ophthalmology

Question 1

what is the purpose of the cornea?

Answer 1

primary absorptive site

Question 2

what is the conjunctiva?

Answer 2

thin mucus membrane that covers the sclera

Question 3

what is the main purpose of the ciliary body?

Answer 3

make aqueous humor

Question 4

what is the nasolacrimal duct?

Answer 4

connection where the drug drains from the eye to the nasal cavity

Question 5

what are all parts of the eye?

Answer 5

optic nerve
retina
sclera
vitreous
iris
lens
pupil
cornea

Question 6

what is step 1 in administering eye drops and eye ointments?

Answer 6

wash hands with soap and water
remove contacts if applicable

Question 7

what is the proper administration of eye drops?

Answer 7

1) wash hands. remove contacts
2) tilt head back. form pocket in lower eyelid
3) hold dropper to eye without touching it
4) look up and squeeze a singular drop into the pocket
5) close eyes for 2-3 minutes with head down
6) apply pressure to tear duct with finger

Question 8

what is the proper administration of eye ointment?

Answer 8

1) wash hands. remove contact.
2) hold tube between thumb and forefinger and place near eye without touching it
3) tilt head back and form pocket of lower lid
4) squeeze into pocket
5) blink eye gently and then close for 1-2 minutes
6) wipe excess from eye
7) wipe tip of tube clean

Question 9

what are some general rules about contacts when it comes to administration of ocular medications?

Answer 9

wait 15 minutes after eye drops to reinsert contacts
ointments are not recommended with contacts

Question 10

how long should one wait between eye drops?

Answer 10

if same medication, wait 5 minutes
if different medication, wait 5-10 minutes

Question 11

how long should one wait between two ointments?

Answer 11

30 minutes

Question 12

how long should one wait between ointment and a drop?

Answer 12

use the drop first then wait 5-10 minutes

Question 13

how is bacterial conjunctivitis presented?

Answer 13

redness
discharge
unilateral
purulent discharge (yellow, white, or green

Question 14

what is the non-pharmacologic treatment of bacterial conjunctivitis?

Answer 14

avoid sharing products
remove contacts

Question 15

what is the first line treatment of bacterial conjunctivitis?

Answer 15

antibiotics specifically polytrim and erythromycin

Question 16

what does erythromycin treat?

Answer 16

staphylococci (bacterial) conjunctivitis

Question 17

what does moxifloxacin and ofloxacin treat?

Answer 17

pseudomona conjuncitivitis

Question 18

what does polytrim treat?

Answer 18

gram-negative and gram-positive (bacterial) conjunctivitis

Question 19

what is the generic name of polytrim?

Answer 19

trimethoprim-polymyxin B

Question 20

what does viral conjunctivitis present like?

Answer 20

watery eyes
burning, sandy, gritty feeling in the eye
both eyes

Question 21

what is a common cause of viral conjunctivitis?

Answer 21

adenovirus (highly contagious)

Question 22

what is the non-pharmacologic treatment of viral conjunctivitis?

Answer 22

remove contact lenses until no discharge for 24 hours
avoid sharing products
warm or cool compress

Question 23

what is the pharmacologic treatment of viral conjunctivitis?

Answer 23

topical decongestants for acute use only - up to 72 hours
naphazoline or tetrahydrozoline

Question 24

how is allergic conjunctivitis presented?

Answer 24

bilateral redness
watery discharge
itching

Question 25

what are non-pharmacologic treatments of allergic conjunctivitis?

Answer 25

don't rub eyes cool compress avoid contact with known allergen

Question 26

what are the pharmacologic treatments of allergic conjunctivitis?

Answer 26

depends on type in general, antihistamines and mast cell stabilizers

Question 27

how is acute allergic conjunctivitis treated?

Answer 27

non-medicated artifical tears (to remove allergen and provide relief) topical antihistamines/decongestant combination (pheniramine/naphazoline) topical antihistamine with mast cell stabilizer properties (use prior to exposure if anticipated)

Question 28

how is seasonal allergic conjunctivitis treated?

