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Emergency Medicine > Ocular conditions > Flashcards

Ocular conditions Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

subconjunctival hemorrhages

definition

A

common finding

bleeding between the conjunctiva and the sclera

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2
Q

cause of subconjunctival hemorrhage?

A

traumatic, spontaneous or secondary to a systemic illness

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3
Q

treatment of subconjunctival hemorrhage?

A

usu asx and don’t require tx
for mild irritation- artificial tears can be used
aspirin and NSAID use should be discouraged for recurrent cases

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4
Q

viral conjunctivitis

definition

A

infection of the mucus membrane of the surface of the eye

MC virus- adenovirus

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5
Q

SSX of viral conjunctivitis?

A 
usu self limited
last longer than bacterial infxn (2-4 weeks), less inflammation and without purulent d/c
itching
foreign body sensation
tearing
redness
photophobia
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6
Q

tx of viral conjunctivitis?

A 
chamomile tea bag 
artificial tears
cold compresses
good hand hygiene
antiviral tx- for varicella-zoster and herpes infxn
if all fails- opthalmic Abx or refer
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7
Q

SSX of bacterial conjunctivitis?

A

can be differentiated from viral by the purulent d/c

sexually active + urethritis- gonorrhea or CT

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8
Q

TX of bacterial conjunctivitis?

A

topical antibiotic tx

systemic Abx for gonorrhea or CT

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9
Q

Hordeolum

definition

A

outside the eyelid
infection of the glands of Zeis
aka Stye

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10
Q

SSX of hordeolum

A

pain
warm
swelling
edema

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11
Q

TX of hordeolum

A 
usu self limiting
eyelid hygiene
warm compresses
massage
topical Abx
systemic Abx- pre-septal cellulitis 
incision and drainage for large hordeolum
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12
Q

Chalazions

definition

A

deep within the lid
granulomatous inflammatory rxn of meibomian gland
MC on upper lid

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13
Q

SSX of chalazions

A

single, firm, nontender nodule

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14
Q

with the appearance of lots of floaters you should consider what condition?

A

retinal detachment

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15
Q

what can help to visualize corneal abrasions?

A

blue light, the abrasion will appear yellow green

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16
Q

TX of corneal abrasions?

A

self limited (typically heal within 24 hrs)
ice compresses
non-steroidal anti-inflammatory eye drops
prophylactic Abx
close follow up necessary bc of risk of developing a corneal ulcer

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17
Q

what’s a corneal ulcer?

A

full thickness epithelial loss

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18
Q

SSX of corneal ulcer?

A

pain
discomfort
blurry vision
may lead to loss of vision

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19
Q

DX of corneal ulcer?

A

appear as white or grey spots on the cornea

uptake of fluorescein dye

20
Q

TX of corneal ulcer?

A

antibiotic drops

occasionally Abx injection or surgery

21
Q

what’s a cataract?

A

clouding of the lens inside the eye which leads to decreased vision

22
Q

fun fact about cataracts?

A

MC cause of blindness

23
Q

SSX of cataracts?

A

difficulty with color vision and changes in contrast

difficulty with driving, reading, recognizing faces, glare from bright lights

24
Q

what’s acute angle-closure glaucoma?

A

elevated intraocular pressure (IOP) due to obstruction of outflow from the anterior chamber
one of two types of glaucoma (chronic being the other) where the optic nerve is damaged
associated with farsighted patients

25
Q

SSX of acute angle-closure glaucoma?

A 
sudden onset of severe ocular pain
h/a
nausea and vomiting
blurred vision with halos around lights
loss of vision 
conjunctival injection
corneal edema 
mid-dilated nonreactive pupil 
shallow anterior chamber 
IOP > 21 mmHg
26
Q

TX of acute angle-closure glaucoma?

A

immediate reduction in IOP
suppression of inflammation
reversal of angle closure

27
Q

SSX of temporal arteritis?

A

h/a
scalp tenderness
jaw claudication
reduced visual acuity in right eye

28
Q

what’s retrobulbar hematoma?

A

results from trauma, a complication of orbital surgery, or retrobulbar injection

29
Q

SSX of retrobulbar hematoma?

A 
painful proptosis
dec visual acuity
scintillating scotoma
lid ecchymosis
chemosis
mydriasis
afferent pupillary defect
increased IOP
30
Q

TX of retrobulbar hematoma?

A 
immediate opthalmologic consultation
ice packs
pain control
bed rest
IV acetazolamide, mannitol and steroids
31
Q

What’s a hyphema?

A

injury to the anterior chamber that disrupts the vasculature supporting the iris or ciliary body
blood forms a characteristic meniscus

32
Q

SSX of hyphema?

A

pain
photophobia
blurred vision

33
Q

TX of hyphema?

A

head slightly elevated
eye shielded
pain meds without anti-platelet/anticoagulation activity
IOP measured

34
Q

Classic finding for central retinal artery occlusion?

A

cherry-red spot

35
Q

SSX of central retinal artery occlusion?

A

sudden, PAINLESS loss of vision

36
Q

TX of central retinal artery occlusion?

A

dilation of the central retinal artery by rebreathing expired CO2, breathing carbogen, or sublingual nitroglycerin

37
Q

Classic finding for central retinal vein occlusion?

A

retinal hemorrhages extending outward from the optic disk

“blood and thunder” appearance

38
Q

SSX of central retinal vein occlusion?

A

asx or present with gradual vision loss that is more pronounced in the morning

39
Q

what’s retinal detachment mean?

A

occurs from a break or tear in the neuronal layer with subsequent sub-retinal fluid accumulation

40
Q

SSX of retinal detachment?

A 
flashes of light
floaters
*a curtain or shadow moving over the field of vision*
peripheral or central vision loss 
pain ABSENT
41
Q

DX of retinal detachment?

A

direct and indirect ophthamoscopy

42
Q

TX of retinal detachment?

A

lying down while transported

laser treatment to tack down retina

43
Q

SSX of orbital cellulitis?

A 
fever
erythematous, swollen, tender eyelid 
recent Hx of sinusitis or URI
proptosis
tenderness
pain with EOMs
chemosis
visual changes
44
Q

TX of orbital cellulitis?

A

CT is mandatory
pts require hospitalization
broad spectrum antibiotics
opthalmologic and otolaryngology consultation is warranted

45
Q

common finding of alkaline chemical injury to the eye?

A

stromal haze with opacification of the cornea

46
Q

why are alkaline chemical agents so damaging to the eye?

A

they are both hydrophilic and lipophilic, allowing rapid penetration of cell membranes inducing saponification of cell membranes and cell death

Emergency Medicine (8 decks)

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