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Clin Med I - Eye > Red Eye > Flashcards

Red Eye Flashcards

1
Q

what is included in complete eye exam?

A
  • vision
  • external eye exam
  • pupils
  • motility
  • anterior segment
  • opthalmoscopy
  • pressures
  • visual fields
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2
Q

danger signs of red eye?

A
  • reduced vision
  • ocular pain
  • photophobia
  • conjunctival injection
  • circumcorneal injection
  • corneal staining
  • abnormal pupil size
  • high or low IOP
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3
Q

Are acidic or alkaline burns a greater emergency? what is #1 critical tx for chemical burns?

A

alkaline: eats thru tissue until it neutralizes itself

IMMEDIATE IRRIGATION

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4
Q

How are chemical burns of eye treated initially?

A
  • topical anesthesia
  • irrigation
  • removal of FB
  • debride necrotic corneal or conjunctival tissue
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5
Q

what is involved in secondary treatment of chemical eye burns?

A
  • topical cycloplegic (stops lens movement)
  • topical antibiotic
  • patch eye
  • referral
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6
Q

what is symblephron?

A

adhesion of palpebral conjunctiva to cornea of eye from trauma or disease

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7
Q

what are common symptoms of corneal abrasions?

A
  • FB sensation
  • pain
  • tearing
  • photophobia
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8
Q

what is the treatment for corneal abrasions?

A
  • topical cycloplegic
  • topical antibiotic
  • pressure patch over eye (maybe not for sm. abrasion)
  • check for seidel’s sign
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9
Q

what is seidel’s sign?

A

stain eye

black water droplet = aqueous fluid dripping out of eye… area between outside of eye and anterior chamber (FB in eye)

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10
Q

what are non-traumatic possible causes of red eye?

A
  • conjunctivitis
  • iritis
  • corneal inflammation
  • acute glaucoma
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11
Q

what are signs of allergic conjunctivitis?

A
  • itching
  • conjunctival injection
  • papillae
  • discharge
  • trantas
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12
Q

if discharge from eye is “thick and ropy” what could it be a sign of?

A

VKC (vernal ketatoconjunctiviti)

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13
Q

what causes palpebral conjunctival papules?

A

LT CL wear

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14
Q

signs of VKC?

A
  • thick discharge
  • trantas dots
  • palpebral conjunctival papules
  • conjunctival injection
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15
Q

who does atopic keratoconjunctivitis affect?

A

individuals with hay fever, atopic dermatitis, and asthma

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16
Q

how does AKC differ from VKC? how are they similar?

A

AKC is chronic and more serious; presentation similar

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17
Q

how does AKC present?

A

thickened, macerated, red eyelids

advance stages: symblpharon and cicatrization

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18
Q

what is cicatrization?

A

scaring

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19
Q

what is the treatment for AKC?

A
  • antihistamines
  • lubricants
  • mast cell stabilizers
  • steroids
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20
Q

treatment for allergic conjunctivitis?

A
  • remove allergen
  • lubricants
  • topical decongestants
  • mast cell stabilizers
  • steroids
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21
Q

what is giant papillary conjunctivitis? how should u tx it?

A

big bumps under eye lid, remove CL or allergen

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22
Q

signs of bacterial conjunctivitis?

A
  1. bilateral
  2. mucopurulent d/c
  3. lid crusting
  4. chemosis (swelling of conjunctiva)
  5. conjunctival papillae
  6. no preauricular adenopathy
  7. red
  8. FB sensation
  9. heat in and around eye
  10. tightness
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23
Q

treatment for bacterial conjunctivitis?

A
  • broad spectrum antibiotics (polytrim, gentamicin, tobramycin, fluroquinolones)
  • steroids?

4x/day - q1h

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24
Q

when should you NOT give steroids?

A

cataracts or HSV

25
Q

signs of viral conjunctivitis?

A
  • bilateral
  • preauricular lymphadenopathy
  • conjunctival inflammation
  • watery discharge
  • itching
  • burning
  • FB sensation
  • conjunctival follicles
  • subepithelial infilrates
  • pseudomembrane
  • subconjunctivitis hemorrhages
26
Q

what are viral conjunctivitis treatment?

A
  • usually self-limiting
  • cold compresses
  • artificial tears
  • topical vasoconstrictors
  • steroids
  • very contagious 10-12 d from onset
27
Q

what is chronic conjunctivitis? who is at risk for it?

A
  • chalamydial inclusion conjunctivitis

- found in sexually active, hx of vaginitis, cervicitis, urethritis

28
Q

signs of chalamydial inclusion conjunctivitis? (STI)

A
  • inferior tarsal conjunctival follicles
  • superior pannus (vessel growing into eye)
  • preauricular node
  • SEI peripheral
  • stringy mucous discharge
  • giemsa stain
  • corneal meltdown
  • young adult
  • conjunctival follicles
29
Q

signs of bacterial keratitis?

A
  • unilateral
  • painful
  • photophobia
  • vision reduced
  • tearing
  • opacification
  • corneal edema
  • conjunctival vessels deeply engorged
30
Q

what is bacterial keratitis?

A

infection of the cornea

31
Q

what is tx for bacterial keratitis?

