Opthomology Flashcards
1
Q
Eyelid & Lashes turned outward
A
Ectropion
2
Q
Eyelid & eye lashes turned inward
A
Entropion
3
Q
Ectropion is due to the relaxation of the _______ muscle
A
Orbicularis oculi
4
Q
Management or Tx for ectropion or Entropion
A
Sx correction or lubricating eye drops
5
Q
Tearing, tenderness, edema, & redness to medial canthus
A
Dacrocystitis infection of the lacrimal sac
6
Q
MC culprit in Dacrocystitis
A
S. Aureus, GABHS, S. Epidermis, H flu, S. Pneumo
7
Q
Eyelid burning, erythema, crusting, scaling, red rimming, and eyelash flaking. seborrheic or infectious
A
Blepharitis (Inflammation of both eyelids)
8
Q
MC culprit in Blepharitis
A
S. Aureus or Staph Epidermis
9
Q
Blepharitis management Tx
A
Warm Compress, eyelid hygiene, scrubbing w/ baby shampoo, (Post.= Expression of the Meibomian gland)
Staph Infx: Erythromycin
Doxy: Meibomian Gland Dysfx
10
Q
Painful, warm, swollen red lump on eyelid. Eyelid margin abscess external sebaceous gland (Ext.)
Internal sebaceous gland (Internal)
A
Hordeolum (stye)
11
Q
painless granuloma of the internal Meibomian sebaceous gland. Large, firm, slow growing
A
Chalazion
12
Q
Tx for Hordeolum
A
Warm compress, + or - Abx Erythromycin or Bacitracin
I and D if no drainage w/I 48 hours . most point and drain spontaneously
13
Q
Tx for chalazion
A
eyelid hygiene warm compress, abx not necessary, injection of corticosteroid or incision
Injected Triamcinolone steroid if no resolution X 3-4 wks. CI: Dark Pigment Pts
14
Q
Elevated superficial fleshy, triangular shape growing fibrovascular mass MC in inner corner nasal side of eye
A
Pterygium
15
Q
Elevated superficial fleshy, triangular shape growing fibrovascular mass MC in outer corner of eye.
Caused by UV as well as dust and sand exposure. Fat /protein does not grow
A
Pinguecula
16
Q
Pinguecula and Pterygium Tx
A
Observation for most, artificial tears, removal of affects vision or cosmetics reason
17
Q
Severe conjunctival hemorrhage. Tear drop or irregularly shaped pupil, hyphema, enopthalmus
diplopia, visual acuity reduced ( may be light perception only, ocular pain, prolapse of the iris, obscured red reflex
A
Globe rupture
18
Q
Globe rupture tx
A
Rigid eye shield (stabilize impaled object)
Immediate optho consult : IV Abx
Avoid topical solutions
19
Q
decreased visual acuity post trauma Diplopia especially w upward gaze. orbital emphysema w nose blowing,
Epistaxis anesthesia to anteromedial cheek due to stretching of infraorbital nerve
A
orbital blowout fx
20
Q
diagnostic of choice for blow out fx
A
CT - will show teardrop sign
21
Q
Blow Fractures management
A
Initial - Nasal decongestant (for pain ). Avoid blowing nose and steroids to reduce edema
Abx - Ampicillin/sulbactam or clindamycin
Severe cases require surgery
22
Q
MC cause of permanent legal blindness and visual loss in the elderly >60. Central vision loss BL and detail/color vis
Scotomas (Blind spots and shadows), metamorphopsia (bent straight lines), micropsia (small obj),
A
Macular Degeneration
23
Q
Gradual break down of the macula and central blur. Drusen- Small round yellow spots on outer retina
(Accumulation of waste products from the retinal pigment epithelium)
A
Dry (Atrophic) Macular degeneration
24
Q
New abnormal vessels, grow under the central retina, which leak and bleed –>retinal scarring
Progresses rapidly (Fluorescein angiography Dx)
A
Wet (Neovascular) or exudative Macular Degeneration
25
Macular Degeneration Dry Tx
Amsler grid at home- monitors stability. Vit A, C, E may slow progression.
