MTB 1 Flashcards
Presentation of episcleritis
Acute onset
Mild-moderate discomfort
Photophobia, watery d/c
PE: Diffuse, localized bulbar conjunctival injection
Presentation of Hordeolum
Stye
Acute infxn of gland(s) of eye
Presentation of Viral Conjunctivitis
Bilateral Watery Discharge Easily transmissable Normal vision Itchy Preauricular adenopathy No tx
Presentation of Bacterial Conjunctivitis
Unilateral Purulent, thick Discharge Poorly transmissable Normal vision Not Itchy No adenopathy Topical Abx
Presentation of Chalazion
Pathophys
Painful swelling progresses to nodular rubbery lesion
Obstruction of meibomian gland - granulomatous
If persistent, think meibomian gland carcinoma (sebaceous ca)
Basal Cell Carcinoma on eye
Solitary nodule on lid margin MC malignant tumor of eye Fair skinned ppl Hx - sun exposure Pearly quality, rolled edges Bleed, ulcerate Thinning of eyelashes
Itchy eyes, discharge, normal pupils
Conjunctivitis
Pain and fixed midpoint pupil
Glaucoma
Trauma and feels like sand in eyes
Abrasion
How does open angle glaucoma present
Gradual onset
Loss of peripheral vision = tunnel vision
How does acute angle-closure glaucoma present
Sudden onset Extremely painful Red eye Hard on palpation Pupil does not react to light Greater than 0.3 cup to disc ratio
How is acute angle-closure glaucoma diagnosed
Tonometry
How is chronic glaucoma diagnosed
Tonometry shows increased IOP
Tx for Chronic Glaucoma
- PG Analogues - latanoprost, etc
- Topical Beta blockers - Timolol, Carteolol…
- Topical CA Inhibitors - Dorzolamide
- Alpha 2 agonists - Apraclonidine
- Pilocarpine
- Laser btrabeculoplasty
TX for acute angle-closure glaucoma
- IV Acetazolamide
- IV Mannitol - osmotic draws fluid out
- Pilocarpine and beta blockers constrict pupil, increase drainage
- Laser Iridotomy
What is keratitis
Infxn of cornea
Presentation of Herpes Keratitis
Red
Swollen
Painful
Test for Herpes Keratitis
Fluorescein staining - confirms dendritic pattern
TX for Herpes Keratitis
Oral Acyclovir, Famiclovir, Valacyclovir
Topical antiherpetic: trifluridine, idoxuridine
Do NOT use steroids = worsen
Presentation for CMV Retinitis
Painless
Fundoscopic exam: hemorrhages, fluffy granular lesions around retinal vessels
TX for cataracts
Surgically remove the lens
What is a vitreous hemorrhage
Sudden Loss of vision Onset of floaters MCC - DM Retinopathy Fundus - Hard to visualize
Presentation of retinal detachment
Sudden Painless Unilateral loss of vision Floaters "curtain coming down"
Etiology of retinal detachment
Trauma
Myopia
Diabetic retinopathy
TX for retinal detachment
Reattachment via:
Mechanical methods - surgery, laser, cryotherapy, injection of gas
MCC blindness in older individuals in U.S.
Macular Degeneration
How does Macular Degeneration present
Bilateral Visual loss
Older pts
Normal external appearance of eye
Loss of Central vision
Best initial TX for Macular Degeneration
VEGF Inhibitors - Ranibizumab, Bevacizumab
Vit C, E, Zinc, Copper, B-Carotene
Retinal vessel Occlusion Presentation
Sudden
Painless
Loss of vision - Monocular
Retinal Artery v. Retinal Vein occlusion
Artery -Cherry Red Spot in fovea
Vein - more gradual, Cotton wool spots, retinal hemorrhages
Cherry Red Spot
Retinal Artery Occlusion
Tay Sachs
Neiman Pick
Tx for Retinal Artery occlusion
100% Oxygen
Acetazolamide
Thrombolytics
TX for Retinal Vein occlusion
Laser Photocoagulation
What are Cataracts
Clouding of lens
Progressive vision loss
Difficulty w night driving
opacity of lens, decreased red reflex
Red eye + CVD
Uveitis
Scleritis
Red eye + corneal ulceration
HSV Keratitis
Red eye + itching
Allergic
Red eye + colored halos
Acute angle closure glaucoma
Red eye + Preauricular LN
Viral
Red eye + dry eyes
Keratoconjunctivitis
Sjogrens
Red eye + shallow anterior chamber
Acute angle closure glaucoma
