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OD2 Semester 1 - Applied Clinical Training > M: Ocular disease table (study) > Flashcards

M: Ocular disease table (study) Flashcards

1
Q

Name 7 ocular conditions that affect the eyelids and tissue surrounding the eyes

A
  • Blepharitis
  • Hordeolum
  • Chalazion
  • Preseptal Cellulitis
  • Dacryoadentis
  • Canaliculitis
  • Dacryocystitis
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2
Q

Name 3 ocular conditions that affect the conjunctiva

A
  • conjunctivitis
  • trachoma
  • inclusion conjunctivitis (adults)
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3
Q

Name 1 ocular condition that affects the cornea

A
  • keratitis
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4
Q

Name 2 ocular conditions that affect the intraocular area

A
  • orbital cellulitis

- endophthalmitis

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5
Q

In regards to Blepharitis:
A: Describe the condition (1)
B: List the pathogens that can cause it (3)
C: Describe management of this condition (3)

A

A: infection of the eyelid follicles along the edge of the eyelid
B: (Anterior Blepharitis): Mite infection, Staph. aureus, or a mixed infection of S. aureus + S. epidermidis and proprionibacterium acnes
C: eyelid hygeine, antibiotic ointment, condition may never be cured

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6
Q

In regards to Blepharitis:
A: bilateral or unilateral?
B: List 9 symptoms

A

A: Can be either
B: burning, flaking, crusting, tearing, irritation, itching, redness in eyelid margins, FB sensation, scales at base of eyelashes

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7
Q

In regards to Blepharitis:
A: state the long term effects of Anterior blepharitis without treatment, if severe
B: Describe Posterior blepharitis

A

A: ectropion, trichiasis, entropion
B: involves meibomianitis - excess oil production by the gland

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8
Q

In regards to Blepharitis:

A: How do we maintain good eyelid hygeine? List what we can use (4)

A
  • baby shampoo
  • dilute sodium bicarbonate
  • warm compress
  • artificial tears
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9
Q

In regards to Blepharitis:

A: List 3 antibiotic ointments used to treat. How long do we use them for?

A

Framycetin, Tetracyclin, or Chloramphenicol. Treat until clinically resolved

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10
Q

In regards to Hordeolum:
A: Describe the condition (2) (External vs Internal)
B: List the pathogens that can cause it (2)
C: Describe management of this condition (6)

A

A: External = acute localized swelling of eyelid (typically due to obstruction or infection of eyelash follicle). Internal = Infection of meibomian gland
B: External: usually staph species. Internal: also usually staph species
C: External: hot compress; sometimes drainage. Internal: warm compress, Oral anti-staph. antibiotics, surgery if persistent

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11
Q

In regards to Chalazion:
A: Describe the condition (1)
B: List the pathogens that can cause it (1)
C: Describe management of this condition (4)

A

A: inflammation of a blocked meibomian gland, usually on upper eyelid
B: Not an infection
C: Warm compress (to soften hard oil), don’t squeeze, often disappear without tx, may need corticosteroid

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12
Q

In regards to Preseptal Cellulitis:
A: Describe its onset, which eye, and pain presence
B: How does it differ from orbital?
C: What does it typically involve?

A

A: Acute onset, unilateral, pain, fever (mild)
B: No proptosis or visual acuity disturbance
C: periocular swelling, may be difficult to open eye

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13
Q

In regards to Preseptal Cellulitis:

- List the pathogens that can predispose to it (6)

A

Staph. Aureus, Strep. Pneum., Strep. pyog., Haemophilus influenzae type B, Peptostreptococcus, HSV 1 and 2 and VZV

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14
Q

List the sources of the pathogens that cause preseptal cellulitis (5)

A
  • Upper resp. infection or Otitis Media: S. pneum., HaemB (if unvacc), S. aureus
  • Insect/Animal bites or lesions: S. aureus, S. pyogenes, peptostrep.
  • Skin infections: s. pyogenes, s. aureus
  • Ruptured dacryocoele (infants): s. aureus, s. pyogenes
  • Herpetic disease: HSV1/HSV2, VSV
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15
Q

Describe the management of Preseptal Cellulitis (3)

A
  • essential to prevent spread to post-septal area (orbital cellulitis) or through to the meninges
  • oral therapy if child is otherwise well
  • IV antimicrobials if severely ill + blood cultures + CT scan of sinuses
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16
Q

Are topical antimicrobial agents adequate to treat preseptal cellulitis?

