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clinical med exam 2 > Red eye > Flashcards

Red eye Flashcards

1
Q

conjunctiva vs sclera

A

conjuntiva

  • mucous membrane; blood supply

sclera

  • fibrous connective tissue; structural rigidity
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2
Q

problem focused exam: red eye

A
  1. visual acuity
  2. Tonometry
  3. Slit lamp (pen light) exam
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3
Q

presbyopia

A

age-related focus dysfunction

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4
Q

if vision is worse than 20/400, what steps should you take to assess vision?

A
  1. count fingers at given distance
  2. hand motion
  3. light perception
  4. no light perception
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5
Q

tonometry

A
  • measurement of intraocular pressure
  • 0-80 mm Hg (no emergency if < 30)
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6
Q

what does slit lamp offer than pen light does not when assessing a lesion

A

depth of lesion

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7
Q

2 big categories of causes of red eye

A
  1. inflammatory (infectious/non-infectious)
  2. Traumatic
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8
Q

questions to ask when assessing red eye

A
  • duration
  • trauma?
  • contact lens use
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9
Q

what is blepharitis

A

eyelid inflammation

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10
Q

clinical presentation

  • chronic itching, burning scratchy
  • worse in AM
  • PE: no vision decrease; erythema, scales
A

blepharitis

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11
Q

management of blepharitis

A
  • warm compress
  • baby shampoo lid scrubs
  • Abx/steroids
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12
Q

identify

A

pingueculum: a yellowish patch on the white (sclera) of the eye.

  • associated with aging
  • usually no vision loss
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13
Q

identify

A

pterygium: triangular thickening of bulbar conjunctiva that grows slowly across outer surface of cornea usually from nasal side

** may interfere with vision as it reaches pupil

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14
Q

clinical presentation

  • acute onset of pain, swelling, and +/- systemic
  • PE: +/- vision decrease; warm, edema, erythema, tender
A

cellulitis

preseptal vs orbital (involvement of extraocular muscles)

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15
Q

blepharitis can contribute to what syndrome

A

dry eye syndrome: deficient aqueous tear production

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16
Q

clinical presentation

  • chronic itching, burning, scratchy
  • “tired” eyes, esp in PM
  • PE: vision fluctuation; poor tear film, punctate epithelial erosions
A

dry eye

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17
Q

treatment of preseptal or orbital cellulitis

A
  • systemic abx
  • ophthalmology referral
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18
Q

managment of dry eye

A
  • artificial tears
  • topical cyclosporin
  • punctal plugs
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19
Q

clinical presentation

  • acute onset
  • bilateral
  • itching, burning, soreness
  • mild to severe redness
  • watery discharge
  • URI symptoms; preauricular LAD
A

viral conjunctivitis

20
Q

clinical presentation

  • acute onset
  • unilateral
  • burning, general irritation
  • mod to severe redness
  • mucopurulent dx
  • adherent lids
A

bacterial conjunctivitis

21
Q

clinical presentation

  • chronic (seasonal) onset
  • bilat eyes affected
  • itching
  • mild to mod redness
  • stingy, mucoid dx
  • chemosis
A

allergic conjunctivitis

22
Q

treatment of viral conjunctivitis. duration of symptoms

A
  • tears/ compress vasoconstrictors
  • days to weeks
23
Q

treatment of bacterial conjunctivitis. duration of illness

A
  • topical abx +/- systemic abx
  • days to weeks
24
Q

treatment of allergic conjunctivitis. duration of illness

A
  • artificial tears; topical antihistamine
  • weeks to months
25
Q

clinical presentation

  • acute
  • asymptomatic
  • PE: vision unaffected; diffuse red patch

** management??

A

subconjunctival hemorrhage

managment: reassurance

26
Q

what is episcleritis/scleritis

A

inflammation of episcleritis or scleritis tissue; can be associated with systemic autoimmune disease

27
Q

clinical presentation

  • subacute onset of foreign body sensation/pain
  • PE: vision usually unaffected
    • focal injection: scleritis: deep, bluish hue
    • +/- nodule
A

episcleritis/scleritis

28
Q

mangement of episcleritis/scleritis

A

ophthalmology referral

29
Q

clincal presentation

  • acute onset of pain, FB sensation, epiphora (watery eyes)
  • PE: +/- vision affected; epithelial defect; fluorscein staining +
A

corneal abrasion

30
Q

managment of cornal abrasion

A
  • topical lubricant
  • topical Abx
  • oral pain meds
  • do not give topical anesthetic drops
31
Q

managment of chemical injury

**vision decreased

A
  • irrigate ASAP
  • topical lubricant
  • refer to ophthalmology
32
Q

managment of corneal foreign body

A
  • remove via irrigation or cotton-tipped aplicator
  • lubricant/abx
  • +/- refer to ophthalmology
33
Q

clinical presentation

  • acute onset of pain
  • mucous discharge
  • contact lens abuse
  • PE: vision usually decreased
  • white infiltrate
A

keratitis/ corneal ulcer

34
Q

management of keratitis/corneal ulcer

A
  • intensive topical abx
  • ophthalmology referral
35
Q

keratitis associated with a dendritic pattern. Diagnosis? Treatment?

A

HSV

treat with topical antivirals

do not use steroids

* refer to ophthalmology

36
Q

what is included in uveal tissue

A
  • iris; ciliary body; choroid
37
Q

clinical presentation

  • acute onset photophobia
  • PE: +/- vision decrease; ciliary flush
A

iritis/uveitis

38
Q

management for iritis/uveitis

A

ophthalmology referral

39
Q

hyphema

A

blood in anterior chamber: trauma to iris or uvea

40
Q

clinical presentation

  • acute onset pain
  • photophobia
  • PE: +/- vision decrease; layered heme
A

hyphema

41
Q

management of hyphema

A
  • eyeshield
  • control intraocular pressure
  • refer to ophthalmology
42
Q

what is acute angle closure glaucoma

A

acute rise of intraocular pressure due to outflow obstruction (rare in real life)

43
Q

clinical presentation

  • acute decreased vision
  • halos around lights
  • nausea, +/- pain
  • feeling of pressure
  • PE: decreased vision; ciliary flush, steamy cornea, mid-dilated pupil, narrow anterior chamber
A

acute angle closure glaucoma

44
Q

management of acute angle closure glaucoma

A
  • ophthalmology referral
  • topical anti-ocular hypertensives
  • laser peripheral iridotomy
45
Q

what topical abx is commonly used for eye infections

A

erythromycin ointment

clinical med exam 2 (6 decks)

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