Miscellaneous Flashcards
Corneal abrasion investigation
-Trauma
-Corneal epithelial defect staining with fluorescein (2% minimum eye drop, blue light pen torch)
Corneal abrasion treatment
-Antibiotic ointment (chloramphenicol BD)
-Pressure patch (pad and bandage) to prevent blinking
-Sore 24-48 hours (analgesia)
-Detailed ophthalmological examination required if not settle
Overview of conjunctivitis
-Symptoms: watery/mucoid/purulent discharge, itching, red eye, eyelids stuck together in morning, tender pre auricular lymphadenopathy (viral), chemosis
-Investigation: rapid adenovirus immunoassay, cell culture
-Treatment:
=Allergic (artificial tears, cool compress, mast cell stabiliser, antihistamine, topical NSAID/ corticosteroid)
=Bacterial (azithromycin, topical fluoroquinolone, systemic abx, chloramphenicol)
=Viral (antihistamine, topical corticosteroid, antivirals)
Overview of dry eye
-Tear film abnormalities and/or ocular surface inflammation. Sjogren syndrome?
-Symptoms: ocular irritation, foreign body sensation, burning, transient blurred vision, tearing, blepharitis, older females
-Investigation: reduced tear film meniscus height (aqueous deficiency), reduced fluorescein break up time, Schirmer’s test (reduced tear production)
-Treatment: topical lubricant, underlying cause, ciclosporin eye drops
Overview of blepharitis
-Inflammation of eyelid margins
-Meibomian gland dysfunction (posterior)/ seborrhoea dermatitis or staph infection (anterior)
-Symptoms: BILATERAL burning, itching, grittiness and discomfort, foreign body sensation, crusting of eyelids after sticky in morning, dry eye, lid erythema, collarettes around lashes, swollen in staph, styles and chalazions more common
-Investigation: lid biopsy (exclude carcinoma), lid margin culture (staph epidermis)
-Treatment: eyelid hygiene (hot compresses twice a day, cotton wool buds, baby shampoo/ sodium bicarbonate), treat underlying (eczema), artificial tears. topical antibiotics