26
Macular Degeneration Wet Tx
Intravitreal anti-angiogenics Bevacizumab- Inh. vascular endothelial growth factor red. neovascularization
27
Retinal vessel damage leads to ischemia, edema.
Proliferative neovascularization
Non-proliferative Micro aneurysms flame shapes (Cotton wool spots, hard exudates, hemorrhages)
Diabetic Retinopathy
28
excess sugars attach collagen in vessels --> breakdown of vessel capillary wall
Glycosylation-
29
Diabetic Neuropathy Tx
Proliferative (Neovascularization)- Bevacizumab, laser coagulation tx, tight glucose control
Maculopathy- Laser
30
I.Copper wiring-Vessel wall thickening and lumen narrowing, II. AV nicking-compression @ jx by Inc. press.
III Cotton wool spots- fluffy white spots, flame shape hemorrhages, IV papilledema
Hypertensive Retinopathy
31
Photopsia- Flashing lights--> Floaters-->progressive UL vision loss "Shadow or curtain coming down" periph 1st
--> central visual field. No pain or redness. Detached tissue flapping in vitreous humor. Tobacco dust (Shaffer)
Retinal Detachment
32
Retinal Detachment type w predisposing factors of myopia and cataracts.
Inner sensory layer detaches from choroid plexus
Rhegmatogenous MC Type
33
Adhesions separate the retina from its base.
predisposing factors
predisposing factors Proliferative DM retinopathy, sickle cell, trauma
Traction Retinal Detachment
34
Fluid accumulates beneath the retina--> detachment
Exudative Retinal Detachment
35
Clumping of brown-colored pigment cells in the ant. vitreous humor resembles Tobacco dust
Shaffer's sign
36
Retinal detachment Tx
Optho ER- keep patient supine while awaiting consult don't use miotic drops
Laser, cryotherapy, ocular surgery
37
Curtain that lifts up usually within 1 hour
Amaurosis Fugax
38
FB Sensation, tearing, red and painful eye
| Fluorescein staining required
Ocular FB and corneal Abrasions
39
Ocular FB and corneal Abrasions Tx
Removal w cotton tip swab- No topical anesthetics
Patch for > 5mm. No patching > 24 hours. Rust ring = remove w/I 24 hrs
No patch in contact lens wearers (Pseudomonas) Cipro gtts 24 hr F/U
40
FB sensation, erythema, and itching. May have viral S/S
pre-auricular LAD, copious water D/C scant mucoid D/C; Follicular response, subepithelial LAD
Often BL. May have punctate staining on slit lamp MC Adenovirus
Viral conjunctivitis
41
Viral conjunctivitis Tx
cold compress, artificial tears
42
Nerve and muscle that closes the eye
Cranial nerve VII (Facial) and Orbicularis Muscle
43
Nerve and muscle that opens the eye
cranial Nerve III (Oculomotor) Levator muscle and muellers
44
Muscle that assists opening the eyelids
Mueller's Muscle
45
Produces aqueous humor
Ciliary Body
46
Allows focus on near objects, accommodates or contracts creating changes on zonular fibers
Ciliary Muscle
47
Provides blood supply for the outer retinal layers
Choroid
48
Responsible for fine central vision, depression in the center is fovea. Contains mostly cones
Macula
49
Location where nerve fibers converge and leave the eye (Physiologic blind spot )
Optic disc
50
considered moderate low vision
20/80- 20/160
51
Meds for dilation
Mydriatics
52
Cholinergic Blocking medication lasting Max effect 30 min. lasts 2-6 hours
Tropicamide
53
Cholinergic Blocking medication lasting Max effect 340 min. lasts 1-2 weeks
Atropine
54
what to look for in eye exam
```
Red reflex
Optic Disk
Retinal circulation
Retinal Background
Macula
```
55
Intraocular pressure ranges
10 - 21 mmhg with tonometer
