Ophthalmology Flashcards
What are causes of blepharitis, or what types of conditions can contribute to blepharitis?
5 answers
Rosacea
Staphylococcal infection
Contact dermatitis
Seborrhoeic Dermatitis
Infestation by the Dermodex mite
What is this?
Right lower eyelid anterior Blepharitis
What is the general treatment for Blepharitis?
3 parts
Warm compressors applied to the eyelids (with closed eyes) for 2-5 minutes to soften the crusts followed by …
gentle scrubbing of the eye lashes with a sodium bicarb solution, baby shampoo solution or proprietary eyelid solutions.
If conservative management fails then
Topical chloramphenicol for anterior blepharitis and oral doxycycline for posterior blepharitis
What is the potential pharmacological management for this?
(anterior blepharitis)
chloramphenicol 1% eye ointment topically, applied to the eyelid margin of both eyes, twice daily for 1 to 2 weeks.
How could you pharmacologically treat this?
(posterior blepharitis)
Adult
Doxycycline 100mg, oral, daily until improvement and then 50mg oral, daily for a minimum of 8 weeks
review at 8 weeks
What is this? how is it treated?
This is a stye (hordeolum) it is a lesion on the eyelid margin.
Treated with warm compressors
Antibiotics are not needed
Incision and Drainage may be needed for persistent lesions
What is this? How is it treated?
This is a Chalazion. It is usually associated with blepharitis. Occurs on the eyelid, not the margin. Due to the blocked Meibomian gland.
Treated with warm compressors.
Antibiotics NOT indicated.
If signs of periorbital cellultis then yes antibiotics.
May need Incision and Drainage if persistent.
After a corneal abrasion, is there an indication for chloramphenicol eye drops?
No there is no clinical benefit
But can consider
chloramphenicol eye drops 0.5%, 1 drop into affected eye, four times a day until healed.
What is the most important step in management with this condition?
Patient wears soft contact lenses
(3)
(bacterial keratitis)
Answer: urgent referral to an ophthalmologist to prevent visual loss
Also not to wear contact lenses
Ideally specialist would do a corneal scraping for MCS. However
If referral is delayed, you can start ciprofloxacin eye drops
What are the ocular manifestations of an HSV outbreak? Which of them require an urgent referral?
(5)
Conjunctivitis
iritis
blepharitis
retinitis
keratitis (urgent ophthal referral)
How does one get Herpes Zoster Opthalmicus? and what is the most important step in treatment?
Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve
Consult an ophthalmologist in all cases of HZ ophthalmicus.
Should get ORAL antiviral therapy within 72 hours. however can begin later if there are still active vesicles present
A. What condition is this?
B. What is the feature present on staining?
C. how is it treated? (dosing not needed)
- herpes keratitis
- Dendritic ulcer
- Acyclovir eye ointment
Steps in examination for keratitis?
(5)
- Visual acquity, each eye
- Inspect the eyelids and invert
- Inspect the conjunctiva. diffuse injection is more likely to be keratitis
- Inspect the cornea, note any defects
- Enhance any defects with staining and use of cobalt blue light
what is this and how is it treated?
Acute vs chronic
Dacrocysitis.
Acute: cephalexin 500mg (12.5mg/kg) , orally, 6 hourly (not sure how long, assume until clear)
Chronic: no role for Abx. Likely need surgical management.
Explain the difference between a hordeolum and chalazion
Chalazion is a blockage of a meibomian gland - which are glands at the edge of the eyelid.
A hordeolum ( a stye ) is an inflammation near the eyelid margin. they are external or internal. Internal ones are an acute infection of the meibomian gland
These images represent how a person with ____(A)_____ see the world.
B. What would you call these changes? (3)
C. How is this treated?
A. Cataract
B. Discoloured, hazy, double vision or ghosting.
C. Surgery- 3 different types
Name changes you would find in hypertensive retinopathy?
- Arteriovenous nicking
- Copper wiring
- Flame shaped haemorrhages
- Cotton wool spots
- Yellow hard exudates
- optic disc oedema
- Ateriolar constriction
NFC
Nicking Flame Haemorrhages Copper wiring.
What percentage of people with diabetes have a retinopathy?
25%-50%