Ophtho Flashcards
4 borders of the orbit
sup: frontal sinus
medial: ethmoid bone (lamina papyracea “paper thin”)
inferior: maxillary sinus
laterally: zygomatic bone
eye exam
-adnexa
-acuity
-visual fields
-pupils
-EOM
- inspect globe
-retinal exam with fundoscope
- slit lamp –> ant chamber
- fluorescein
- IOP
test for corneal laceration?
Seidel’s sign
normal IOP? contraindication to checking IOP with tonopen?
10-20 mm Hg
-suspected globe rupture
to examine cornea, slit lamp should be?
bright, thin, 45 degree angle (allows assessment of anterior chamber)
common triggers for preseptal cellulitis?
most common age?
most common bugs?
URTI, sinusitis, chalazion, hordeolum, insect bites and trauma. mostly in ppl <10
staph, strep
triggers for orbital cellulitis?
-paranasal sinusitis (esp ethmoid)
-trauma, intraorbital fb, postop, spread for preseptal infection
presentation of orbital cellulitis?
URI, facial pressure, fever, pain with EOM, photophobia, abn pupillary response, decrease visual acuity,
rare but highly m&m complication of orbital cellulitis?
+ other ones?
cavernous sinus thrombosis, presents with HA and deficit of CN 3, 4, 6
meningitis, encephalitis, epidural abcess, brain abcess.
dx and tx of orbital cellulitis?
dx: clinical + CT can also make dx
tx: IV ABX, ophtho consult, lateral canthotomy if inc IOP
abx for orbital cellulitis secondary to sinusitis?
ctx and flagyl
what is stye/hordeolum?
how is it managed
acute bacterial infection from blockage of glands. think “pig stye”, “whoredeolum”, therefore dirty compared with chalazion
usually loacted at lid margin/las line
tx: warm compress, erythro ointment
what is chalazion?
how is it managed
acute or chronic inflammation, no infection.
warm compress
ophtho if not resolving or if vision affected
blepharitis, most common cause and tx
overgrowth of s epidermidis
tx: lid hygiene (wipes) abx oint if severe
3 rule outs in bacterial conjunctivitis
corneal ulcer (look before fluorescein) then, abraision and herpetic lesions (with fluorescein)
