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year 2 > ophthalmology infections/trauma > Flashcards

ophthalmology infections/trauma Flashcards

1
Q

what is dacrocystitis

A

inflammation of the lacrimal sac // infection of stagnant tears

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2
Q

how does dacrocystitis usually present

A

a painful lump at the side of nose adjacent to the lower lid

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3
Q

what is the treatment of dacrocystitis

A

BSABs

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4
Q

where in the eye is redness most obvious in anterior blepharitis

A

lid margin more red than deeper part of lid

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5
Q

does anterior or posterior blepharitis involve the eye lashes/lash follicle?

A

anterior

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6
Q

what are the 2 types of anterior blepharitis

A

seborrhoeic (squamous) and staphylococcal (infection involving the lash follicle)

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7
Q

what are some symptoms of seborrhoeic (squamous) blepharitis

A

scales on lashes
gritty eye/foreign body sensation
mild discharge
no ulceration

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8
Q

what are some symptoms of staphylococcal blepharitis

A 
lashes distorted
teepee sign
loss of lashes
ingrowing of lashes (trichiasis)
styes
ulcers of lid margin
corneal staining
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9
Q

what is the teepee sign

A

lashes stuck together

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10
Q

what is a stye

A

acute purulent infection of a lash follicle

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11
Q

what causes the ulceration in staphylococcal anterior blepharitis

A

exotoxin

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12
Q

what is another name for posterior blepharitis

A

meibomian gland disease

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13
Q

what dermatology condition is associated with meibominan gland disease

A

acne rosacea

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14
Q

what are meibomian glands

A

specialised glands of eyelid which secrete an oily substance that prevents evaporation of tear film

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15
Q

what are chalazia

A

meibomian cysts

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16
Q

where is the eye most red in posterior blepharitis

A

redness is in deeper part of lid - lid margins often look normal

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17
Q

what is seen at the meibomian gland openings in MGD

A

pouting, swollen, dried secretion

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18
Q

what is the treatment for MGD

A 
lid hygiene (daily bathing/warm compress)
supplementary tear drops
fusidic acid
oral doxycycline for 2-3 months
steroid drops
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19
Q

is MGD easy or difficult to treat

A

difficult to eradicate

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20
Q

what is sjogrens syndrome triad

A

keratoconjunctivitis sicca (dry eyes)
xerostomia
rheumatoid arthritis

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21
Q

what is the most common form of conjunctivitis

A

bacterial

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22
Q

what are the most common causes of bacterial conjunctivitis in older ages

A

staph aureus
strep pneumonia
H. influenza

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23
Q

what are the most common causes of bacterial conjunctivitis in neonates

A

staph aureus
neiserria gonorrhoea
chlamydia trachomatis

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24
Q

what are some symptoms of bacterial conjunctivitis

A 
almost always bilateral
sore or gritty eye
good vision
red and sticky eye
purulent thick yellow discharge/pus
presence of papillae (tiny bumps like bubble wrap with little red dot in centre - blood vessel)
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25
Q

what is the treatment of bacterial conjunctivitis

A

topical chloramphenicol
fusidic acid
gentamicin

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26
Q

when should chloramphenicol be avoided

A

if history of allergy or asplastic anaemia

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27
Q

what can be given if someone is allergic to chloramphenicol

A

fucithalmic

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28
Q

what is the treatment for gonoccal conjunctivitis

A

oral and topical penicillin

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29
Q

what should you suspect in a young adult with bilateral conjunctivitis

A

chlamydial conjunctivitis

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30
Q

describe the course of disease with chlamydial conjunctivitis

A

slow/chronic onset of symptoms

mild discomfort for weeks and unresponsive to treatment

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31
Q

what are some symptoms of chlamydial conjunctivitis

A

watery discharge
symblepharon
assoc. hair follices + little wet rice grains (bumps in lower inside of eyelid)

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32
Q

what is symblepharon

A

palpebral conjunctiva gets stuck to bulbar conjunctiva causing turning in of eyelid

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33
Q

what is the treatment for chlamydial conjunctivitis

A 
topical oxytetracycline
topical erythromycin (also in neonates)
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34
Q

what organism causes trachoma

A

chlamydia trachomatis

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35
Q

where is trachoma seen and what does it cause

A

tropics and middle east

blindness

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36
Q

what may precede viral conjunctivitis

A

cold or flu

37
Q

is viral conjunctivitis contagious?

A

yes very

38
Q

what is the discharge like in viral conjunctivitis

A

watery

39
Q

what are the 3 main causative viruses of viral conjunctivitis

A

adenovirus
HSV
HZV

40
Q

what are some symptoms of viral conjunctivitis

A

chemosis
lid oedema
palpable pre-auricular lymph nodes
assoc. follicles (little wet rice grains - bumps in lower inside of eyelid) - bigger bump with red around periphery

41
Q

is HSV conjunctivitis usually unilateral or bilateral

A

unilateral

42
Q

what cutaneous feature is seen in HSV conjunctivitis

A

cutaneous vesicles on eyelids and around skin of eye

43
Q

what kind of ulcer is seen in HSV conjunctivitis

A

dendritic corneal ulcer

44
Q

where does HSV sit and reactivate from

A

CN V ganglion

45
Q

what is Hutchinson sign

A

tip of nose - means involvement of nasociliary branch of trigeminal nerve

46
Q

what is the treatment of viral conjunctivitis

A

self limiting
lubricants and cold compress
strict hygiene
topical steroids when corneal involvement

