Ophthalmic Disorders (exam 1)

Question 1

causes of dry eye

Answer 1

aging
anatomical defects/diseases
refractive eye surgery
environmental conditions
T cell medicated inflammatory response

Question 2

medications that cause dry eye

Answer 2

anticholinergics
antihistamines
decongestants
diuretics
antidepressants
antipsychotics

Question 3

clinical presentation of dry eye

Answer 3

excessive tearing
white or mild red eye
sandy, gritty feeling

Question 4

failure to properly diagnose and treat dry eye can result in

Answer 4

severe damage to eye tissue

Question 5

nonpharmacologic treatments

Answer 5

avoiding dry or dusty places
use humidifiers
avoiding prolong use of computer screens
wearing eye protection outdoors

Question 6

1st line for dry eyes

Answer 6

artificial tears solution

Question 7

example of artificial tears

Answer 7

hydroxypropyl methylcellulose
carboxymethylcellulose
polyvinyl alcohol
povidone

Question 8

main properties of artificial tears

Answer 8

protect the cornea
stabilize the film
reduce the tear evaporation
promote wound healing

Question 9

artificial tear products can be used in

Answer 9

infants, children, adolescents and adults

Question 10

gel drops are more ___________ and stay ______________

Answer 10

viscous

on the eye longer

Question 11

primary components of ophthalmic ointments and what they do

Answer 11

petrolatum (lubricant)
mineral oil (melting)
lanolin (prevents evaporation)

Question 12

common side effect of ophthalmic ointments is __________________ due to ___________

when should these be used?

Answer 12

blurred vision

viscosity

at bedtime

Question 13

ophthalmic preservatives cause

Answer 13

irritation to the ocular surface, conjunctival and corneal damage

Question 14

ophthalmic preservatives are not recommended in

Answer 14

severe dry eyes and for long term use

Question 15

examples of surfactant preservatives

Answer 15

benzalkonium chloride
benzethonium chloride

Question 16

examples of metal and alcohol preservatives

Answer 16

mercury
iodine

Question 17

examples of esters preservatives

Answer 17

methylparaben
propylparaben

Question 18

how to use artificial tears solutions in mild dry eyes

Answer 18

1-2 times per day

Question 19

how to use artificial tears solutions in moderate dry eyes

Answer 19

3-4 times a day
use preservative free solutions or viscous gel

Question 20

how to use artificial tears solutions in severe dry eyes

Answer 20

drops hourly
preservative free solutions with or without nightly viscous ointment

Question 21

allergic conjunctivitis causes

Answer 21

allergens
pollen
animal dander
dust and smoke

Question 22

what is the hallmark symptom of allergic conjunctivitis

Answer 22

itching

Question 23

clinical presentation of allergic conjunctivitis

Answer 23

itching
red eye with watery discharge
blurred vision

Question 24

nonpharmacologic treatment for allergic conjunctivitis

Answer 24

applying cold compresses 3-4 times/day
avoidance of allergen

Question 25

first line for allergic conjunctivitis

Answer 25

artificial tears prn does not diminish allergic response

Question 26

second line for allergic conjunctivitis

Answer 26

ophthalmic decongestants ophthalmic antihistamines/decongestants ophthalmic antihistamine/mast cell stabilizer

Question 27

examples of ophthalmic decongestants

Answer 27

naphazoline oxymetazoline tetrahydrozoline

Question 28

ophthalmic decongestants is used in patients _______________ and only for __________ hours

Answer 28

6 years and older 72

Question 29

examples of ophthalmic antihistamines/decongestants

Answer 29

naphcon (naphazoline/pheniramine) vasocon (naphazoline/antazoline)

Question 30

ophthalmic antihistamines/decongestants is used in patients ______________ and only for _____________ hours

Answer 30

6 years and older 72

Question 31

why shouldn't decongestants be used over 72 hours?

Answer 31

rebound hyperemia and tachyphylaxis

Question 32

ophthalmic decongestants are contraindicated in

Answer 32

glaucoma

Question 33

use ophthalmic decongestants cautiously in patients with

Answer 33

hypertension, thyroid disorders, and diabetes

Question 34

brimonidine can be used in patients

Answer 34

5 years and older

Question 35

what makes brimonidine so special?

Answer 35

it maintains oxygen availability to surrounding tissue which decreases potential for rebound hyperemia and tachyphylaxis

Question 36

ophthalmic antihistamine/mast cell stabilizer is contraindicated in

Answer 36

glaucoma

Question 37

examples of ophthalmic antihistamine/mast cell stabilizer

Answer 37

ketotifen olopatadine

Question 38

zaditor/alaway (ketotifen) can be used in patients

Answer 38

3 years and older

Question 39

patanol/pataday can be used in patients

Answer 39

2 years and older

Question 40

how long can ophthalmic antihistamine/mast cell stabilizer be used for?

Answer 40

over 72 hours

Question 41

ophthalmic antihistamine/mast cell stabilizer does not contain

Answer 41

a vasoconstrictor

Question 42

third line for allergic conjunctivitis

Answer 42

oral antihistamine can be added to second line regimen if needed

Question 43

fourth line for allergic conjunctivitis

Answer 43

MD referral persistent, unresolved symptoms

Question 44

viral conjunctivitis is ___________ and resolves within _______________

Answer 44

self limiting 1-3 weeks

Question 45

how can you differentiate viral conjunctivitis from bacterial conjunctivitis and atypical chlamydial conjunctivitis

Answer 45

they have thicker, more purulent discharge

Question 46

clinical presentations of viral conjunctivitis

Answer 46

large amount of watery discharge redness, itchiness and gritty feeling in one or both eye low grade fever swollen glands blurred vision highly contagious

Question 47

nonpharmacologic treatment for viral conjunctivitis

Answer 47

proper hygiene avoid contact lenses

Question 48

pharmacological treatment for viral conjunctivitis

Answer 48

artificial tear products ocular decongestants

Question 49

exclusions for self treatment of ophthalmic disorders

Answer 49

eye pain blurred vision not associated with ointments sensitivity to light history of contact lens wearer blunt trauma to eye chemical exposure to eye eye exposure to heat, excluding sun exposure symptoms that have persisted over 72 hrs

Question 50

how long can you treat dry eye before MD referral?

Answer 50

1 week

Question 51

how long can you treat allergic conjunctivitis before MD referral?

Answer 51

72 hours

Question 52

what to use to treat corneal edema

Answer 52

first has to be diagnosed! 2% or 5% saline solution/ointment