56
standard of care measurement for IOP
Goldmann Tonometry
57
Iris bows forward in patient with shallow chamber creating a shadow when shining a light from side
Risk for angle glaucoma
58
Evaluates the Macula
Amsler grid testing
59
Farsightedness Axis Length of the eye is too______
+ Hyperopia (short )
60
Nearsightedness Axis Length of the eye is too______
- Myopia (Long )
61
Eye shaped more like a football
Astigmatism
62
Old eyes loss of accommodation
Presbyopia
63
Eyes are parallel when both eyes are open but when you cover one eye the covered eye moves away
Heterophoria ( Eso, Exo, Hyper, Hypo, cyclo)
64
condition when both eyes do not point in the same direction when both eyes are open
Heterotropia (Eso in, Exo out, Hyper up, hypo down)
65
Misalignment of the two eyes
Strabismus
66
Double vision
Diplopia
67
Eye that is deviated most of the time with increased poor vision
Defective vision without detectable anatomic damage
Amblyopia (Lazy eye)
68
Test used to find deviation during light reflex deviation
Hirschberg Test
69
Strabismus Tx
Patching of the better eye to force use of bad eye. Full time patching is best. 1 week/year of age
Over age 11 typically unsuccesful
70
The inability to completely close eyes
Lagophthalmos
71
Meibomian Gland dysfunction Blepharitis Tx
Doxycycline
72
inflammation of the lacrimal sack S/S tearing, pain, erythema, mucopurulent discharge
Dacrocystitis
73
Dacrocystitis tx
Augmentin 500 mg every 8 hours
Febrile hospitalize Iv Abx
74
Inflammation of the lacrimal gland s/s lateral lid swelling, pain, tearing, tender and erythematous lacrimal gland
Dacryoadenitis
75
Dacryoadenitis Tx
Augmentin 250- 500 mg TID
cephalexin 250-500 mg
76
Most common cancer of the eyelid
Basal cell carcinoma
77
Squamous cell carcinoma tx
Surgical removal Moh's surgery
78
Ocular Mucopurulent D/C can rapidly invade cornea. Edema and erythema of the lid.
Adhesion of lid especially in the a.m
Bacterial Conjunctivitis
79
Bacterial Conjunctivitis tx
Trimethoprim/Polymyxin B QID X 7 days
Ceftriaxone 1 G IM then IV 1 G q 24 hrs
+ Azithromycin 1 G po single dose (Gonocc/Chlam)
80
Work up for Bacterial Conjunctivitis Gono/Chlam suspected
Gram Stain and conjunctival cultures
81
Intense ocular itching and watery D/C Bilat. erythema and edema w stringy mucoid D/C
Conjunctival Papillae elevations w prominent central vessel
Allergic Conjunctivitis
82
Allergic Conjunctivitis tx
Mild - Artificial Tears
Moderate- Topical AH1 (Olapatadine or Ketotifen)
Severe- Loteprednol Top Steroid
-PO AH1
83
Is a nodular lesion growth at the limbus caused by sensitivity to bacterial proteins staph/Tb
Phlyctenule
84
Phlyctenule tx
Steroid and Abx combo drop Tobradex or Zylet
85
Typically Asymptomatic benign pigmented lesion freely mobile over the sclera
Rare progression to malignancy middle aged elderly
Requires biopsy if growth or change in appearance
Conjunctival Nevus
86
Main concern is ruptured globe with intraocular or orbital FB Metal striking metal or BB gun injury
Fluorescein stain required R/O scleral involvement
Conjunctival Laceration
87
Conjunctival Laceration tx
< 1cm of length = Erythromycin TID
> 1cm of length = Sx closure
88
Caused by trauma, Valsalva, heavy lifting, chronic cough, constipation, and use of aspirin or warfarin
IOP, BP check, PT and PTT, TX Art tears DC ASA
Subconjunctival hemorrhage
89
Damage to cornea that tends to be extremely painful. Severe damage/blindness w/I 24-48 hrs.
