optho Flashcards

1
Q

Neonate has unilateral painless excessive tearing and discharge

A

Blocked tear duct (dacryostenosis)

Tx - nasolacrimal massage up until 1 year. If persistant >1yr nasal duct probe

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2
Q

Tx for viral conjunctivitis

A

None is necessary, just good hygiene

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3
Q

5 day old baby w/ b/l conjunctivitis and purulent discharge

A

Gonococcal ophtalmia
Tx - systemic ceftriaxone (already failed topical erythromycin)
If left untreated -> blindness

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4
Q

Febrile pt is unable to look down and out, pupils are dilated and fixed. Why?

A

Oribtal cellulitis
Complication of sinusitis, eyelid trauma, dental/oral infections
Can lead to permanent vision loss, meningitis, and cavernous sinus thrombosis
Tx - IV or po abx

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5
Q

Pt with vision loss on retinal exam the neurosensory retina is separating from the retinal pigment epithelium. Abn growth of the choroidal vessels

A

Wet Macular degeneration

Tx- Laser photocoagulation of the subretinal neovascular membranes may delay onset of permanent vision loss

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6
Q

After prolonged contact wear (days) pt presents with a corneal ulcer. Tx?

A

Scrape the ulcer for Gram stain and culture to evaluate for sensitivities prior to starting a abx

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7
Q

Eyelid nodule that is firm painless indurated w/ loss of lashes and a yellowish lid

A

Suspicious for sebaceous cell carcinoma. Get a bx

Upper lid of a femal >50

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8
Q

Trisomy 21 baby has a pupil that turns inward on lateral gaze and corneal light reflex is symmetric

A

Pseudostrabismus
Common in Trisomy 21, reassure that the child is normal
if corneal reflex is ASYMMETRIC -> true strabismus

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9
Q

Unilateral eye pain, red eye on CT - retrobulbar fat-stranding and inflammation

A

Orbital inflammatory pseudotumor
Idiopathic
Tx - corticosteroids

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10
Q

Blowout fx of the optic orbit

A

Ophthalmologic emergency

Can cause inferior rectus entrapment and enophthalmos

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11
Q

Flame shaped hemorrhages and multiple cotton wool spots

A

Hypertensive retinopathy

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12
Q

Pt has chemosis, large cobblestone-appearing papillae, lymphoid follicles at the limbus. Dx and Tx?

A

Allergic conjunctivitis
Acute - OTC antihistamine
Subacute (more than 2 episodes/month) - top ketotifen

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13
Q

Crohn’s pt with unilateral eye pain, photophobia, decreased vision in affected eye

A

Suspect anterior nongranulomatous uveitis

Exam - small keratic preceipitates on the corneal epithelium

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14
Q

DM pt w/ retina with cotton-wool spots and hard exudates

A

Nonproliferative retinopathy

Tx - Laser photocoagulation

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15
Q

Pt has a wedge shaped growth of superficial tissue growing over the right eye

A

Pterygium
Benign growth of vascularized conjunctiva extending onto the cornea
Occurs in pts repeatedly subjected to conjunctival irritation (wind, sun, dust)
Tx - surgical removal

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16
Q

Pt taking orlistat develops night blindness. Why?

A

Deficiency of fat soluble vitamins (vit A)

17
Q

Glaucoma with a steamy cornea

A

Anterior uveitis with secondary acute angle closure

18
Q

Infant has newly developed unilateral white reflex. Now what?

A

Get an emergent opthalmologic consult
New leukocoria
Suspicious for retinoblastoma

19
Q

How frequently should a person be screened for glaucoma?

A

Annually if >40 and RF’s present (elevated IOP, black, FHx, DM)

20
Q

AIDS pt has c/o clear floaters in her eyes and flashy lights

A

Be concerned for CMV retinitis
Causes retinal edema and necrosis
Scotoma = floaters
Photopsia = flashing lights

21
Q

Following URI pt has unilateral conjunctivits. Most likely cause?

A

Adenovirus

22
Q

On slit lamp, part of the retina is opaque

A

Be suspicious for a cataract. Mature cataract would occlude the entire retina
Follow this patient closely

23
Q

Proptosis + HA + blurry vision. CT reveals mass in the lacrimal gland

A

Adenocarcinoma of the lacrimal gland

24
Q

Acute angle-closure glaucoma occurs due to lesion in the?

A

Iris
Trabecular mesh becomes blocked
Tx - iridotomy

25
Conjunctivitis pt has whitish eye discharge. Tx w/?
Sulfa ophtahalmic drops Staph, Strep, H. flu, pseudomonas, Moraxella Viral discharge is more watery
26
Pt suspicious for corneal abrasion but cannot do a good exam
``` Top tetracaine (anesthetic) Helps to allow for an adequate fundoscopy and fluorescin slit lamp ```
27
Days after a cataract surgery pt presents with swollen eyelid, edematous conjunctiva, exudates in anterior chamber, and decreased visual acuity
Postop endophthalmitis Usually occurs w/in six weeks of surgery Infection of the eye, particularly the vitreous Tx- abx or vitrectomy
28
Fundoscopy = cupping of the optic disc | Constricted peripheral vision
Primary open angle glaucoma More common in AA Tunnel vision over a period of years
29
Conact wearer presents with painful red eye, opacification and ulcertion of the cornea
Contact lens keratitis Most common cause (pseudomonas) Medical emergency - remove lens and bbroad spectrum abx
30
Presbyopia
Loss of near vision due to decreased lens elasticity
31
What meds should be avoided in a pt with acute glaucoma?
``` mydriatic agents (atropine) Causes the eye to dilate ```
32
What is useful in tx acute angle glaucoma?
Narcotics | Mannitol, acetazolamide, timolol, pilocarpine
33
After loss of vision in one eye due to a penetrating injury, the other eye has floaters and blurred vision
Sympathetic ophtalmia | Uncovers hidden antigents
34
Emergent tx of retinal a. occlusion
Ocular massage and high flow oxygen