Which antibiotic ointment can be used for eye infection in blepharitis sufferers?
Chloramphenicol ointment can be used for signs of eye infection in individuals with blepharitis.
What is ear wax composed of?
Ear wax is a combination of cerumen, sebum, desquamated corneocytes, sweat, hair, and foreign matter like dust.
Why is ear wax considered normal and necessary?
Ear wax is needed to protect the ear canal, but it becomes a problem if it causes deafness, pain, or obstructs inspection by a healthcare professional.
