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Ophthalmology > Lecture V > Flashcards

Lecture V Flashcards

1
Q

Flashes and floaters = ?

A

Retinal detachment

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2
Q

What are the 9 diagnostic steps of the red eye?

A
  1. Visual Acuity
  2. Pattern of injection
  3. Conjunctival d/c
  4. Corneal Opacification
  5. Corneal epithelial defects
  6. A/C depth
  7. Pupil irregularities
  8. IOP, EOM limitations
  9. Proptosis
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3
Q

True or false: if there is decreased vision with an injected eye, you should always refer

A

True

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4
Q

What should be done with preseptal cellulitis?

A
  • X-ray if h/o trauma

- Systemic abx

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5
Q

What is the treatment for preseptal cellulitis?

A

Warm compresses and systemic abx

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6
Q

What is the treatment for orbital cellulitis?

A

Hospitalization and abx

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7
Q

What are the usual etiologies of orbital cellulitis?

A

Extensions of bacterial sinusitis

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8
Q

What are the s/sx of orbital cellulitis?

A
  • External erythema/edema
  • Impaired motility
  • Proptosis
  • Optic nerve involvement
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9
Q

What is the major difference between preseptal and orbital cellulitis?

A

Orbital cellulitis has actual inflammation of the orbit, leading to EOM restriction

Also, Optic nerve involvement may appear with orbital cellulitis

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10
Q

What are the fundoscopic exam findings of orbital cellulitis?

A

Disc edema

Decreased vision

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11
Q

What are the bacteria that usually cause orbital cellulitis? (3)

A

Staph
Strep
M. Catarrhalis

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12
Q

What is the treatment for fungal orbital cellulitis?

A

Surgical debridement

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13
Q

What is the indication for surgical intervention for orbital cellulitis?

A

If unresponsive to 24 hr abx

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14
Q

What are the complications of orbital cellulitis? (3)

A
  • Cavernous sinus thrombosis
  • Meningitis
  • Brain abscesses
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15
Q

What are the s/sx of Herpes zoster orbital cellulitis?

A
  • intense pain/discomfort
  • Itching
  • Photophobia
  • Vesicles
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16
Q

Does HZO cross midline?

A

No

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17
Q

What are the ocular complications of HZO? (4)

A
  • Conjunctivitis
  • Keratitis
  • Uveitis
  • Glaucoma
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18
Q

What is the indication for referral for HZO?

A

If eye s/sx occur

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19
Q

What are the complications of HZO?

A
  • optic neuritis

- EOM dysfunction

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20
Q

What is the leading cause of infectious blindness in the US?

A

HZO

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21
Q

What may be seen in the cornea with HZO? What can this lead to?

A

Neovascularization

Blindness

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22
Q

What is the treatment for HZO?

A

Acyclovir or valacyclovir

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23
Q

What is the prognosis of congenital NLDO?

A

80% resolve after 8 months (most within a few days)

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24
Q

What are the manifestations of congenital NLD obstructions?

A
  • Amniotocele, mucocele
  • Dacryocystitis
  • tearing and mattering
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25
Q

What is Dacryocystitis?

A

an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac

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26
Q

What is the treatment for congenital NLD obstruction? (drugs, home care, surgical)

A
  • Topical/systemic abx
  • Massage tear sac daily
  • Probing and irrigation
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27
Q

What are the causes of acquired NLO? What are these essentially like?

A
  • 2/2 polyp, or tumor

- Essentially dacryocystitis

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28
Q

What is the treatment for acquired NLO? (2)

A
  • systemic abx

- surgery after medically treated

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29
Q

What is blepharitis? What usually causes it? (2)

A

Chronic inflammation of the lid margin

-Staph or seborrheic combination

30
Q

What are the s/sx of blepharitis? (3)

A

FB sensation
Burning
Mattering

31
Q

What is the treatment for blepharitis?

A
  • Warm, moist compresses

- abx sol QID (at night)

32
Q

gtt/ ou BID?

A

ONe drop, both eyes, BID

33
Q

What is ocular surface disease? What are the two types?