Infiltrates- accumulation of cells or fluid in the cornea
Corneal Ulcers and Erosions
90
Irritation, conjunctival injection, and photophobia. MC unilateral Advanced disease- Stromal scarring
Epithelial Dendrites
Herpes Simplex Keratitis
91
Herpes Simplex Keratitis Tx
Topical Antivirals
Topical Steroids = tissue loss
92
Ulceration of epithelium w incr. ANt. chamber reaction w or w/o hypopyon. Upper eyelid edema,
surrounding corneal inflammation, conjunctival hyperemia, mucopurulent D/C
Bacterial keratitis
93
Bacterial keratitis Tx *
Gram Stain and Giemsa
Aggressive topical Fluoroquinolone (Mild or Med risk (
Vision Threatened= Q 30 min Tobramycin Gentamycin Cefazolin or Vancomycin
94
History of outdoor eye trauma w vegetable matter involved, steroid use, sx, contact lens use
FB sensation, incr. pain, decrease vision, feathery white yellow opacity, hypopion
Fungal Keratitis
95
Fungal Keratitis Tx
Surgical debridement ( No Steroids)
Meds= Natamycin topical, Amphotericin B Top.,
Fluconazole/voriconazole PO
96
Corneal pigmentation- Corneal deposits
Chloroquines or Hydroxyxhloroquines
97
Corneal Pigmtation- whorl-shaped deposits
Amiodorone
98
No current hx of trauma. Typically occurs upon wakening, felt sharp pain when opened the eye
Felt like eye was stuck to front of the eye. After healing, diffuse irregularity of cornea
Recurrent Corneal Erosion
99
Recurrent Corneal Erosion Tx
Hypertonic Saline ointment Muro 128 (Sx if Severe)
Bandage contact lens if large (analgesia PRN)
100
Progressive thinning of the central cornea degenerative in nature. Left untreated--> cornea perf.
Results in scarring and blindness. bulging of inferior lid/cornea from thinning central cornea- Munson sign.
Keratoconus
101
Kayser Fleischer ring are result of depositions of iron in the form of hemosiderin. Fleischer rings are indicative of ?
Keratoconus
102
Associated w herpes zoster, systemic dz such as RA, SLE, Rosacea.. Thyroid disease and syphilis
injection at sclera can be moved w Q-tip. Mild to Mod pain. Phenylephrine --> blanching post min.
Episcleritis
103
Episcleritis Treatment
Refer: Typically self limited, cold compress, artificial tears,
Mod - severe topical steroids oral NSAID
104
Associated w systemic disease w SEVERE boring pain that radiates to forehead, jaw, and brow. Pain awakens pt
photophobia, tearing, bluish hue. Phenylephrine does not blanch. Exam for systemic issues.
Scleritis
105
Scleritis Tx
H2 blocker- Ranitidine
NSAIDS Ibuprofen or Indomethacin
Steroids prednisone
Cyclophosphamide for posterior scleritis
106
Associated with HLA-B27 Positive, Ank. spondylitis, Reiters, Juvenile arthritis, syphilis. Uni or Bilat "Mutton Fat" KERATIC PRECIPITATES *
onset acute and insidious, photophobia, ciliary injection, floating cells, hypopyon, koeppe nodules (iris)
Anterior Uveitis
107
Anterior Uveitis Tx *
Dialate scopolamine mild- mod *****
Atropine- Severe ******
Steroid Prednisone
1st time = excellent
recurrent = poor
108
Related to systemic dz. inflammatory cells w/I vitreous w hazy exam findings. Optic disk swelling w edema.
