Ocular Flashcards

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1
Q

What causes subconjunctival hemorrhages and how should they be treated?

A

Bleeding b/w the conjunctiva and sclera.
(May be traumatic, spontaneous, or secondary to a systemic illness)
Very common.
No tx required, often asymptomatic.

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2
Q

What virus is most common in viral conjunctivitis? How is it treated?

A

Adenovirus.
Self-limiting
Tx: chamomile tea bags (tears, cold compresses, hand hygiene).

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3
Q

How can bacterial conjunctivitis be differentiated from viral?

A

Bacterial often has a purulent discharge.

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4
Q

What two glands are acutely infected resulting in an internal or external hordeolum (stye)?

A

Zeis [external]

Meibomian [internal]

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5
Q

How are chalazions and hordeola similar and different?

A

Both effect meibomian or zeis glands.
Chalazions are granulomas that develop when lipid breakdown products leak into the surrounding tissues. They are single, firm, non-tender nodules and may be chronic.
Hordeolum are acute infectious focal abscesses of PMNs with sx of pain, warmth, swelling, and edema.

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6
Q

How do you check for a corneal abrasion?

A

Apply flourescein dye and inspect under a blue light. The abrasion will appear more pronounced and yellow-green.

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7
Q

What increases your risk of a corneal ulcer? How do you identify one? And what is the treatment?

A

Extended-wear soft contact lenses.
They are gray or white spots on the cornea that may be visible w/ the naked eye.
It’s an emergency b/c it may result in vision loss. Tx. is antibiotic drops.

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8
Q

What is the most common cause of blindness? Describe it.

A

Cataracts.

A clouding of the lens inside the eye.

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9
Q

What are the SSX of acute angle closure glaucoma?

A
Happens more commonly in far-sighted pts
Severe ocular pain
Headache
N/V
Blurred vision w/ halos around lights
Loss of vision
Conjunctival injection
Corneal edema
Mid-dilated, nonreactive pupil
Evidence of shallow anterior chamber
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10
Q

How do you treat acute angle closure glaucoma?

A

Intra-ocular pressure reduction
Suppression of inflammation
Reversal of angle closure
Immediate ophthalmologic evaluation is indicated

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11
Q

What is the most common form of glaucoma?

A

Chronic open angle glaucoma

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12
Q

What are the risk factors for chronic open angle glaucoma?

A

Increasing age
>40 w/ FH of glaucoma
Diabetes
Short-sightedness

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13
Q

What condition can lead to permanent visual loss if not treated and includes an elevated ESR, headache, scalp tenderness, jaw claudication, and is associated with increased age and polymyalgia rheumatica?

A

Temporal arteritis

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14
Q

What condition is the result of facial trauma and involves painful proptosis, decreased visual acuity, scintillating scotomas, lid ecchymosis, and afferent pupillary defect?

A

Retrobulbar hematoma - immediate ophthalmologic referral.

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15
Q

What precedes a hyphema?

A

An injury to the anterior chamber that disrupts the vasculature supporting the iris or ciliary body.

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16
Q

What condition is characterized by a “cherry red spot” on the fovea and includes painless loss of vision and is associated with vascular problems?

A

Central retinal ARTERY occlusion

17
Q

What condition has a “blood and thunder appearance” with marked hemorrhage, optic disc blurring and marked macular paleness?

A

Central retinal VEIN occlusion

18
Q

What should you suspect in a patient who reports flashes of light, floaters, a curtain/shadow, central or peripheral visual loss, but is painless?

A

Retinal detachment

19
Q

What might you see on an ophthalmologic exam of retinal detachment?

A

Pigmented cells in the anterior vitreous
Vitreous hemorrhage
Posterior vitreous detachment
Elevation of the retina

20
Q

What SSX are different for vitreous hemorrhage compared to retinal detachment?

A

Similar symptoms, but add smoke signals and lines in the visual field.
The condition may occur secondary to trauma, retinal disease or diabetes.
Decreased red reflex
Blood in the vitreous gel

21
Q

What test is mandatory in patients with suspected orbital cellulitis?

A

CT

22
Q

What are the SSX of orbital cellulitis?

A
Proptosis
Tenderness
Pain w/ EOM
Chemosis
Visual changes (double vision or decreased acuity)
23
Q

What is the treatment for orbital cellulitis?

A

Hospitalization
Parenteral, broad-spectrum antibiotics
Maybe surgical drainage

24
Q

Why are alkaline agents so damaging to the eye?

A

They are both hydrophilic and lipophilic, allowing rapid penetration of cells membranes where hydroxyl ion induce saponification which leads to liquefaction necrosis.