A

“dry eye syndrome”

-Aqueous tear deficiency OR evaporative compromised lipid layer

34
Q

What are the three layers of tear film that sit on top of the cornea, in order from superficial to deep?

A
  • Lipid layer
  • Aqueous layer
  • Mucin layer
35
Q

What are the s/sx of aqueous tears deficiency?

A
  • Burning
  • FB sensation
  • Photophobia
  • Tearing
36
Q

What is the most common manifestation of CT disease?

A

Aqueous tears deficiency

37
Q

What is the pathophysiology behind excessive tearing?

A

Due to the poor quality of tears, a small area drys out, and sends signals to produce more tears.

38
Q

What are the causes of aqueous tear deficiency states?

A
  • aging
  • RA
  • Systemic medications
39
Q

Why are women more commonly affected with aqueous tear deficiency?

A

The tearing reflex is a testosterone regulated system–thus menopause causes an increase in the incidence of dry eyes

40
Q

What is the constellation of Sjogren’s syndrome?

A

-Dry eye
-Dry mouth
+/- CT disorders

41
Q

What is the treatment for ocular surface diseases?

A
  • Artificial tears
  • Lubricating ointment at night
  • Lid hygiene
  • Topical anti-inflammatory
42
Q

What is the abx that can be used to lower the melting point of the oils in the tears?

A

Doxycycline

43
Q

What drug class is notorious for causing dry eyes?

44
Q

What is the treatment for styes/hordeolum? (2)

A
  • Warm compresses and abx drop

- Incision with curettage if no response

45
Q

What are styes/hordeolum?

A

Acute inflammation of glands of the eyelid (Zeis or moll glands)

46
Q

What are chalazions? Are they painful? What gland are they derived from?

A

a generally painless cyst in the eyelid that is caused by inflammation of a blocked meibomian gland,

47
Q

What are ectropions? Treatment?

A

Eyelid turns outward

Surgery

48
Q

What are the s/sx of ectropions?

A

burning, tearing mattering, keratitis

49
Q

What is the treatment for ectropions?

A

abx and may surgery

50
Q

What the s/sx of entropions?

A
  • FB sensation

- Tearing, mattering, abrasion

51
Q

What is the treatment for entropion?

A

Abx and surgery

52
Q

What is the treatment for styes/chalazions?

A

Warm compresses

Incision with curettage if no response to medical therapy

53
Q

What are the viruses that usually cause conjunctivitis?

A
  • Adenovirus
  • HSV
  • Zoster
54
Q

Stringy. white mucus d/c = ?

55
Q

Purulent d/c = ?

56
Q

Clear d/c = ?

A

Viruses/chemicals

57
Q

Preauricular LAD with conjunctivitis usually signals what type of infx?

58
Q

Raccoon eyes = ?

59
Q

What are the s/sx of allergic conjunctivitis?

A

Bilateral itchiness with hyperemia and lid edema

60
Q

How effective are avoidance of allergens?

61
Q

What are the drugs that can be used to treat allergic conjunctivitis?

A
  • Antihistamines
  • Decongestant
  • Tear substitutes
62
Q

Why are ocular decongestants stupid?

A

Rebound vasodilation

63
Q

What is the MOA of crolom?

A

Mast cell stabilizer

64
Q

What is the MOA of alamast?

A

Mast cell stabilizer

65
Q

What are the most efficacious drugs for allergic conjunctivitis? Why are these not used more often?

A

Steroids

May develop a steroid induced glaucoma

66
Q

What are the systemic therapies for allergic conjunctivitis? How effective are these? Why?

A
  • Oral antihistamines

- Ineffective against ocular symptoms, and dry the eyes out

67
Q

What is the hallmark of macular degeneration?

A

Macular drusen

68
Q

What is the major indication for cataract surgery?

A

Affecting patient’s ADL

69
Q

What is keratitis?

A

Corneal inflammation, leading to a erythema, gritty feeling, and photophobia

70
Q

Cobblestoning beneath the lids = ?

A

Allergic conjunctivitis

Ophthalmology (14 decks)

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