Retinal and choroid hemorrhages. Decreased vision and floaters
Posterior Uveitis (Eschar black optic nerve pic)
Tx= Anterior uveitis
109
Age related most common association. Diabetes, trauma, Toxic steroids, uveitis, Radiation. tumor
Decreased vision, infant keeps eye closed, Leukocoria white pupil, absent/abn. red reflex.
Cataracts or congenita cataracts
110
Types of cataracts ******
Nuclear- Central part yellowing, blur distant vision.
Posterior- Opaque post. of lens. Glare and reading diff.
Diabetes, trauma, radiation, *******
Cortical- Spoke like opacity asymptomatic
111
cataract considered an emergency
congenita cataracts
112
Brain learns to see with macula at what age?
3- 4 months of life (Prevent Amblyopia)
113
RF is Trauma. MC cause: Marfans syndrome, Homocystinuria, syphilis.
Zonular fibers ruptured, crescent moon Iris pic
Lens Dislocation
114
caused by small aggregates in the vitrous cavity from a normal aging process
Acute onset = Uveitis, SC anemia, Retinal detach/ tear
Floaters and flashes
115
Supplies the inner retina towards center of eye
Central Retinal artery
116
Supplies the outer retina towards center of eye, towards wall supplies photo receptors
High oxygen demand
The choroid process
117
Unilateral acute vision loss, happens over seconds noticed on arising in a.m markedly white retina
cherry spot in macula. BOx car segmented arterioles
Retinal Artery occlusion ( Branch or Central)
118
Retinal Artery occlusion Tx
Decrease IOP Timolol and Acetazolomide, paracentesis
119
Retinal Artery occlusion you must R/O
Giant cell Arteritis
Tx = High dose Steroids
120
Painless loss of vision unilateral. Cotton wool spots and exudates vitrous hemorrhage
flame shaped hemorrhage Blood and thunder
Retinal vein occlusion
121
How do you differentiate ischemic versus non ischemic
Afferent Pupillary defect
122
Retinal vein occlusion Tx
Evaluate w/I 48 - 72 hrs
D/C BC and reduce IOP and ASA
123
Group of dz w progressive optic nerve damage and visual field loss. IOP above normal range MC
Glaucoma
124
Monocular Halos around light intense ocular pain w photophobia, frontal HA, NV, IOP= 60-70
Entrance to very dark room or drugs trigger:
****Mid-Dialated Pupil****
Acute Angle-closure glaucoma
125
Acute Angle-closure glaucoma
Timolol
Acetazolamide IV (Sulfa NKA)
Isosorbide or Mannitol
126
Blockage of aqueous outflow. MC in increased age or African American. FM Hx 6 times incr. RF DM X2-3 incr
IOP may be normal highest in a.m hours crescent shadow narrow chamber. cup/ disk 0.6 > progressive visual field loss
Open-Angle Glaucoma
127
Treatment for glaucoma decreases aqueous humor
Beta Adrenergic blockers. -Lols (NO asthma)
Alpha adrenergic blockers -idine (Conjunctivitis, dermatitis)
carbonic anhydrase Inh. - -mides
128
Treatment for glaucoma Increases outflow of aqueous humor
Sympathomimetics epi and memantine (HTN)
Prostaglandins analogs- - prosts (hyperemia)
Miotic Agent - Pilocarpine
129
**Asymptomatic** possible decreased vision/field loss
| elevated IOP 40mmhg, optic nerve damage pupil normal
Chronic Angle Closure Glaucoma
130
Glaucoma that is temporarily treated until cornea is clear for goiniotomy (Incise trabecular mesh work)
Congenital Glaucoma
Tx Levobunolol/Timolol
131
steroid response glaucoma affects trabecular mesh work with prolonged use of steroids topical over
2-4 weeks
132
Glaucoma requires two things
Progressive optic nerve damage
Progressive visual field loss
133
Light travels up the optic nerve via the Afferent
CN II
134
signals travel efferent via the ____ from the EW in the occipital lobe
CN III
135
Associated w neurosyphilis damage to central pupil pathway. Pupil is small
Responds slow or not at all to light **responds normally to near** accommodation. Anisocoria
