Minor Ailments - Ophthalmic & Otic Health Flashcards
1
Q
Anatomy of the Human eye
A
2
Q
Overview of Eye Anatomy
A
-
Sclera = White of the eye, protects the eye
and helps keep its shape - Cornea = Transparent dome shaped covering at front of eye, refracts the light entering the eye onto the lens
-
Lens= Responsible for ‘fine focusing’
light onto the retina -
Retina = Composed of
millions of light sensitive cells, light is converted
to electric signals which are sent to the brain, which interprets what is being seen - Macula = Small sensitive area of the retina, provides vision for fine work/reading
-
Pupil = Circular opening at the centre of
the iris, through which light passes into the lens of the eye -
Iris = Coloured part of the eye, controls
the amount of light entering the pupil - Ciliary body = Attached to the iris and holds the lens in place
- Conjuctiva= Membrane that covers the inside of your eyelid & the white of your eye
2
Q
How the eye works
A
- Main function of the eye is to detect light patterns, photons & translate that into images that we see.
- Light passes through the cornea, refracted onto the lens & then it goes onto the retina that has lots of photoreceptors & then the images travels as electrical impulses to the brain through the optic nerve = formulates the image that we see
3
Q
Ophthalmic Health
A
- Affected eyes ( both or one)
- Discharge ( watery ( conjunctivitis?) or thick, green or yellow (bacterial infection?)
- Pain/discomfort/itch
- Photophobia = abnormal sensitivity to light
- Visual changes = blurred vision , double vision or vision loss
- Associated symptoms
- Duration of symptoms
- Treatment tried
- Consider family history
- look @ the eye ( it can tell you a lot )
3
Q
What is Red Eye?
A
- Most common ophthalmic complaint
- AKA conjuctivits
- 3 main causes = bacterial , viral, allergic
- Inflammation of the conjunctiva
- Can occur alone or with pain, discharge, altered vision
- Take accurate history to aid diagnosis
- Causes can be serious and non serious
- Treatment is dependent on cause
- Red eye w/ pain could suggest = serious like glucoma
- Or it could be conjunctivitis -= not as serious
3
Q
Management of bacterial
conjunctivitis
A
- Usually self limiting, resolves w/i 5 – 10 days w/o treatment
- Clean discharge away with cotton wool soaked in cooled boiled water
- Avoid wearing contact lenses until resolved
- For Severe symptoms: Chloramphenicol ( anti-bacterial eyedrop) 0.5% eye drops (P), 1 drop 2 hourly for 2 days then 4 hourly, 5 day course.
- Chloramphenicol 1 % eye ointment (P) apply 4 times a day, preferred in younger children = Easier to apply
- Chloramphenicol not licensed OTC for children under 2 years = POM to under 2
- Self care: use separate towels, wash hands thoroughly = to prevent contamination & spreading to others
4
Q
What is Bacterial Conjunctivitis?
A
- Inflammation of conjunctiva caused by bacterial infection, usually streptococcus pneumoniae, staphylococcus aureus and haemophilus influenzae
- v/ common , ocours @ any age, affects men & women equally
- one eye affected a day before the other = contagious= As you rub one eye you can spread the infection to the other eye
- Symptoms: gritty/burning feeling, generalised redness, sticky purulent green yellow discharge, eyelids stuck together on waking
- Common in Contact lens wearers (contaminations) and immunocompromised people are at risk of complications
5
Q
What is Allergic Conjunctivitis?
A
- Redness of the conjunctiva that is caused by allergens
- Inflammation of the conjunctiva caused by
allergens e.g. pollen, animal fur - Affects both eyes, not contagious, occurs
seasonally or with allergen exposure - Reduce exposure & it will typically go away
- Symptoms: itchy, watery eyes, generalised
redness - Associated with sneezing, itchy throat
6
Q
How to manage allergic
conjunctivitis?
A
- Avoidance of the allergen
- Topical mast cell stabilisers e.g. Sodium
cromoglicate 2% eye drops (P) 1-2 drops up to 4
times a day, slower acting, may sting = 1st line treatment - Oral antihistamine e.g. loratadine 10 mg tablets
(GSL/P) 1 daily, cetirizine 10 mg tablets (GSL/P)
1 daily - Self care: avoid allergens if possible, avoid eye
rubbing= may irritate the eyes further
6
Q
What are Dry Eyes?
A
- can be caused by reduction of tear
production, alteration in tear composition, increased evaporation of tears from the eye or increased tear drainage - A side effect of a med they are taking e.g diuretics, anithistamines
- Common with increasing age, especially in women
- usually both eyes
- Symptoms: eyes look normal but burn/feel gritty, irritated, tired, watery, vision unaffected
- Often associated with blepharitis
6
Q
How to manage dry eyes?
A
- Chronic condition = no cure
- Reduce use of contact lenses
- Avoid long periods without blinking i.e staring at a screen
- Avoid antihistamines – exacerbate dry eyes
- Artificial tears e.g. Hypromellose 0.3% eye drops
(P), Viscotears 0.2% eye gel (P), Hylo forte 0.2%
eye drops ( dosen’t expire for 6 months) (P) - Some eye drops particularly for dry eyes are
considered medical devices, will have CE or UKCA
marking
7
Q
what are Subconjunctival Haemorrhage?
A
- Spontaneous rupture of a blood vessel under the conjunctiva, typically in 1 eye
- triggered by coughing
- More common in older people – use of aspirin,
anticoagulants - Symptoms: a portion or a large part of the white
of the eye becomes bright red, no pain, vision is
unaffected - Typically settles down itself
- May look alarming
*
8
Q
How to manage subconjunctival
haemorrhage?
A
- Symptoms resolve without treatment within 10-14 days
- Give reassurance
- Measure bp= if patient has hypotension high bp could have cause the rupture
8
Q
What is a stye?
A
- Staphylococcal bacterial infection of one eyelash root
- Fairly common, may experience 1-2 times in lifetime
- Symptoms: small painful red lump on the outer
eyelid, sensitive to touch - May be associated with conjunctivitis
- Blepharitis may increase risk of styes
8
Q
How to manage styes?
A
- Self limiting, resolves within a few days or weeks without treatment
- Antibiotic use including topical, is not
recommended - Warm compress 3-4 times daily to encourage the release of pus to heal quicker
- Avoid puncturing stye = increases risk of infection
- Avoid makeup & contact lenses
13
Q
Anatomy of the ear
A
