Opthalmology: Anterior eye- Gelson Flashcards
Two main causes of conjunctivitis
Viral or bacterial. Viral is more common. Often follows URI. Adenovirus is the most common form of viral.
Two most common causes of bacterial conjunctivitis.
Staphlyococcus aureus and Streptococcus pneumoniae.
What is the treatment for bacterial conjunctivitis?
Typically don’t take cultures.
The go-to is fluoroquinolone eye-drops. Gentamycin is quite toxic to the eye, so don’t recommend that.
What is iritis? What are the notable signs/symptoms? What is the cause?
Inflammation of the iris. Acute onset. Patients complain of periorbital pain, photophobia, blurred vision. Redness surrounds the iris.
Most notable sign–> the iris may not be round. You get adhesions between the iris and the lens, which is what causes this irregularity.
Most cases are idiopathic.
Tx for iritis?
Topical steroid, maybe a dilating drop to prevent scar formation. Pressure may need to be lowered as well.
What illnesses (chronic) can be assx with iritis? (many)
Anyklosing spondylitis, RA Crohns UC Lupus Sarcoiditis Syphilis TB
What stain can be used to visualized epithelial defects (brasions) on the cornea?
Fluorescein
What is the Tx for abrasions (corneal)?
Artificial tears, lubricant
Tape the eye closed for a day or two.
Topical Abx
NO TOPICAL ANESTHETIC–> delay healing
Sleeping in contacts puts you at 10x risk for what condition?
Who else is at risk?
What is the treatment?
What is the consequence (worst)?
Corneal ulcer. Infection of the corneal stroma (S. aureus, Pseudomonas)
Dry eyes, cranial nerve 7 palsy (can’t blink fully) are also at elevated at risk.
Tx is hourly fluoroquinolones.
Can result in permanent vision deficit, sometimes require corneal transplant.
What are two bilateral causes of red eye?
Dry eyes
Allergic conjunctivitis
A patient presents with unilateral eye redness, photophobia, pain, and tearing. Florescein highlights “dendrites” on the cornea. What is the diagnosis? Prognosis? Treatment?
HSV-1 .
Most cases self-limiting, but acyclovir is often used to shorten disease course. Patients may develop a corneal scar which blurs vision. Can require contacts or a corneal transplant.
One of the most common causes of vision loss.
What is an important consideration for a patient with facial Herpes-zoster (shingles)?
If the nose is involved, the eye likely is too. Both innervated bt the nasociliary nerve. Treat with acyclovir.
What is the name of the benign fibrovascular tumor? What is the treatment?
Pterygium. Caused by UV. Can remove it, replace the strip of cornea so it doesn’t regrow.
You wake up with a large swath of red covering the lateral sclera of your left eye. It doesn’t hurt. You have had a bad cold the last few days, and have been sneezing frequently. What is the likely diagnosis?
Subconjunctival heme. Sneezing coughing, rubbing.
People on anti-coag or anti-platelet are at a higher risk as well.
A patient presents with severe eye pain including nausea and vomiting, blurry vision and halos/rings around lights. What is the diagnosis? What is the etiology? What is the treatment?
Acute-angle glaucoma–> more of a medical emergency. People present with The distance between the cornea and the iris is small, due to the high IOP. Pathology - iris becomes attached to the lens, and the fluid can’t drain. Definitive tx is making a hole in the iris (laser peripheral iridotomy).
