Ophth

Question 1

How long should ophth minor aliments be for?

Answer 1

2 days

Question 2

What are the red flags for black eyes?

Answer 2

Changes in vision (especially double-vision) Severe pain starts
Signs of infection
Behavioral changes, lethargy
Nausea, vomiting, dizzy
Inability to move eye
Blood in eye itself
Any lacerations to eye area

Question 3

Tx for black eye

Answer 3

cold compress
analgesics

Question 4

What types of things can be flushed out of the eye?

Answer 4

dust
wood chips
parts of insect
iron fillings

Question 5

Red flags for foreign body in the eye

Answer 5

see immediate help if there is tearing, irritation and scratchy

Question 6

What to do if chemical contact in eye?

Answer 6

flush eye
pull eyelids away from eye at times
at least 15 mins

Question 7

What if contact lesnes are in when getting chemicals in your eye?

Answer 7

see MD and take them out if possible

Question 8

Sx of radiant energy from sun in eye

Answer 8

red eyes
itchy, foreign body sensations

Question 9

What to do for mild cases of radiant energy in eye?

Answer 9

cool compresses
non medicated eye drops
sunglasses for few days

Question 10

What are the three layers of the eye function?

Answer 10

out layer is oily
middle is aquenous
inner is mucoidal

Question 11

What is the function of tears?

Answer 11

lubricating
protecting
nourishing

Question 12

What is the etiology of dry eyes?

Answer 12

change to any tear component
alteration in blink frequency/efficiency

Question 13

Sx of dry eyes

Answer 13

difficulty blinking
generally less tears produced

Question 14

What to consider for dry eyes if they have blepharitis

Answer 14

oil glands can be compromised

Question 15

What to consider for dry eyes if they have medications

Answer 15

acutane
drugs with anticholinergic effects

Question 16

What to consider for dry eyes if they have lasik

Answer 16

cuts the nerves

Question 17

What to consider for dry eyes if they have sjogren’s syndrome

Answer 17

dry eyes
dry mouth
arthritic joint pain

Question 18

Tx for dry eyes

Answer 18

artificial tears, look for simple watch out for mfg claims

Question 19

Other options for dry eyes

Answer 19

humidifier (if winter)
lid margin hygiene
plug the ducts
cyclosporine drops (RestasisR)
omega 3 fatty acids
lifitegrast drops
heat at night

Question 20

What does xiidra do?

Answer 20

anti-inflammatory

Question 21

What does tyrvaya do?

Answer 21

activates the trigeminal nerve –> cholinergic stim –> increase tear film

this is a nasal spray

Question 22

What is punctal occlusion?

Answer 22

blocking b/c the tears are not doing great

Question 23

Etiology of stye

Answer 23

staph aureus infection in an eyelash follicle

Question 24

Tx for a stye

Answer 24

warm compress
keep clean
should be gone in 7 days
no real tx
DO NOT squeeze

Question 25

Etiology of Chalazion

Answer 25

Obstruction of an oil gland can be painless or tender slow to develop --> lasts longer

Question 26

Tx of chalazion

Answer 26

warm compresses + massage - warm up fat - extract

Question 27

What is conjunctival hyperemia?

Answer 27

conjuntiva irritated microlayer membrane impacted clears ~7-10 days

Question 28

Etiology of Coj hyperemia

Answer 28

dust, smoke, chlorine (low level risk - few days) low humidity eye strain symptom of ocular conditions (Blepharitis, Rosacea …) contact lenses --> eye Dr

Question 29

Treatment of conj hyperemia

Answer 29

might be able to flush the cause out cool compresses topical decongestants?

Question 30

Topical decongestants -conj hyperemia

Answer 30

for red eye used q6h phenylephrine

Question 31

When to use topical decongestants for conj hyperemia?

