opthalmology Flashcards
Near-sightedness occurs when the
optical power of the eye is too
large and causes light to focus in
______ of the retina.
front
Viral Conjunctivitis is More common than bacterial
conjunctivitis, Most commonly occurs after an
upper respiratory tract infection with _______
being the most common organism.
Adenovirus
Viral Conjunctivitis is associated with
Moderate inflammation of the conjunctiva (appears pink).
Watery discharge.
May have a pre-auricular lymph node enlargement.
Bacterial Conjunctivitis
• Most common organisms are: _________
Staphylococcus aureus and
Streptococcus pneumoniae.
what are the treatments for Bacterial Conjunctivitis
• Treatment:
– Cultures are not routinely taken and empirical treatment is started.
–
– Alternatives include sulfacetamide or tobramycin.
–
Antibiotic eye drops usually for one week.
– Preferably 3rd or 4th generation fluoroquinolone (ciprofloxacin,ofloxacin, or moxifloxacin))
In bacterial conjuctivitis Tx, _______ drops can be toxic and cause irritation with prolonged use
Gentamicin
Iritis is a form of _______ with
inflammation of the iris
uveitis
what are the Symptoms of Iritis
ocular or periorbital eye pain, photophobia, blurred or cloudy vision. Redness (near the limbus). May have an irregular shaped pupil.
Iritis
• Treatment:
– Topical Steroid Eye Drops (prednisolone acetate, difluprednate)
– Dilating Eye Drops help prevent synechiae within the eye and with pain
(cyclopentolate, atropine)
– Occasionally Topical Glaucoma Drops (brimonidine, timolol)
Herpetic keratitis is a common
viral infection that affects the
corneal epithelium, primarily caused by ______
HSV1.
Patient presents with
unilateral eye redness (can be
bilateral), pain, photophobia,
decreased vision, and tearing, what does shoe most likely have?
Herpetic keratitis
In Herpetic keratitis, _______ on the ocular surface
shows dendritic epithelial ulcer in
branching pattern with terminal
bulbs.
Fluorescein
Patient presents with
unilateral eye redness (can be
bilateral), pain, photophobia,
decreased vision, and tearing, what does shoe most likely have?
Herpetic keratitis
In Herpetic keratitis, _______ on the ocular surface
shows dendritic epithelial ulcer in
branching pattern with terminal
bulbs.
Fluorescein
what is the Treatment for Herpetic keratitis
– Topical trifluridine Q2H.
– Oral acyclovir 400mg 5x/day or
valacyclovir 1g TID.
– Most cases will resolve
spontaneously within three
weeks. Medication can shorten
the duration.
• Herpes Zoster Ophthalmicus is a reactivation of VZV. Represents about 10-25% of all cases of Herpes Zoster and up to \_\_\_\_\_\_\_ may develop ocular manifestations.
65%
Herpes Zoster Ophthalmicus has Dermatological involvement of _____ distribution.
V1
• Symptoms of Herpes Zoster Ophthalmicus are ?
prodromal period
of fatigue, low-grade fever, unilateral
rash on forehead, upper eyelid and
nose.
Fluorescein applied to corneal
surface can reveals multiple swollen
lesions with staining around them. what does this patient have?
Herpes Zoster Ophthalmicus
Herpes Zoster Ophthalmicus
• Treatment:
– Oral acyclovir 800mg 5x/day for 10 days
– Oral valacyclovir 1g 3x/day for 10 days
Subconjunctival Hemorrhage
• Risks factors:
– Sneezing – Coughing – Excessive eye rubbing – Anti-coagulation – Trauma (if there is a history then the should have a complete eye exam)
Benign fibrovascular tumor, UV
induced, often inflammed is called _____?
Pterygium
Ocular redness without irritation that resolves spontaneously. • Typically transient (days to weeks) in 20-50 year olds. • Classified as nodular or diffuse. what is it ?
Episcleritis
what is the most common form of scleritis?
Nodular 44%
Scleritis vessels cannot be moved, and _______with
phenylephrine, whereas episcleritis does ______
with phenylephrine
do not blanch,
blanch
which autoimmune diseases can be present with scleritis?
– Rheumatoid arthritis
– Lupus
– Sero-negative spondylarthropathies
• Wegener’s
• Polyarteritis nodosa
– Syphilis
– Tuberculosiswhat are the Sx’s and presentation of Dry Eye Syndrome
foreign body sensation, blurred vision, reflex
tearing.
• Condition worsens towards end of
the day and activities that require
attention – reading, computer
work.
• describe Squamous cell carcinoma in the eye.
is a malignant epithelial lesion. – Conjunctival intraepithelial neoplasia in which cells have invaded through the conjunctival basement membrane. – Rarely invades the sclera.
what is the initial Tx for Squamous Cell Carcinoma
topical chemotherapeutic agents
– Interferon-alpha
– 5-fluorouracil
– Mitomycin C
you see elevated, mobile salmon pink mass on the
conjunctiva, what are you dealing with?
Non-Hodgkin B-cell conjunctival
lymphoma
Angle closure glaucoma may occur with dilation which results in pupillary block after watching
television in dark room or certain
medications, name the 4 types (a
anticholinergics,
antihistamines,
tricyclic antidepressants,
MAO inhibitors
what causes Angle Closure Glaucoma
Rapid increase in eye pressure due to the iris being pushed forward up against the trabecular meshwork preventing the outflow of aqueous humor.