Argyll Robertson
136
irregular dilated pupil. Reacts poorly to light better to accommodate. rx is sluggish. Pilocarpine=constrict
unilateral and in women assoc with loss of tendon reflex knee/ankle. EOM Normal no ptosis
Adie's Tonic Pupil
137
EOMs abnormal, Down and out eye position or Ptosis= _________
Dilated pupil = bad, MRI R/o aneurysm
CN III palsy
138
Occurs with injury to sympathetic nerves of the face. Includes Ptosis, Miosis, and anhidrosis
cause- stroke in the brainstem, carotid injury, Pancoast tumor, Cluster HA. Cocaine gtts will not dilate pupil
Horner's Syndrome
139
Light is shone in normal eye and pupils constrict, the other abnormal eye, pupils dilate
Brain does not receive message. Afferent Pupil defect
Marcus Gunn Pupil
140
Bilateral disc edema caused by mass, thrombosis, meningitis, idiopathic ICHTN Pseudomoto cerbri fat women.
HA, NV, transient vison loss, pulsatile tinnitus. can --> 6th CN palsy. Requires MRI
Papilledema
141
Pseudomotor Cerebri Tx
Weight loss, Acetazolamide, Furosemide, NeuroSx shunt.
142
Disc swelling from inflammation from thrombosis. Sudden painless VA loss, Assoc. w DM, HTN, Amourosis fugax
Freq noted on walking in the morning.
Ischemic Optic Neuropathy
143
Ischemic Optic Neuropathy Tx
NAION None arterial Ischemic Optic neuropathy
ASA resolves w/I 8 wks
AION- Systemic Steroids 250 mg IV q 6hrs, 72 hrs, then PO. Temporal Biopsy
144
Unilateral painful vision loss over several hours or days. results from demyelination of the optic nerve.
Orbital pain especially w EOM, decreased color visions, normal disc 2/3 of pts. MRI required
Optic Neuritis *Multiple Sclerosis MC*
145
Optic Neuritis Tx
Pulsed IV steroid f/u w 11-14 day PO taper
DO NOT start po steroid Increases recurrent rate
146
Objects appear tilted , pt may adopt a head tilt to minimize diplopia. Eye does not depress well when adducted
Does not look as far down. MRI if < 45 y/o or other CN involved
Fourth cranial nerve palsy
147
Horizontal diplopia, HA or periorbital pain, abduction deficit. Pt adopts head turn position min. diplopia
CN VI Palsy
148
hemorrhages, micro-aneurysms, exudates, may include profound vision loss, and new vessel growth
may lead to swelling of the macula from extremely fragile vessels
Diabetic Retinopathy
149
Types of Diabetic Retinopathy
Nonproliferative and proliferative
150
Diabetic Retinopathy that includes hemorrhages, micro-aneurysms, exudates Mild-mod-sev
Nonproliferative
151
Diabetic Retinopathy that includes profound vision loss, and new vessel growth from ischemia.
Lacy fine vessels seen, pre-retinal hemorrhages, cotton wool spots, dot and blot hemorrhages, loss of red reflex
proliferative Diabetic retinopathy
152
proliferative Diabetic retinopathy Tx
Tight Glycemic control, Photocoagulation laser sx
153
Earliest detectable clinical alteration, microaneurysms leak through incr. permeability. Accumulates at fovea
Diabetic Macular Edema
154
Diffuse arteriolar narrowing- blood vessel wall virtually invisible copper wire vessel, yellowing of the light reflex
silver wire sclerosis of the vessels, AV nicking, 2;3 AV ration change
Hypertensive Retinopathy
155
Extreme sudden vision loss, HA, scalp and temple tenderness, myalgia, Low grade fever, jaw claudication
< 50 rare, 60 > MC cases pale optic disc swelling, 3rd 4th or 6th cranial nerve palsy
Giant cell Arteritis
156
Giant cell Arteritis work-up
ESR immediate, Temporal biopsy,
Tx IV methylprednisone 250 mg IV q 6hrs, 72hrs, PO daily
157
Autoimmune DO of NM junction, variable weakness of voluntary muscles (Multiple muscles), improves w rest and worsens w activity
Variable ptosis, visible fatigue w sustained up gaze.
