Ocular emergencies

Question 1

A patient presents to the ED reporting discharge in both eyes, crust on the eyes that has to be removed often, and eye redness. What is the best test to rule out a more serious dx in this case, the likely dx, and tx?

Answer 1

Fluorescein stain to r/o corneal abrasion
DX is bacterial conjunctivitis
TX is topical ABX

Question 2

What condition presents with Watery discharge; swelling of eyelid; conjunctival inflammation?

Answer 2

viral conjunctivitis

Question 3

What is an Acute infection on oil gland on eyelid; and how is it treated?

Answer 3

Hordeolum
Warm compress and erythromycin ointment

Question 4

What presents with Swollen scaly eyelids; self-limited; from infection, oil buildup; bilateral; itchy, burn, flaking on eyes?

Answer 4

blepharitis

Question 5

Tx for blepharitis?

Answer 5

Warm compress & Nsadis, ABX

Question 6

What is Dacryocystitis and how does it present?

Answer 6

Inflammation of the lacrimal sac
presents as redness, swelling, discharge from inner portion of eye

Question 7

What presents with pain and visual loss following eye surgery or trauma?

Answer 7

Endophthalmitis

Question 8

This condition is dx with a Slit lamp examination that shows a staining corneal defect with a surrounding white hazy infiltrate?

Answer 8

corneal ulcer

Question 9

This condition presents as excessive tearing, erythema, warmth; TTP; BUTTTT visual acuity, pupillary responses, eye looks NL; no px?

Answer 9

periorbital cellulitis

Question 10

Patients with this condition should be placed either fully upright or head-of-bead (HOB) to 30° to 45°; do exam to r/o ruptured globe?

Answer 10

hyphemia

Question 11

A patient reports to the ED after going to a movie theater and experiencing sudden severe eye pain followed by cloudy vision, vomiting, and says they see halos around lights. What is the likely dx, test result for this condition?

Answer 11

Acute angle closure glaucoma
IOP test will show pressure at 40-70 mmHg

Question 12

sudden, painless, severe monocular loss of vision could be what 2 dx?

Answer 12

central retinal artery or vein occlusion

Question 13

PE showing optic disc edema, cotton wool spots, and retinal hemorrhages in all four quadrants (blood and thunder fundus) is indicative of what?

Answer 13

central retinal vein occlusion

Question 14

Sudden change in vision (curtain coming down, flashes of light) and floaters is likely what dx?

Answer 14

retinal detatchment

Question 15

What is acute vision loss, with a particular reduction in color vision?

Answer 15

optic neuritis

Question 16

flame hemorrhages; afferent pupillary defect in a 55y/o female with a hx of polymyalgia rheumatica is likely what dx?

Answer 16

Temporal arteritis

Question 17

Treatment and dx test for temporal arteritis?

Answer 17

TA biopsy
Methylprednisone if PT has vision loss
prednisone if no vision loss

Question 18

TX of uveitis?

Answer 18

ABX, NSAIDS, and immunosuppressant if needed

Question 19

Treatment for iritis?

Answer 19

systemic tropicamide

Question 20

What is severe ocular inflammatory condition affecting the sclera?

Answer 20

scleritis

Question 21

TX for keratitis?

Answer 21

ketorolac ophthalmic solution one drop four times a day for pain control & topical ABX; For severe burns use more aggressive control