Ocular conditions Flashcards
What to you want to make sure you document for EVERY patient who presents with an ocular complaint?
Visual Acuity
Subconjunctival hemorrhages caused by _________ between the ___________ and the __________ (which two layers?)
bleeding, conjunctive, sclera
What are some potential causes of subconjuctival hemorrhages?
- trauma
- spontaneous
- secondary to serious illness (bleeding disorder, hypertension, febrile infections)
True or False: Subconjunctival hemorrhages are typically very painful and require immediate treatment.
False: The hemorrhages are typically asymptomatic and do not require any treatment.
The use of what medication should be discouraged in patients with recurrent subconjunctival hemorrhages? 2
Aspirin and NSAIDs
What is the most common virus responsible for viral conjunctivitis?
adenovirus
True or false: The quality of eye discharge indicates whether conjunctivitis is viral, allergic, or bacterial.
False: discharge does not indicate the types. Rather consider patient’s history.
True or false: conjunctivitis is generally a painless condition.
True. There may an itching or sandy sensation. I f it is very painful, consider a different dx.
What is the treatment for conjunctivitis?
- start with teabag treatment (chamomile is good)
- prescribe an antibiotic eyedropper and tell them to pick it up if symptoms worsen.
- irrigate the eye to reduce the count of virus or bacteria
What is a hordeolum? Where is it usually located?
A stye. Found at the lid margin. resolves on its own.
hot compresses
What is a chalazion located compared to a hordeolum?
Mor internal
What is a chalazion?
Granulomas of either the Meibomian gland or the Zeis gland.
How do you treat a chalazion?
warm compress
What are floaters?
Bits of protein moving across the visual field in the aqueous humor
If patient has no history of floaters and then all of the sudden has A LOT of floaters, this may be what condition?
Retinal detachment
What is used to visual a corneal abrasion
blue light with fluorescent die.
What are treatment option for a corneal abrasions?
Apply ointment, pt closes eyes, they wear an eye patch.
What is the most common cause of corneal ulcer?
extended use of contact lenses.
Is a corneal ulcer a medical emergency
Yes, because it can progress to vision loss.
How do corneal ulcers appear?
white or grey spots on the cornea that may be visual with the naked eye.
What is a PE findings for a cataract?
No red reflex
What is the most common cause of blindness?
Cataract?
What population of people have a greater chance of developing cataracts? ( I don’t mean elderly)
Diabetics
What are symptoms of acute angle-closure glaucoma? (7)
- Severe eye pain
- headache
- nausea/vomiting
- vision changes
- blurred vision with halos around objects and loss of vision
- conjunctival injection
- no dilation of pupil, nonreactive
What causes acute angle-closure glaucoma?
There is elevates intraocular pressure due to an obstruction to outflow from the anterior chamber
What are the symptoms of Temporal arteritis? (4)
- Headache
- scalp tenderness
- jaw claudication (pain in the jaw associated with chewing)
- reduce visual acuity
What is temporal arteritis?
Inflammatory disease of blood vessels most commonly involving large and medium arteries of the head
What condition is temporal arteritis often associated with?
Polymyalgia rheumatica
What is retrobulbar hematoma caused by?
- facial trauma
- complication or orbital surgery
- retrobulbar injection
What are signs of retrobulbar hematoma?
- painful proptosis (profusion of eyeball)
- decreased visual acuity
- occasionally scintillating scotomas
- lid ecchymosis
- chmosis
- mydriasis (pupil dilation)
Treatment of retrobulbar hematoma?
Patient needs and eye shield!
What is a hyphema?
Blood pooling in the anterior chamber of the eye.
What are some causes of hyphema?
- usually due to trauma
- people with bleeding disorders
What is the characteristic sign of Central retinal artery occlusion?
Cherry red spot over the macula!!!!
What is the common cause of central retinal artery occlusion?
Embolism
What is the main symptoms of central retinal artery occlusion?
Sudden, painless loss of vision
What is the characteristic sign of central retinal vein occlusion?
Bood and thunder appearance.
What are the main symptoms of central retinal VEIN occlusion?
Marked changes in visual acuity
Pain
What are symptoms a pt may report with retinal detachment?
Flashes of light, lots of floaters, a curtain or a shadow moving over their field of vision. Peripheral or central vision loss
No pain
What is seen in an ophthalmoscopic exam with a retinal detachment
Pale area of the retina
What are symptoms a pt may report with virtuous hemorrhage?
Hazy vision
Photophobia
Shadows, floaters, smoke signals, cobwebs or lines int eh visual field - complaints are more noticeable with eye movements.
What is seen in an eye exam with vitrious hemorrhage?
blood in the vitreous gel. Range from orange to whitish yellow.
What condition is seen as dendritic figures with fluorescien die?
Herpes simplex, Herpes zoster
