MDT Eye Corneal Abrasion and Ulcer Flashcards

1
Q

Corneal epithelium regenerates quickly, so healing time for abrasions is short, usually within how many hours?

A

24 to 48 Hours

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2
Q

Patient has these issues what would you suspect?

(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).

A

Corneal Abrasion

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3
Q

Patient has these issues what Labs/studies would you perform?

(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).

A

Slit lamp to identify dimensions of abrasion.

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4
Q

Corneal Abrasion Differential Diagnosis:

A

(1) Conjunctival abrasion
(2) Subconjuctival hemmorrhage
(3) Foreign body

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5
Q

Patient has these issues

(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).

WHAT antibiotics would you order for a non-contact lens wearer?

A
Antibiotic ointment (e.g., erythromycin, bacitracin, or bacitracin/polymyxin B q2– 4h)
OR
Antibiotic drops (e.g., polymyxin B/trimethoprim or a fluoroquinolone)
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6
Q

Patient has these issues

(1) Severe pain, tearing and photophobia.
(2) History of trauma to the eye, commonly involving a foreign object (fingernail, piece of paper, or contact lens).

WHAT antibiotics would you order for a contact lens wearer?

A

Fluoroquinolone drops

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7
Q

Topical nonsteroidal anti-inflammatory drug (NSAID) drops for Corneal Abrasion

A

Ketorolac 0.4% to 0.5% q.i.d. for 3 days) for pain control

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8
Q

Pain management for Corneal abrasion

A

Oral acetaminophen or NSAIDs

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9
Q

True/False

Debride loose or hanging epithelium because it may inhibit healing

A

True

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10
Q

True/False

Your Patient can continue to wear their contacts while healing from a corneal abrasion.

A

False

They should not wear contact lenses

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11
Q

Corneal Abrasion Follow Up

A

(a) Follow up in 24 hours (or sooner if the symptoms worsen) for re-evaluation.
(b) Revisit every 3 to 5 days until healed.

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12
Q

Corneal Abrasion Complications:

A

(1) Corneal ulcer

2) Development of infection (Iritis

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13
Q

Corneal ulcer is also known as what?

A

Infectious keratitis

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14
Q

What is the biggest risk factor for corneal ulcer

A

improper contact lens use

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15
Q

Causative Organisms for Corneal ulcers

Bacteria:

A

Pseudomonas aeruginosa,
Streptococcus pneumoniae,
Staphylococcus species,
Moraxella species

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16
Q

Causative Organisms for Corneal ulcers

Viruses

A

Herpes simplex

Varicella zoster

17
Q

Causative Organisms for Corneal ulcers

Fungi:

A

Candida,
Aspergillus,
Penicillium,
Cephalosporium

18
Q

_______ is a serious infection involving multiple layers of the cornea

A

Infectious keratitis/Corneal Ulcer

19
Q

Patient has these issues, what would you suspect

(a) Erythema and edema of lids and conjunctivae; discharge; ocular pain or foreign body sensation; photophobia; or blurred vision.
(b) Visual acuity is decreased if the ulcer is located in the central visual axis
(c) Cornea reveals a round or irregular opacity or infiltrate – classically central in location
(d) Severe cases may have hypopyon (white, hazy base - due to WBC infiltration)
(e) Fluorescein reveals staining epithelial defect

A

corneal ulcer

20
Q

Patient has these issues, what Antibiotics would you give?

(a) Erythema and edema of lids and conjunctivae; discharge; ocular pain or foreign body sensation; photophobia; or blurred vision.
(b) Visual acuity is decreased if the ulcer is located in the central visual axis
(c) Cornea reveals a round or irregular opacity or infiltrate – classically central in location
(d) Severe cases may have hypopyon (white, hazy base - due to WBC infiltration)
(e) Fluorescein reveals staining epithelial defect

A

1) Ciprofloxacin (Ciloxan) or Ofloxacin (Ocuflox) Ophthalmic drops
2) Fluroquinolone (Vigamox) Q1h.

21
Q

Treatment for Corneal Ulcer
True/False
Do not patch the eye because of the risk of Pseudomonas infection, which can cause rapid, aggressive ulceration with corneal melting and perforation.

A

TRUE

DO NOT PATCH THE DAMN EYE

22
Q

For a corneal Ulcer should you patch the EYE?

A

NO

23
Q

Why cant you patch the eye for a corneal Ulcer

A

the risk of Pseudomonas infection

24
Q

Complications for corneal ulcer

A

Corneal scarring, corneal perforation, development of anterior and posterior synechiae, glaucoma, and cataracts.

25
Q

True/False

You can manage a Corneal Ulcer as an IDC

A

FALSE
MEDIVAC
Refer to an ophthalmologist to be seen within 12 to 24 h.