Midterm - Eye disorders Flashcards
Viral conjunctivitis - signs and symptoms
- Can present with or without cold symptoms.
- itchy red eyes
- clear to no drainage
- preauricular lymph node swelling
Cause of viral conjunctivitis
Usually caused by the adenovirus.
Preauricular lymph node swelling is common with which type of conjunctivitis
Viral conjunctivitis
In viral conjunctivitis if skin vesicles are present with dendrite appearance, this is characteristic of what?
HSV1-HSV2 conjunctivitis.
Patient education for conjunctivitis
- How to administer drops w/o touching eye
- Throw all makeup away and start fresh
- Dispose of contact lenses
- Bacterial conjunctivitis is very contagious, stay home until 24 hours of antibiotic treatment or as soon as redness and discharge has improved
Viral conjunctivitis treatments
- Pyrimidine eye drops
- Acyclovir (PO)
Bacterial conjunctivitis treatment
- erythromycin
- azithromycin
- Trimethoprim
- neomycin
Signs and symptoms of bacterial conjunctivitis
- Red eye with crusted eyelid
- Visual acuity normal
- Watery/itching eyes
- Photophobia
Cataracts
Opacity in the lens of the eye.
Causes gradual, painless and progressive loss of vision.
Surgery only when cataract is big enough.
Signs and symptoms of cataracts
- lack of red reflex
- blurred or distorted vision
- complaints of glare when driving at night or when there is bright light
Blepharitis
Inflammation of the eyelid margin that is caused by staph infection at the lash base and dysfunctional meiobian glands
- Treated with 0.5% bacitracin ointment
- For resistant infections order a quinolone antibacterial ointment or a sulfacetamide/corticosteroid combination that has shown to be effective against staph. Discontinue the bacitracin if starting this.
Chalazion
Cyst or small lump or swelling which develops in the eyelid as a result of a blockage in a gland. Not usually painful
If it persists for more than 4 weeks needs referral to ophthalmologist for incision and drainage, biopsy or local injection with glucocorticoids.
Signs and symptoms of dry eyes
- Usually affects both eyes
- Feels like sand in the eyes when blinking
- May feel hot, irriated, gritty and become red
- Blurred vision
- Lack of tears
- Burning
- Itching
- Foreign body sensation
- Sensitivity to light
- Loss of glossy appearance of cornea
First line treatment for dry eyes
Educate your patient.
- Goggles when swimming
- preservative free artificial tears
- Rest from computer and electronic devices
Assessment for dry eyes
- Get a good history
- current meds
- symptoms
- joint pain
- genital discharge
- rash
-smoking history/exposure - Tests
- Slit lamp exam or Schirmer test to measure lacrimal secretions
Epiphora
Overflow of tears onto the face instead of into the lacrimal ducts. Caused by insufficient tear film drainage.
Common in the elderly and those with allergies.
Treatment for epiphora
- For trauma or infection – topical antibiotics
- Do not use corticosteroid or anesthetic eye drops at they block healing and increases the risk for infection.
Subconjunctival hemorrhage
Bright red blood in a sharply defined area surrounded by normal-appearing conjunctiva.
Resolves on its own in 4 weeks.
Patients with vision changes or more extensive hemorrhage should be referred to ophthalmologist or ER
Risk factors for subconjuntival hemorrhage
- Valsalva maneuvers
- Blood thinners
- Diabetes
- HTN
Herpes zoster opthalmicus
Shingles involving the eye or surrounding area. Signs and symptoms include:
- Rash on the forehead
- swelling of the eyelid
- eye pain/tenderness
- inflammation of conjunctiva, cornea, uvea,
- photophobia
- mucoid discharge
- Fever may precede rash
Treatment: acyclovir (within 72 hours of onset if possible)
First line of treatment for herpes zoster opthalmicus
Prevention through vaccination
Hordeolum
Small, red, painful lump in the edge of the eyelid usually caused by bacterial infection.
- Red, hot, very tender, swelling near edge of eyelid.
- Most cases resolve without treatment