Answer 28

topical antihistamine with mast cell stabilizer properties are preferred (start 2-4 weeks before anticipated onset of symtpoms) ketotifen then olopatadine

Question 29

how does acute allergic conjunctivitis present?

Answer 29

sudden onset caused by environmental exposure to allergen (like cat dander)

Question 30

how does seasonal allergic conjunctivitis present?

Answer 30

onset developing over days to weeks in response to season allergens (like pollen) frequently associated with rhinitis

Question 31

how does perennial allergic conjunctivitis present?

Answer 31

mild, chronic, waxing and waning allergic conjunctivitis related to environmental exposure to year-round allergens (like dust mites or mold)

Question 32

what are low corticosteroids?

Answer 32

dexamethasone 0.05% dexamethasone 0.1% medrysone 1%

Question 33

what are intermediate corticosteroids?

Answer 33

dexamethasone alcohol 0.1% difluprednate 0.05% fluorometholone 0.1% fluorometholone 0.25% loteprednol 0.2% loteprednol 0.5% prednisolone acetate 0.12% prednisolone sodium phosphate 0.125% prednisolone sodium phosphate 1%

Question 34

what are high corticosteroids?

Answer 34

fluorometholone acetate 0.1% prednisolone acetate 1% (pred forte) rimexolone 1%

Question 35

what is uveitis?

Answer 35

intraocular inflammation

Question 36

how does uveitis present?

Answer 36

patterned wagon wheel redness associated with iritis dilated pupil discomfort and sensitivity to light

Question 37

how is uveitis treated?

Answer 37

refer to opthalmologist or optometrist for 4-6 weeks long treatment

Question 38

what are some side effects of uveitis?

Answer 38

steroid toxicity --> secondary infections, secondary open-angle glaucoma, and increase intraocular pressure (IOP)

Question 39

how does dry macular degeneration present?

Answer 39

common over the age of 50 yo 90% of MD cases bilateral gradual loss of vision

Question 40

what is the treatment goal of dry macular degeneration?

Answer 40

slow progression prevent severe visual impairment or blindness

Question 41

how are supplements related to macular degeneration?

Answer 41

used in dry MD PreserVision AREDS Lutein and AREDS 2 contains beta-caroetene which has an increased risk of lung cancer in smokers

Question 42

how is macular degeneration treated?

Answer 42

with vascular endothelial growth factor (VEGF) inhibitors to slow disease progression and moderate gains in vision

Question 43

what are the basics of VEGF inhibitors?

Answer 43

antineoplastic agents typically used to treat certain forms of cancer and prevent tumors from creating blood vessels drugs --> bevacizumab, ranibizumab, aflibercept, pegaptanib, verteporfin

Question 44

what are some side effects of VEGF inhibitors?

Answer 44

increased BP retinal detachment increased IOP eye infection vitreous floaters

Question 45

how is wet macular degeneration presented?

Answer 45

advanced care vision loss may be rapid loss of central vision due to abnormal growth of new blood vessels

Question 46

how is wet macular degeneration treated?

Answer 46

similar to age-related MD, but less focused on supplement usage

Question 47

what is the first step in treatment of dry eyes?

Answer 47

tear supplementation warm compress address environmental factors d/c medications that may worsen dryness

Question 48

what is the second step in treatment of dry eyes?

Answer 48

topical treatment (secretagogoues --> lifitegrast and cyclosporine) in office procedures

Question 49

what is the third step of treatment of dry eyes?

Answer 49

oral drug therapy? (antioxidants and omega-3 fatty acids) sclera contact lenses surgery investigation drugs

Question 50

what are some non-pharmacologic treatments of dry eyes?

Answer 50

increase blinking frequency schedule breaks from computer work or reading warm compress smoking cessation humidifier protective eyewear in windy environment minimize exposure to wind or fans sufficient oral fluid intake