NB topics Flashcards
6 Eye problems in HIV/ AIDS
- Abnormal conjunctival lesions
- Abnormal vernal keratoconjunctivitis
- HZ infection
- Herpes Simplex Keratitis in periphery
- Kaposi’s Sarcoma
- Orbital cellulitis
What is needed for near vision
- Convergence
- Pupillary constriction
- Accommodation
Hypermetropia
Indications for treatment
Treatment
Indications for treatment: < VA, eye exhaustion, strabismus
Treatment:
1. Convex lenses
2. Contact lenses
Myopia
treatment
- Concave lens
- Contact lenses
- Refractory surgery
Anterior Uveitis: Clinical tests
- Consensual light reflex–> Pain in contralateral eye
- Accommodation test
- Eclipse test
Posterior Uveitis Symptoms Causes Signs Complications
Symptoms: < VA
Causes: Toxoplasmosis from animals
Signs: Dull fundus, yellow/white choroid, retinal vasculitis
Complications: Chorio-retinal scar formation, exudative retinal detachment, rhegmatogenous retinal detachment, papillitis
Diagnostic drugs
• Fluorescein: orange liquid, under blue light bright green/yellow
• Midriatics: parasympathetic drugs -> paralysis of iris sphincter:
oAtropine sulphate: 7-14 days (longest) -> therapeutic
oScopolamine: 2-3 days
oTropicamide: 6-8hrs -> shortest
oCyclopentolate: 6-24 hrs
oSide-effects: nausea; vomiting; pallor
oSympathomimetics: Phenylephrine (use in combination with pSympathetic)
Side effects: Steroids, Ethambutol, Phenothiazine
- Steroids: cataracts; glaucoma
- Ethambutol: optic neuritis
- Phenothiazine: opacities in lens/corneal epithelium
Meibomian Cyst
Definition
Clinical picture
Treatment
- Definition: Lipogranulomatous inflammation secondary to the retention of meibomian due to obstruction
- Clinical Picture: firm round swelling in tarsal plate; often painless; red raised conjunctiva
- Treatment: Incision and curettage
Blepharitis treatment
- Lid hygiene
- topical antibiotic, post. Blepharitis = systemic tetracyclines
- warm compress; expression of meibomian glands
Ptosis classifications and treatment
Classification: Neurogenic, Aponeuritic, Mechanical, Myogenic
Treatment: refer to ophthalmologist, avoid amblyopia, suspect CN III palsy
Causes of mucin & lipid layer deficiency
- Chemical burns
- Trachoma
- Steven-Johnson syndrome
- Vit A deficiency
Lid Abnormalities: Causes of abnormal lid contours & disruption of lid movement
Countour: Trachoma, Trauma, Tumour
Lid Movement: fascial paralysis, Simblephara (trauma, Steven-Johnson, Trachoma)
Dacryocystitis: Definition, Signs & Treatment
Definition: obstruction of the tear flow distal to lacrimal sac leading to stasis, secondary infection can occur, filling sac with pus
Symptoms: Epiphora, Pain
Signs: Swelling, Redness, Tenderness over lacrimal sac, can break skin
Treatment: local/systemic antibiotics, drainage of abscess
Difference between pre-orbital cellulitis & orbital cellulitis
Orbital: Chemosis, Redness, Pain, Proptosis, Decrease in eye movement
Pre-orbital: opposite of above
Pterygium: Treatment & Indications for surgery
Treatment:
- artificial tears
- antihistamines
- vasoconstrictors
- antibiotics, steroids
Indications:
- medical treatment failure
- increasing astigmatism,
- growth over visual axis,
- to be able to wear contact lenses,
- cosmesis
- suspected malignancy
Classify bacterial conjunctivitis, viral conjunctivitis, allergic conjunctivitis
- Bacterial: Acute, Gonococcal, Chlamydial, Chronic blepharoconjunctivitis
- Viral: Adeno virus (pharyngo (adeno 3 & 7), epidemic keratoconjunctivitis (8 & 19)) Acute haemorrhagic; Herpes simplex; Molluscum contagiosum keratoconjunctivitis
- Allergic: Hayfever; Acute allergic blepharoconjunctivitis; Vernal conjunctivitis; Giant papillary conjunctivitis; Steven-Johnson
Adenovirus conjunctivitis syndromes: Clinical picture & treatment
Picture: acute follicular conjunctivitis with pre-auricular lymphadenopathy; red eyes; years; itches; photophobia
Treatment: no specific Mx, antibiotic & vasoconstrictor drops (steroids only if vision is affected & herpes simplex excluded)
Allergic Conjunctivitis: Treatment
- Antihistamines
- Vasoconstrictors
- Ice packs
- Topical steroids