A
  • culture ulcer
  • fluroquinolone q 15 minutes x 6 hours; then q 30 min x 18 hrs
  • atropine BID
32
Q

predict the etiology of the following discharge types and signs:

  • purulent
  • serous/clear
  • stringy/white
  • preauricular lymph node enlargement
A
  • purulent: bacterial
  • serous/clear: viral
  • stringy/white: allergic
  • preauricular lymph node enlargement: viral
33
Q

what are the signs of iritis?

A
  • photophobia
  • deep ocular pain
  • blurred vision
  • constricted pupil
  • circumcorneal injection
  • low IOP
34
Q

tx for iritis?

A
  • homatropine 5% TID/QID
  • prednisolone 1% q2h-3h & taper
  • blood test if recurrent (serology… autoimmune?)
35
Q

what are the symptoms of dacryocystitis?

A
  • pain
  • redness***
  • swelling over the innermost lower lid
  • tearing
  • discharge (puss out of puncta)
  • fever
  • tender swelling ***
36
Q

treatment of dacryocystitis?

A
  • augmentin (500 mg PO q8)
  • keflex (500 mg PO q6)
  • topical antibiotic
  • warm compress
  • pain medications
  • I&D
  • dacryocystorhinostomy DCR (bone removed to allow drainage thru silicone tube straight to nasal mucosa)
37
Q

symptoms of dacryoadenitis?

A
  • unilateral pain
  • redness***
  • swelling over outer 1/3 of upper lid***
  • tenderness***
  • ipsilateral preauricular lymphadenopathy ***
  • chemosis ***
  • fever ***
  • elevated WBC***
  • tearing
  • discharge
  • kids or young adults
38
Q

treatment for viral and bacterial dacryoadenitis?

A

bacterial:

  • augmentin (500 mg q8)
  • keflex (500 mg q6)
  • ancef (1 gm IV q8)

viral:

  • cool compress
  • analgesics
39
Q

what is blepharitis?

A

common, persistent inflammation of eye lids by bacteria that thrives on skin at base of eyelash

inflammation results in irritation and overactivity of oil glands resulting in dandruff like scales

40
Q

when is blepharitis common?

A
  • oily skin
  • dandruff
  • dry eyes
41
Q

symptoms of blepharitis?

A
  • dandruff like scales
  • itching
  • stinging
  • burning
  • redness
  • discharge
42
Q

what is usually the cause of posterior blepharitis?

A

meibomian gland dysfunction from ocular rosacea

43
Q

what is usually the cause of anterior blepharitis?

A
  • staph (hard brittle scales forming around base of eyelashes forming balls)
  • corynebacterium (seborrheic) soft, greasy, eyelashes stuck together
44
Q

tx for blepharitis?

A
  • lid scrubs BID or TID
  • antibiotic ointment qHS or BID
  • artificial tears
  • steroid/antibiotic combos BID to QID
  • oral antibiotic for chronic cases
  • watch for rosecea
45
Q

symptoms of hordeolum?

A
  • eyelid lump
  • swelling
  • pain
  • tenderness
  • redness
46
Q

tx of hordeolum?

A
  • warm compress
  • topical antibiotic
  • oral antibiotic
  • kenelog injection (may lead to permanent depigmentation)
  • surgery
47
Q

signs of ectropian?

A
  • tearing
  • eye or eyelid irritation
  • outward turning of lid
  • SPK (corneal exposure)
  • conjunctival injection
  • thickening of lid margin
  • keratinization
48
Q

tx of ectropian?

A
  • lubricating agents
  • warm compresses
  • antibiotics
  • taping eyelid
  • surgical treatment is only thing that will resolve it
49
Q

symptoms of entropian?

A
  • ocular irritation
  • FB sensation
  • tearing
  • redness
  • inward turning of eyelid margin
  • SPK (infiltrates of cornea)
50
Q

tx of entropian?

A
  • antibiotic ointment tid for SPK
  • taping lid margin away from globe
  • surgery for permanent correction
51
Q

signs of hyphema?

A
  • redness
  • pain
  • increased IOP (blockage of trabecular meshwork)
  • blood in AC (can cause scaring in angles)
  • tears in CB and iris
52
Q

Treatment for hyphema?

A
  • hospitalized bed rest for 6 days
  • head elevated clearing superior angle
  • presnisone
  • anti glaucoma meds for IOPs?
53
Q

8 ball hyphema results in…

A

total vision loss

54
Q

what are signs of HSV?

A
  • unilateral red eye
  • pain
  • photophobia
  • tearing
  • decreased vision
  • skin rash on eyelid
  • dendritic or stallate keratitis
  • decreased corneal sensitivity (no rxn to wisp)
  • corneal ulceration
  • heaped up swollen epithelial cells stain with rose bengal
55
Q

treatment for HSV?

A
  • viroptic or Vira A ointment q3h
  • cyclogel
  • oral acyclovir (400 mg 5x/d 7-14 d)
  • ganciclovir (1 ggt 5x/d until lesion heals and then 1 get BID or TID for 7 days)
56
Q

treatment for chlamydia?

A

tetracycline (500 mg PO QID)
erythromycin (ung 2-3/d)
follow up 1-3 weeks

57
Q

how does metal in eye present?

A

rust ring

corneal edema

58
Q

treatment for rust ring?

A

take out with needle, burr out rust

59
Q

how does a blow out fracture present?

A
  • huge bruise under eye
  • eye doesn’t raise up/diplopia
  • inferior rectus trapped in sphenous area of inferior orbit (broken)
  • blowing nose= conjunctival tissue poking out

Clin Med I - Eye (5 decks)

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