HEENT Flashcards
Meibomian Gland
Secrete the oil layer to the tear film
Schlemm’s Canal
When this openning is narrow can cause acute angle-closure glaucoma
acute angle-closure glaucoma
Decreased drainage of aqueous humor via the canal of Schlemm, increases interocular pressure
Hordeolum
Stye, acute, can be internla or external.
Painful, tender, warm, erythematous, swollen, soft lump on eyelid
Internal hordeolum - inflammation/bacterial infection of meibomian gland.
External hordeolum - inflammation/bacterial infection of the glands of zeiz
Chalazion
Chronic condition, caused by a chronically blocked meibomian gland. Or as a result of untreated hordeolum.
Nonpainful, nontender, swollen, hard lump on eyelid
Viral Conjunctivitis
Most common pathogen - adenovirus, occurs with upper respiratory infection
Most common source - swimming pool
Symptoms: foreign body sensation, watery discharge, bilateral, no vision changes, prequricular lymphadenopathy, conjuctival infection.
Bacterial Conjunctivitis
Most common pathogen - staph aureus, strep pneumoniae
symptoms: purulent discharge, a lot less conjunctival injection, crusting on lashes, no vision changes, unilateral, eye matted shut when wakes up in AM
Treatment: Abx drops (ofloxacin, tobramycin)
Allergic Conjunctivitis
Patient may have history of seasonal allergies
symptoms: cobblestone mucosa to inner eyelids, itching, tearing, conjunctival injection, bilateral, chemosis (conjunctival swelling)
Treatment: antihistamine drops: ketotifen (zaditor), olopatadine (pataday, pazeo)
Subconjunctival Hemorrhage
Subconjunctival bleeding due to broken vessels
Caused by heavy lifting, coughing, sneezing, blood thinners, recent eye surgery, child birth.
Treatment: cold artificial tears. Similar to a bruise in the eye, body will absorb blood with time.
Pinguecula
yellow, elevated conjunctival nodue nasally, does not grow, but can get inflamed cause irritation, no vision changes
Cause: sun, wind, dust exposure
Treatment: observe
Pterygium
Elevated, fleshy, vascular, triangular shaped mass that extends into the cornea
Cause: sun exposure, wind, dust
Treatment: artificial tears, wear sunglasses, surgery if grows into visual axis
Corneal Abrasion
Causes: scratched eye, foreign body, poked eye
Symptoms: blurred/decreased vision, pain, tearing, photophobia, foreign body sensation, conjunctival injection (red conjunctiva), pain relieved w/propericaine drops
Dx: fluorescein drops then observe w/slit lamp cobalt blue light
Treatment: antibiotic drop, bandage contact lens (BCL), remove foreign body if present
Bacterial Corneal Ulcer
Cause: pseudomonas (contact lens wearers), acanthamoeba
symptoms: pain, photophobia, reduced visual acuity, tearing, hazy cornea, discharge conjunctival injection (redness in conjunctiva), ciliary injection (limbic flush) injection at the border of the cornea and sclera
Treatment: floroquinalone antibiotic drops: ofloxacin, moxifloxacin
Viral Corneal Ulcer (HSV keratitis)
Cause: herpes simplex virus (HSV)
Symptoms: pain, photophobia, tearing, decreased visual acuity
Dendritic lesions (describes shape of lesion)
Treatment: PO acyclovir, PO valacyclovir, Trifluridine drops
Herpes Zoster Ophthalamicus
Cause: herpes zoster virus (shingles)
Symptoms: painful vesicular rash along CN V dermatome, eye pain, decreased visual acuity, hutchingson’s sign (lesions on nose) = ocular involvment
Treatment: PO acyclovir
Uveitis
Cell and flare seen when eye examined w/slit lamp
Cataract
The proteins in the lens break down and become cloudy, as we age. Also, smoking, steroid use, diabetes, sun exposure, congenital ToRCH syndrome (Toxoplasmosis, Rubella, CMV, HSV)
