Opthalmology

Question 1

Glaucoma

Answer 1

Acute Angle Closure Glaucoma: severe eye pain or frontal headache; typically starting in evening when pupils have been dilated. While waiting for opthalmologist, administer systemic carbonic anhydrase and apply topical beta blockers and alpha 2 selective adrenergic agonists.

Mannitol and pilocarpine may also be used.

Question 2

Orbital Cellulitis

Answer 2

Ophthalmologic emergency. When eyelid is pried open, pupil is dilated and fixed. Eye has limited motion. Pus is in orbit; emergency CT scan and drainage has to be done.

Question 3

Chemical Burns of the Eye

Answer 3

Massive irrigation with plain water 1st ALWAYS before arrival to hospital 30 minutes later.
At hospital more irrigation, then pH is measured to make sure conjunctival sac has no more harmful chemicals.

Alkaline burns are worse than acid burns.

Question 4

Retinal Detachment

Answer 4

Pt reports seeing flashes of light and floaters in eye.
More floaters = bad.

Emergency intervention with laser “spot welding” will protect remaining retina.

Question 5

Embolic Occlusion of Retinal Artery

Answer 5

Emergency; in 30 minutes the damage will be irreversible. Standard recommendation is for patient to breathe in bag and have person press hard on the eye. while going to ER

Question 6

Newly Diagnosed Diabetes

Answer 6

Need ophthalmologic evaluation if they have type 2.May have had for years before diagnosis was made.