Opthalmology Flashcards
Cause of dendritic ulcer
Herpes Simplex Virus
Dendritic ulcer
Causes corneal ulcer
Photophobia and eye watering
Diagnosing corneal ulcer
Fluoroscein drops
Treating dendritic ulcer
Do not give steroids without acyclovir cover - may cause corneal scarring
Symptoms of orbital cellulitis
Painful inflammation of the orbit
Fever
Lid swelling
Decreased eye movements
Common bugs for orbital cellulitis
Staphs, Strep pyogenes/pneumoniae
Management of orbital cellulitis
CT
IV Abx
Symptoms of ophthalmic shingles
Purulent conjunctivitis, visual loss, episcleritis/scleritis, cranial nerve palsy, optic atrophy, blistering rash, corneal signs and iritis.
Hutchinsons sign
Shingles
Involvement of nose tip means involvement of nasociliary branch of trigeminal nerve which supplies the globe therefore eye likely to be affected
Treating opthalmic shingles
Oral antiviral within four days of onset
Conjunctivitis
Diffuse injection
Gritty pain
Bilateral often
Normal vision, pupil size and IOP
Keratitis
Diffuse injection Gritty pain Photophobia Reduced vision Normal pupil and IOP
Anterior Uveitis (Iritis)
Circumcorneal injection Painful photophobia Reduced vision Constricted pupil Normal or raised IOP HLAB27 associations - psoriatic arthritis, ank spond, IBD, sarcoidosis, TB
Acute glaucoma
Diffuse injection Unilateral Severe pain and nausea Mild photophobia Reduced vision FIXED MID DILATED PUPIL Raised IOP
Classic Triad of redness, pain and photophobia
Anterior Uveitis
Treatment of anterior Uveitis
Topical steroid eg dexamethasone
Dilate pupil with cyclopentolate to prevent formation of posterior synethechiae
If IOP raised use beta Blockers and lantoprost or acetazolamide
Differences in episcleritis and scleritis
Scleritis = painful
Scleritis = associated with RA, Wegeners etc. Associated Uveitis common
Episcleritis = redness improves in phenylephrine test
Episcleritis = associated with gout, recurrent, nodules may occur, self limiting
Treatment of episcleritis
Self limiting
Lubricants/topical NSAIDs/ mild steroids
Treatment of scleritis
Oral NSAIDs
Oral steroids
Steroid sparing agents
Treatment of angle closure glaucoma
IV Acetazolamide (reduce IOP)
Pilocarpine (constrict pupil and improve aqueous outflow)
Beta Blockers and prostaglandin analogues