A

No

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17
Q

In regards to Dacryoadentis
A: Describe the condition (2)
B: List the pathogens that can cause it (2) (Kids vs Adults)
C: Describe management of this condition (2)

A

A: Inflammation of lacrimal gland (painful swelling in outer region of upper lid, with some degree of ptosis)
B: Children - viral infections (mumps, HSV). Adults - neisseria gonorrhoea
C: If viral: rest + warm compress. If other: specific treatment for microbe

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18
Q

In regards to Canaliculitis:
A: Describe the condition (1)
B: List the pathogens that can cause it (7)

A

A: Inflammation of lacrimal (tear) duct
B: Actinomyces Israelii, “proprionibacterium” spp., Strep. spp., Staph. spp., Candida Albicans + other fungi, Pseudomonas aeruginosa

19
Q

In regards to Canaliculitis:

- Describe the management of this condition (3)

A
  • remove concretions
  • antibiotics
  • surgery (possibly)
20
Q

In regards to Canaliculitis, describe the following:
A: How rare and who does it typically affect?
B: Acute or chronic? Uni or Bilateral?
C: List 3 symptoms

A

A: Rare. Adults over 50yrs
B: Chronic unilatral
C: red eye, epiphora, and discharge

21
Q

What does canaliculitis result in the formation of?

A

Dacryoliths: concretions that impede fluid drainage

22
Q

Define epiphora

A

overflow of tears (and mucoid discharge) onto face

23
Q

In regards to Dacryocystitis:
A: Describe the condition (2)
B: List the pathogens that can cause it (7) (congenital vs acquired)
C: Describe management of this condition (3)

A

A: Obstruction of nasolacrimal sac – stasis of lacrimal sac contents
B: Congenital: HaemB. Acquired: Psue.Aeruginosa, cutibacterium acnes, actino.israeilii . Both: S. aureus, S. pyogenes, S. pneumoniae
C: oral antibiotics and analgesia. Drainage

24
Q

Compare the 2 types of Dacryocystitis

A
  1. Congenital: rare, but potentially fatal

2. Acquired: (typically over 40yrs), can be acute or chronic

25
Q

In regards to Conjunctivitis:
A: Describe the condition (2)
B: List the pathogens that can cause it (8)

A

A: inflammation of the conjunctiva and inner surface of eyelid
B: S. aureus, pyogenes, pneumoniae, H. influenzae incl. biogroup aegypticus, moraxella spp., neisseria gonorrhea, c. trachomatis

26
Q

In regards to Conjunctivitis:

- list 6 risk factors for developing the condition

A
  • poor hygeine (body and CLs)
  • contaminated cosmetics
  • crowded living/social conditions
  • ocular diseases incl. dry eye, blepharitis, anatomic abnormalities of ocular surface and lids
  • recent ocular surgery
  • immune compromised
27
Q

In regards to Conjunctivitis:

- describe management i.e. list 3 ways to prevent

A

Prevention:

  • good hygiene
  • don’t share towels
  • exclude symptomatic people from childcare, school, work, etc.
28
Q

What is the best way to treat acute conjunctivitis? What can we do to treat suspected bacterial infections?