Icepack X2 min, if improvement = Positive
Myasthenia Gravis
158
Myasthenia Gravis Tx
Edrophonium Chloride tensilon testing
Acetylcholine Receptor AB test
Tx: Pyridostigmine and prednisone
159
Keratic precipitates (Stellate Shapes) and vitrous cells, hemorrhages with retinal whitening.
HIV Aids
TX: Ganciclovir or Foscarnet
160
Systemic multisystem collagen vascular disease. FB sensation, corneal ulcer, scleral thinning slow and painless.
Rheumatoid arthritis
161
Rheumatoid arthritis Tx
preservative free art tears
No steroids Increase risk of corneal perforation
162
MC malignancy in eyelid
Basal Cell Carcinoma
163
MC malignancy in conjunctiva
Squamous cell Carcinoma
164
tumor that develops in the cell of the retina under age 5
Retinoblastoma
165
Non-malignant tumor in CNS composed of astrocytes
Astrocytoma
166
Typically 5-40 y/o 1-3mm brown/red deposit at peripheral cornea.
S/S cirrhosis, Neuro DO, Psych issues, Renal dz
Wilsons Diease ( Kayser-Flaischer ring)
Subscapular copper deposit - sunflower cataract
167
Whorls on the corneal epithelium
Amiodarone drug use
168
Blurred vision and night blindness (RA Tx >5yrs)
Macular pigment stippling "Bulls eye"
Chloroquine Drug use
169
yellow orange vision
Digoxin
170
Visual field loss with drugs
Ethambutol
171
color vision loss use w drugs
Isoniazid
172
inflammation and infection of the eyelid, warm erythematous tenderness, pain diplopia, periorbital swelling
Low grade fever, proptosis, reduced ocular motility, pain with EOM, decr. pupil response
Orbital cellulitis
173
inflammation and infection of the eyelid. periorbital swelling swollen lids, No pain w EOM
No restricted Ocular motility, no proptosis, no optic neuropathy
Preseptal Cellulitis
174
Orbital cellulitis Tx
Broad spectrum IV Abx. X 72hrs, then po X 1 wk
Vancomycin + Ampicillin-sulbactam.
Sx drainage if no response X 2-3 days
175
Preseptal Cellulitis Tx
PO Abx if Mild
IV abx if toxic or noncompliant or
No improvement w/I 48 hrs child< 5 y/o
176
Hx of welding or sunlamp. requires lid eversion and fluorescein instillation.
Tx
Ultraviolet Keratitis
Cyclopentolate, Erythromycin qid, patch affected eye
177
copious irrigation for 30 min. or 2 L LR more close to tear Ph. Evert eyelids IOP should be assessed
Scopolamine post irrigation, Erythromycin, IOP control
Chemical Injury
178
Lid Laceration work up
R/o Optic nerve injury. Ct if globe involved
Evaluate ptosis- Levator Muscle injury
Tetanus Imm.
Optho if canalicular system, ptosis, globe, orbit fat, more than 1/3 of tissue
179
Posterior Uveitis MC Cause
Toxoplasmosis Black Eschar in Fundus
180
Homonymous Hemianopia
Same side in both eyes
181
Hemianopia
Loss of entire half of the visual field
182
Leading cause of blindness in US for ages 20-64
Diabetes
