Opthalmology I Flashcards
1
Q
Indications for treatment of orbital trauma
A
- Immediate: Muscle entrapment, oculocardiac reflex (bradycardia)
- Early repair: symptomatic diplopia, hypoglobus, large fracture, enopthalmus > 2mm (recession of eyeball), progressive infraorbital hypesthesia.
2
Q
Mechanisms of treatment of orbital trauma
A
- Go in the inside part of eyelid, dissect down to infraorbital layer
- incise periosteum
- expose bone, widely expose floor of orbit
- cut an implant from porous polyethylene, put it over the fracture
- ensure that eyes can move freely
3
Q
Common pediatric orbital tumors
A
- capillary hemangioma
- dermoid cyst
- lymphangioma
- rhabdomyosarcoma
4
Q
Clinical characteristics & treatment: capillary hemangioma
A
- Dramatic presentation: Mechanical ptosis, superficial are red bumps, deep are deep blue progressive enlarging mass
- Treatment:
- Propranolol and steroid (anti-angiogenic factors)
- surgical excision
- 75% resolve by 5
5
Q
Clinical characteristics & treatment: dermoid cyst
A
- Lateral brow, smooth, slow growing, palpable
- Treatment unknown
6
Q
Clinical characteristics & treatment: lymphangioma
A
- First decade of life, benign vascular formation, increased pressure, big intraocular cyst
- Treatment: Surgery to drain blood and lymph
7
Q
Clinical characteristics & treatment: rhabdomysocarcoma
A
- Most common pediatric orbital malignancy of childhood.
- Sudden onset and rapidly progressive unilateral proptosis (protrusion of eye) in kids, or more subtle if teens.
- Delayed diagnosis can lead to death. Always have on DDx.
- Treatment: radiation and systemic chemotherapy. Exentoration if recurrent cases.
- If confined to orbit, 95% survive.
8
Q
Common adult orbital tumors
A
- cavernous hemangioma
- neural tumors
- schwannoma
- meningioma
9
Q
Clinical characteristics & treatment: cevernous hemangioma
A
- Most commmon benign neoplasm in adults
- Tumor behind eye compressing optic nerve, slowly progressive proptosis
- Treatment: Lateral orbitotomy, benign most often do not reoccur
10
Q
Clinical characteristics & treatment: Shwannoma
A
- Vestibular nerve tumor
- slow growing
- older/young women predominantly
- Tx: lateral orbitotomy
11
Q
Clinical characteristics & treatment: Meningioma
A
- Sphenoid wing
- Optic nerve sheath - enlarged, gradual decrease in vision, proptosis.
- Also optociliary nerve vessels seen on opth exam
- Sphenoid wing meningiomas: observe, radiation, fractionated static radiotherapy, surgery
- lateral orbitotomy possible
12
Q
Clinical features & tx: nasolacrimal duct obstruction
A
- constant tearing w/frequent mucopurlence
- Tx: dacryocystorhinostomy
- incision @ side of nose ==>
- create passage between lacrimal ducts and nasal canal
13
Q
Acute and Chronic conditions resulting from nasolacrimal duct obstruction
A
- Acute: dacrocystitis
- Chronic: epiphora chronic dacrocystitis
14
Q
Clincial features & tx: preseptal cellulitis
A
- infection of skin surrunding eye
- tx:
- antibiotics
- nasal decongestants
- warm compress
15
Q
Clinical features and tx: complicated orbital cellulitis
A
- Caused by sinusitis, disease posterior to orbital septum
- ==> decrease in visiual acuity
- Sx: Fever, leukocytosis, proptosis, chemosis, ptosis, restriction of movement and pain with ocular motility
- Tx:
- Treat immediately
- Oral antibiotics
- low threshold for surgical draining
