opthalmology Flashcards
Primary care suspects retinal detachement - what is the next step?
Refer to opthalmology and dispose with patient with head down position to maintain retinal position.
what is the most common age range for amaurosis fugax?
patients older than 50
what is amaurosis fugax?
“TIA of the retina”
the retina descends and retracts
Unilateral transient acute vision loss
Predisposing factors: A fib, carotid plaques, HTN, DM
What is the number 1 cause of retinal artery occlusion?
Carotid atherosclerosis
Seeing cherry red spots and boxcarring of the arteries on fundus exam should make you think of…
Retinal artery occlusion
What are the predisposing factors for retinal artery occlusion?
clot, sclerosis, HTN, DM, A fib, Temporal arteritis
Treatment for retinal artery occlusion
Emergent referral to opthalmology; Intermittant pressure on eye - to “milk” the clot/blod collection from the eye and improve vision.
What is the treatment for herpes keratitis?
Topical antivirals. STEROIDS ARE CONTRAINDICATED!
A patient describes his vision as painless but if seems that a curtain comes down and then goes back up. This is the hallmark for ….
Amaurosis fugax
Patient presents with a painful red nodule on the upper eyelid. How would you treat?
Suspect hordeolum. Treat with warm compresses and topical antibiotic.
Fundus exam shows cherry red spot. This is pathoneumonic for…
Central retinal artery occlusion
A college student presents to the student health center with a little purulent drainage from the eye and nontender preauricular lymphadenopathy. what is the most likely causative agent?
Chlamydia conjunctivitis
Patient presents to his primary care office with unilateral blurred vision that has deveolped over a few days. Fundus exam shows a “blood and thunder” pattern. What should she be thinking of?
How should it be treated?
Central vein occulsion
This is typically self limited but the underlying cause needs to be addressed and treated.
Is glaucoma more prevalent in males or females?
Females 3:1
Give 2 risk factors for glaucoma
African american heritage and diabetes
Fundal exam shows a cup to disc ratio of >0.5. You also notice vessels bending over the disc. What is most likely diagnosis?
glaucoma
PAtient presents to the after hours clinic with a yellowish fleshy mass on the conjuctiva just outside of the iris. his vision is normal and this mass is painless. What do you tell the patient?
this is Pinguecula. you reassure. no further treatement is neccessary. Counsel on eye protection in the sun and wind.
During the course of the history, a a patient relates that he has glasses for 30 years but no longer seems to need them. What is the most likely diagnosis?
cataracts.
Which quadrant is most likely for retinal detachement?
superior temporal
Patient presents to the office with a central blind spot in his vision. HE also states that sees wavy lines in his vision when looking at something You are concerned for what ?
MAcular degeneration. REfer to opthalmology.
The fundus examination in macular degeneration is likely to show…
drusen deposits
PAtient presents to you busy clinic with unilateral eye pain. When you examine her she has a hazy cornea and fixed pupil. you are thinking….
glaucoma
what is the most common way to test for metamorphopsia?
Amsler grid
What is metamorphopsia?
ITs type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank. People with this condition often first notice this when looking at mini-blinds in their home.
A patient presents with irritation of the eyelids, describes them as burning and increased tearing.
Physical exam shows scurf and scaling at the lash line. fWhat to you counsel them to do nightly?
This is bleoharitis. have them gently scrub the eyelashes with baby wash nightly. Topical antibiotics are not indicated at first.