Ophthalmic disorders Flashcards
T or F: After applying eye drops try to blink to distribute medication throughout the eye.
F; following applicationattempt to close eyes for 2-3 minutes with your head tipped down and do not squeeze or blink eyes.
Who most commonly present with corneal abrasions?
Most common in children
Describe the three severities related to corneal abrasions and the prognosis.
- Minor: Usually heal quickly
- Moderate: 24-72h
- Deep: Require corneal transplants if vision is impaired
What possible medications are available for treatment of corneal abrasion?
- NSAID (Topical)
- Ketorolac
- Diclofenac
- ABX (Topical)
- Ciprofloxacin (TOP CHOICE)
- Erythromycin
- Polymycin B/Trimethoprim
- Sulfacetamide
- Gentamicin
- Oflaxicin
What are benefits to application of topical ABX?
- Prevents infections (Contact lens wearers should choose for coverage of Pseudomonas aeruginosa)
- Often used prophylactically
What is the most common conjunctivitis?
Viral
What is the clincal presentation of Viral Conjunctivitis?
- Observed as Pink Eye
- Most often caused by adenovirus
- Easily spreadable and often associated with an acute respiratory virus
- Mild condition resolve within 2 weeks
What medications are available for treatment of Viral conjunctivitis?
[Goal: prevent spread]
- Artifical tears
- Cold compress
- Topical decongestants
- Naphazoline
- Oxymetazoline
- Phenylephrine
(NO ABX!!!!!)
What are common bacterias that cause Bacterial Conjunctivitis? How is the prognosis? (aka which ar self limiting)
- Strep pneumonia (Self-limiting)
- Staph aureus
- Haemophilius influenzae (Self-limiting)
What are common bacterias that cause Hyperacute Bacterial conjunctivitis?
- N. gonorrhoeae
- N. meningitidis
What treatments are available for Hyperacute Bacterial Conjunctivitis?
- Ceftriaxone (1 GM IM)
- Adjunct Topical medication
What treatments are available for Bacterial Conjunctivitis? What medications are considered 1st LINE?
- Broad spectrum ABX
- Polymycin B/Trimethoprim (1st LINE)
- Polymycin B/Bacitracin (1st LINE)
- Erythromycin (1st LINE)
- Tobramycin
- Fluoroquinolone (topical)
- Levofloxacin
- Gemifloxacin
- Moxifloxacin
What are three different types of Allergic Conjunctivitis?
- Seasonal (most common IgE mediated)
- Perennial
- Conjunctivitis medicamentosa (Drug-induced overuse of vasoconstrictive agents)
What is the pathophysiology of Allergic Conjunctivitis?
Allergen exposure –> Mast cell degranulation –> Histamine release and subsequent itching, redness and swelling –> Mucus secretion and conjunctivial vasodilation (Leukotrienes and prostaglandins)
What medications are available for treatment of Allergic Conjunctivitis?
[Preventive: Avoid allergens]
- Artifical tears
- Topical antihistamine (or antihistamine/decongestant combo)
- Mast cell stabilizer
- Ketorlac (NSAID, topical)
- Topical steroids
What side effects are related to Antihistamine/Decongestant combinations?
Decongestant may cause stinging and mydriasis (Should not be used for longer than 10 days, may cause rebound congestion in long-term use)
What is the treatment time for Allergic Conjunctivitis with Mast Cell Stabilizer?
Full response in about 4 weeks
What is Ketorlac (NSAID, topical) approved for treatment of in association with Allergic Conjuncitivitis?
Ocular itching
What are differences between Topical NSAID and Topical Steriods for treatment of Allergic Conjunctivitis?
Topical NSAIDs less effective as topical steroids but less ADRs (topical steroids are LAST LINE)
What changes in allergic conjunctivitis are observed when treated with topical steroids?
- Mask infection
- Affect wound healing
- INC intraocular pressure
- May contribute to cataract formation
What symptoms are assoicated with Dry Eyes?
- Blurred vision
- Irritation
- Burning
- Itching
- Soreness
- Sensation of a foreign body in eye
What is the pathophysiology of Dry Eyes?
- May cause impaired secreation and/or INC’d tear evaporation
- Related to aging, change hormones, systemic inflammatory diseases, surgery, and medications (anticholinergics)
What treatments are available for Dry Eyes?
Manage disease (if 2ndary to disease)
Mainstay RX artificial tears
What are differences between baterial and viral conjunctivitis?
Bacterial often starts U/L and migrates to B/L (viral begins B/L)