• May occur with dilation which results
in pupillary block after watching
television in dark room or certain
medications, name the 4 types (a
anticholinergics,
antihistamines,
tricyclic antidepressants,
MAO inhibitors
what are the Sx’s of Angle Closure Glaucoma
unilateral severe eye pain,
nausea,
redness,
blurred vision and halos around lights.
on Examination, angle closure glaucoma may show sluggish, mid-dilated pupil, conjunctival
injection, ______ cornea and shallow
anterior chamber. When palpating
the eye it may feel _______
hazy
hard.
In Ocular Burns
• Patients present soon after exposure
complaining of _____
eye pain,
redness,
tearing,
decrease in vision.
in ocular burns _____ materials are more harmful
alkali
In Ocular Burns • Patients present soon after exposure complaining of \_\_\_\_\_ • • Limbal ischemia is a poor prognostic sign.
eye pain,
redness,
tearing,
decrease in vision.
Examination of ocular burns may show ______
conjunctival injection,
corneal abrasion or
opacity.
In Ocular Burns
• ________ is a poor prognostic
sign.
Limbal ischemia
Corneal ulcer is an infection of
the ________.
corneal stroma.
what is the treatment for Corneal Ulcer
– For small ulcers (<1mm) may treated hourly with a 3rd or 4th generation
fluoroquinolone (ciprofloxacin, ofloxacin, or moxifloxacin).
– Larger ulcers require culture to determine the organism.
corneal transplant can be performed in certain cases
________ is a progressive disease of the optic nerve that is often associated with elevated intraocular pressure.
• Open angle glaucoma
what is the treatment for Corneal Ulcer
• Fortified antibiotics including vancomycin and tobramycin.
– Slow healing and can require weeks of therapy.
– Once healed can leave a corneal scar with permanent vision loss.
– In some cases where the ulcer does not decrease in size despite medical
therapy or if the cornea becomes too thin and there is a risk of
perforation then a
– For small ulcers (<1mm) may treated hourly with a 3rd or 4th generation
fluoroquinolone (ciprofloxacin, ofloxacin, or moxifloxacin).
– Larger ulcers require culture to determine the organism.
corneal transplant can be performed in certain cases
________ is a progressive disease of the optic nerve that is often associated with
elevated intraocular pressure.
• Open angle glaucoma
_______is a gradual clouding of
the eye’s natural lens. Purpose of
the lens is to focus light on the
retina.
Cataracts
what are the causes of cataracts in younger patients
– diabetes
– systemic steroids
– trauma
– radiation
what are the 2 mechanisms of orbit fractures?
BUCKLE (ROOF FX IN KIDS) BLOW OUT (FLOOR ADULTS)
what do you see in an ORBITAL FLOOR FX
ENOPHTHALMOS (posterior displacement of the eyeball)
HYPOGLOBUS (downward displacement of the eye)
thyroid eye disease is a PRIMARY INFLAMMATORY DISEASE OF THE ORBITAL SOFT TISSUE,
AUTO-IMMUNE DISEASE (TARGET IS THE ORBITAL ______ )
ASSOCIATED WITH AUTO-IMMUNE THYROID DISEASE (MOST COMMONLY ________).
__________ IS NOT THE CAUSE
FIBROBLAST,
GRAVES DISEASE,
DYSTHYROIDISM
thyroid eye disease ultimately results in ________
Hypertrophy if the extra ocular muscles
basal cell cancer accounts for ____ OF EYELID SKIN Cancer.
COMMONLY INVOLVES _______ EYELID
90%,
LOWER
treatment for basal cell cancer
TREATMENT IS EXCISION WITH MARGIN CONTROL
(FROZENS OR MOHS)
RECONSTRUCTION >
Tarsoconjunctival flap + FTSG (Full thickness skin graft)
what is the TX for NASOLACRIMAL DUCT
OBSTRUCTION
DCR (DACRYOCYSTORHINOSTOMY)
what presentation is seen in chronic NASOLACRIMAL DUCT OBSTRUCTION
Epiphora (overflow of tears onto the face) chronic DACRYOCYSTITS (pain, redness, and swelling in the inner corner of the eye)
describe the management diabetic retinopathy
Glycemic control
Blood Pressure control
Screening eye exams
Laser photocoagulation
Diabetic macular edema – Focal laser
PDR – Panretinal photocoagulation
what findings are seen in acute Hypertensive Retinopathy
Retinal hemorrhage
Macular edema and exudate
Optic disc edema (Papilledema)
describe what you see in Central retinal vein occlusion
- often related to HTN
- dilated veins and extensive hemorrhage
describe what you see inCentral retinal artery occlusion
- ‘stroke’ to eye
- cherry red spot
what is the #1 cause blindness >50 yr old
Age-related Macular Degeneration (AMD)
what is the Tx for Nonexudative (Dry) AMD
antioxidant vitamins
whats is the Tx for exudative (wet) AMD
Anti-VEGF intravitreal injections
describe the management of gluacoma
Lower IOP
Medications
Decrease aqueous production
Increase outflow
Laser
Surgery – with or w/out drainage implants