A

Empirically, with “best guess” therapy. For suspected bacterial infections, can use framycetin or chloramphenicol eye drops or “delayed prescription” approach

29
Q

List 7 symptoms of conjunctivitis

A
  1. redness in white/corner of eye
  2. increased amnt. of tears
  3. thick yellow, green or white discharge (purulent suggests bacterial, serous suggests viral)
  4. itchy + burning eyes
  5. blurred vision
  6. increased sensitivity to light
  7. can spread to other eye
30
Q

In regards to Trachoma

- describe the condition and state sequentially what happens in it (7)

A
  • repeated infections of conjunctiva – lymphoid follicles and inflammatory infiltration – eyelid scarring — trichiasis and entropion – corneal abrasion – scarring – blindness
31
Q

In regards to Inclusion Conjunctivitis, describe the following:
A: Unilateral or bilateral?
B: List 4 symptoms
C: Describe the pathology found (3)

A

A: usually unilateral
B: scanty mucopurulent discharge, epithelial keratitis, red eyes, small bumps on inside of lower eyelid
C: marginal and central infiltrates, potential scarring of cornea + growth of new blood vessels

32
Q

How would you describe seeing small bumps on the inside of the lower eyelid in someone with conjunctivitis?

A

Follicular conjunctivitis

33
Q

In regards to Inclusion Conjunctivitis, describe the following:
A: List the pathogen that causes it (1)
B: List the sources of this pathogen (1 but sort of 4)

A

A: C. trachomatis serovars D-K
B: exposure to infected genital secretions - transmitted to the eye via towel, fingers, etc., occasionally spread by water in swimming pools

34
Q

What is neonatal conjunctivitis? When does it present?

A

A form of inclusion conjunctivitis that is seen in babies born vaginally to (asymptomatic) infected mothers, usually presenting 5-19 days after birth

35
Q

What pathogens can cause neonatal conjunctivitis/ophthalmia neonatorum? (2)

A
  • neisseria gonorrhea

- C trachomatis

36
Q

List 4 symptoms of neonatal conjunctivitis

A
  • swelling of lids
  • hyperaemia
  • conjunctival infiltration
  • discharge
37
Q

What does neonatal conjunctivitis lead to if left untreated?

A

blenorrhoea (excess mucus)

38
Q

In regards to keratitis:
A: Describe the condition (1)
B: list the pathogens that cause it (8)

A

A: inflammation of cornea (may or may not be assoc. with infection)
B: S. aureus, pneumoniae, P. aeruginosa, Enterobacteriaciae, Moraxella, Fungi, Parasites (acanthamoeba), Viruses (HSV, VSV)

39
Q

List 5 symptoms of keratitis

A
  • red eye
  • eye discomfort
  • sensitivity to light
  • pain, vision loss and pus if more serious infection
  • may cause perforation of cornea, endophthalmitis and eye loss
40
Q

List 3 risk factors for CL-assoc, keratitis

A
  1. wearing CL too long
  2. poor disinfection of lenses
  3. wearing lenses while swimming
41
Q

In regards to Orbital cellulitis:
A: briefly describe the condition (1)
B: List the pathogens that cause it (4)
C: Describe how you manage the condition (2)

A

A: Infection of the soft tissues behind the orbital septum
B: S. pneumoniae, aureus, pyogenes, HaemB
C: medical/surgical emergency - urgent IV antimicrobial therapy and hospitalization needed

42
Q

How is orbital cellulitis usually caused? List 4 ways

A

usually caused by infection of the sinuses (over 90% of cases), insect bites, injuries or dental infections

43
Q

In regards to Endophthalmitis:
A: Describe the condition. What causes it? (2)
B: List the pathogens that cause it
C: Describe source of these pathogens (4)

A

A: inflammation of the interior of the eye (inside the globe), typically caused by infection from eye surgery/trauma
B: Everything, basically.
C: Exogenous: direct inoculation of organism as result of ocular surgery (60% of cases), FBs and/or blunt/penetrating (4-13% of cases), ocular trauma. Endogenous: haemotogenous spread from a different source (e.g. endocarditis)

44
Q

Describe the management of Endophthalmitis (4)

A

Acute endophthalmitis is a MEDICAL EMERGENCY. Intravitreal injection of antibiotics needed. Repeated injections used if no response to initial therapy.

Systemic antimicrobials used in cases of endogenous endophthalmitis and exogenous fungal endophthalmitis

OD2 Semester 1 - Applied Clinical Training (47 decks)

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