HSV - aciclovir

47
Q

how does molluscum contagiosum involve the eye

A

pearly umbillicated nodules filled with DNA pox virus can be seen on lid margin
and red eye that generally goes unrecognised

48
Q

what are some treatments for molluscum contagiosum conjunctivitis

A

curetting in central portion of lesion
freezing the centre
completely excising lesion
short course of topical steroids (prednisolone or dexamethasone) if eye is very involved

49
Q

what is the main feature of allergic conjunctivitis

A

itch

50
Q

what are some features of allergic conjunctivitis

A 
itch
redness
soreness
watery, stringy discharge
can cause chemosis
51
Q

what is the treatment for allergi conjunctivitis

A

reduce allergen
antihistamines (e.g. azelastine, emedastine)
topical mast cell stabiliser (e.g. sodium chromoglicate, nedocromial)
Olopatadine - dual action, very effective

52
Q

how could unilateral orbital trauma cause diplopia

A

if it is associated with the zygomatic bone

53
Q

what may be needed in order to examine an eye with a corneal abrasion

A

topical anaesthetic drops

54
Q

give 2 examples of topical anaesthetic drug

A

oxybuprocaine or tetracaine

55
Q

what s/s might indicate a corneal abrasion

A 
severe pain
lacrimation
inability to open eye (blepharospasm)
might be aggravated by blinking/moving eye
foreign body sensation
reduced visual acuity
56
Q

what 3 investigations would be done for a suspected corneal abrasion

A

blue light + fluorescein
eversion of upper eyelid
if suspect IOFB - XRAY

57
Q

what does a tear drop pupil indicate

A

corneal penetration

58
Q

test to prove corneal penetration

A

Seidel’s test (fluorescein)

59
Q

what can be a complication of corneal penetration

A

retinal damage

60
Q

what is worse an acid or alkali burn and why

A

alkali burn

acid coagulates causing little penetration

61
Q

what is the treatment for a chemical injury of the eye

A

immediate irrigation with minimum 2L saline or until pH normal

62
Q

what is sympathetic ophthalmia

A

penetrating injury to one eye causes inflammation of both eyes - exposure of intraocular antigens –> autoimmune reaction in both eyes

63
Q

how can a corneal ulcer lead to permanent visual loss

A

healing occurs by collagen laying down in a haphazard fashion

64
Q

give 4 causes of a central corneal ulcer

A

viral (HSV - dendritic ulcer)
fungal
bacterial
acanthamoeba

65
Q

what is the treatment of a dendritic ulcer

A

aciclovir

66
Q

what is the treatment of a bacterial corneal ulcer

A

ofloxacin hourly

67
Q

what are some cause of a peripheral corneal ulcer

A

RA
GPA, polyarteriitis (rarely)
hypersensitivity - marginal ulcers

68
Q

what is the treatment of a peripheral corneal ulcer

A

oral/topical steroids

69
Q

what are the 3 layers of the cornea

A

epithelium (10%)
stroma (90%)
endothelium

70
Q

when should keratitis be suspected

A

if cornea stains with fluorescein

71
Q

what are some s/s of keratitis

A 
foreign body sensation
pain
photophobia
lacrimation
vision reduced (if ulcer which affects visual axis)
72
Q

how does a dendritic ulcer form

A

HSV keratitis - epithelial cells undergo lysis and form a dendritic ulcer

73
Q

how is a dendritic ulcer observed

A

blue light and fluorescein

74
Q

true or false

HSV keratitis is not very painful and is recurrent

A

HSV keratitis is very painful

can be recurrent

75
Q

where does HSV lie dormant

A

CN V ganglion

76
Q

what is the treatment of HSV keratitis

A

aciclovir

77
Q

what happens if steroids are used in HSV keratitis

A

can lead to spread of virus + ulcer increases in size and corneal melt and perforation
DO NOT USE

78
Q

what usually precedes adenoviral keratitis

A

URTI

79
Q

is adenoviral keratitis usually unilateral or bilateral

A

bilateral

80
Q

what may be seen in adenovrial keratitis

A

subepithelial infiltrates

81
Q

what is the treatment of adenoviral keratitis

A

topical chloramphenicol - prevent secondary infection

steroids if chronic

82
Q

what is usually seen with bacterial keratitis

A

hypopyon

83
Q

what is the treatment for bacterial keratitis

A

hospital admission for hourly administration of drops - ofloxacin

84
Q

what is bacterial keratitis usually assoc. with

A

other corneal pathology or contact lenses

85
Q

when does acanthamoeba (fungal) cause keratitis

A

contact lens wearers

farmers

86
Q

what is the treatment for acanthamoeba keratitis

A

chlorhexidene (every 30 mins for 6 days)

87
Q

what is another cause of keratitis in contact lens wearers

A

pseudomonas aeruginosa

88
Q

what is the treatment for keratitis caused by pseudomonas aeruginosa

A

gentamicin

year 2 (19 decks)

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