Answer 31

Cosmetic reasons (maybe) not going to help much more than that

Question 32

Blepharitis

Answer 32

always MD eyelid disorder can lead to problems with dry eyes can be chronic in elderly oily film is gone/surface film gone

Question 33

Etiology of blepharitis

Answer 33

disorder of meibomain gland can be bacterial or seborrheic

Question 34

Sx of blepharitis

Answer 34

more noticeable in AM inflam of eyelid margins (red, scaly, no discharge) scales = yellowish, bit greasy if seborrheic version eyes can become irritated, dryness vision normal (or some blurring)

Question 35

What are the red flags of blepharitis

Answer 35

vision change

Question 36

What could be mistaken for blepharitis?

Answer 36

eczema of the eyelid

Question 37

Treatment of blepharitis

Answer 37

often needs chronic mgt if bacterial - eyelid hygiene -topical antibiotics if seborrheic - eyelid hygien check/treat sclap warm compress tx lasts 3 wks to montns

Question 38

Etiology of conjunctivitis

Answer 38

viral allergic (will be both eyes) bacterial infection (pink eye) Refer if anything but allergies

Question 39

Tx of allergic conjunctivitis

Answer 39

cool compresses/non-medicated drops topical antihistamines oral antihistamines topical cromolyn decongestants ocular steroids

Question 40

Examples of Topical antihistamines

Answer 40

OTC pyrilamine antazoline pheniramine Rx emedastine ketotifen

Question 41

Examples of topical cromolyn (like)

Answer 41

OTC -- opticrom (frequent dosing) Rx patanol alocril alomide

Question 42

What is cromolyn?

Answer 42

mast cell stabilizer almost no systemic s/e frequent dosing (>QID) OTC

Question 43

What is alocril?

Answer 43

used for allergic conjugate mast cell stabilizer BID Rx

Question 44

What is patanol?

Answer 44

used for allergic conjugate mast cell stabilizer + antiHe BID safe - reduce tx gap Rx

Question 45

What is alomide?

Answer 45

used for allergic conjugate mast cell stabilizer QID Rx

Question 46

What is lumify?

Answer 46

decongestant no rebound breakout use if needed

Question 47

Should topical steroids be used for allergic conjugate?

Answer 47

good addition for chronic allergies worried about increasing intraocular pressure

Question 48

Should loteprednol be used for allergic conjunctivitis?

Answer 48

less steroid induced s/e in seasonal allergic conj reduce effect of increase IOP if you are going with steroids this is the one

Question 49

Describe infectious conjectivitis

Answer 49

virus eye infections exudate from the eye exudate from lid margin starts in 1 eye then moves to 2 often follows a cold

Question 50

What is the difference between viral and bacterial?

Answer 50

viral - 1 eye profuse tearing bacteria ~ both eyes exudate /stuck shut in am

Question 51

Treatment for viral conjunctivitis

Answer 51

most refs suggest symptomatic care saline or tears to wash for TLC self limiting around 7 days

Question 52

Treatment for bacterial conjunctivitis

Answer 52

topical antibiotics 3 day window use an a/biotic MD if you are right should see improvement within 2 days

Question 53

If child is <6 what is the red flags to refer

Answer 53

discharge eyes glued shut in AM eye pain

Question 54

When you think it is bacterial conjunctivitis what OTC is a recommendation?

Answer 54

polysporin pink eye maybe not the best but in your back pocket use for QID for 7-10 d and 2 d after clear

Question 55

If instilling drops are a struggle then...

Answer 55

put in corner of eye when closed + laying down then get them to open their eys

Question 56

Red flag for pink eye

Answer 56

gets worse or does not improve by 5 days see MD

Question 57

What is blepharospasm?

Answer 57

benign twitches in eyelids

Question 58

What is obstructed tear duct?

Answer 58

tears do not drain away seen in newborns most clear on their own

Question 59

What is age related macular degen?

Answer 59

not an OTC condition most are dry type - fat deposits (due to lipids) Wet type (very serious) vascular leakage