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Unit 2- Clin Med > Red eye > Flashcards

Red eye Flashcards

1
Q

vascular layer that lines posterior eye

A

choroid

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2
Q

right behind ciliary body and lens, fluid flows between it and anterior chamber

A

posterior chamber

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3
Q

allows for movement b/w posterior and anterior chamber

A

ciliary body

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4
Q

where we see increased vasculature

A

conjunctiva

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5
Q

lined with epithelial cells (thin layer)

A

cornea

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6
Q

measure of intraocular pressure

A

tonometry

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7
Q

how to examine eye, in place of pen light exam

A

slit lamp

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8
Q

what we want to look at with red eye

A

visual acuity, tonometry, slit lamp/ pen light

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9
Q

OD

A

right

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10
Q

OS

A

left

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11
Q

OU

A

both

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12
Q

age related focus dysfxn, loss of near vision

A

presbyopia

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13
Q

CF

A

count fingers

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14
Q

how far can they see your fingers (how many am i holding)

A

CF

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15
Q

HM

A

hand motion

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16
Q

LP

A

light perception

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17
Q

NLP

A

no light perception

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18
Q

more than 30 need to be seen ASAP

A

intraocular pressure

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19
Q

tonometry normal measure is ___ IOP

A

8-21

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20
Q

tonometry measures from __ to ___

A

0 to 80+

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21
Q

six parts you look at with red eye

A

lids/lashes, conj/ sclera, cornea, ant chamber, iris, lens

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22
Q

meibomian gland dysfxn

A

blepharitis

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23
Q

MGD

A

meibomian gland dysfxn

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24
Q

chronic itching, burning, scratchy, worse in the AM, no vision decrease erythema, scales, debris

A

blepharitis

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25
Q

EES

A

erythromycin

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26
Q

management of blepharitis

A

warm compress, baby shampoo, abx

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27
Q

abx for blepharitis

A

bacitracin and EES ointments, aztirhromycin soln, oral abx (if topical ineffective), opthalmologist if not improving (they prescribe corticosteroid gtts

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28
Q

___ contributes to dry eye syndrom

A

blepharitis

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29
Q

dry eye syndrome

A

deficient aqueous tear production

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30
Q

chronic itching, burning, scratchy, “tired” eyes, esp in PM

A

sxs of dry eye syndrome

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31
Q

vision fluctuation, poor tear film (possibly due to MGD), puncturate epithelial erosions (slit lamp), + schirmer test

A

signs of dry eye syndrome

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32
Q

dry eye tx

A

artificial tears/ ointments, opthamology referral

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33
Q

ophthalmologist tx of dry eye

A

topical cyclosporine, +/- topical steroids, punctual plugs

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34
Q

poor tear films lead to

A

surface problems

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35
Q

infected eyelash root

A

hordeolum

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36
Q

PAINFUL, sweling common, may affect entire eyelid

A

hordeolum

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37
Q

hordeolum tx

A

warm compress, abx, steroid injection, +/- surgical drainage

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38
Q

caused by clogged oil gland (MGD)

A

chalazion

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39
Q

TYPICALLY NOT PAINFUL unless very large, rarely does it make the entire eyelid swell

A

chalazion

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40
Q

chalazion tx

A

warm compress, abx prn, steroid injection, +/- sx drainage

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41
Q

inflammation of lacrimal gland

A

dacryoadenitis

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42
Q

viral or bacterial source: mumps, EBV, staphylococcal, gonococcal

A

acute dacryoadenitis

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43
Q

noninfectious inflammatory disorders, thyroid disease, orbital pseudotumor

A

chronic dacryoadenitis

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44
Q

swelling of outer upper lid, pain in area of swelling, +/- erythema, epiphora, preauricular LAD

A

dacryoadenitis

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45
Q

daryoadenitis dx

A

CT if etiology is unclear, bx if concern for tumor

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46
Q

viral dacryoadenitis tx

A

warm compress

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47
Q

dacryoadenitis tx for bacterial/ other causes

A

treat underlying cause

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48
Q

clear thin tissue that covers part of the sclera, unknown causes (maybe irritation/ sun), associated with aging, usually does not cause vision loss

A

pinguecula

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49
Q

pinguecula tx

A

lubricating drops, sunglasses, +/-cosmetic sx, vision sx

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50
Q

pinguecula can progress to

A

pterygium

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51
Q

thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually on the nasal side, may interfere with vision as it encroaches upon the pupil

A

pterygium

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52
Q

pterygium tx

A

lubricating dros, sx prn vision changes

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53
Q

infection of the periorbital tissues

A

cellulitis- preseptal vs orbital

54
Q

often caused by extension from sinus infxn, ethmoid sinus most common and sometimes by extension from dental/ facial infxn

A

cellulitis

55
Q

etiology of periorbital cellulitis

A

s. pneumoniae, s. aureus, s. pyogenes, h. influenzae

56
Q

eyelid pain, +/- eye pain, +/- erythema, swelling, +/- fever, no proptosis, no vision impairment, no impairment/pain with EOM, rare chemosis

A

preseptal cellulitis

57
Q

preseptal cellulitis dx

A

CT with contrast/ MRI

58
Q

preseptal cellulitis outpatient tx

A

clindamycin, trimethoprim/ sulfamethoxazole

59
Q

preseptal cellulitis inpatient tx

A

vanco, ophthalmologist consult

60
Q

eyelid swelling, erythema, afebrile, common proptosis, impaired/ painful EOM, +/-: impaired vision, diplopia, chemosis, leukocytosis

A

orbital cellulitis

61
Q

orbital cellulitis dx

A

CT with contrast/ MRI

62
Q

orbital cellulitis tx

A

IV ceftriaxone or cefotaxime, +/- vanco, ophth. consult, admission, sx if abscess or to decompress orbit

63
Q

conjunctivitis etiology

A

viral/ bacterial/ allergic

64
Q

vision is/ is not usually affected with conjunctivitis

65
Q

tx of conjunctivitis depends on

66
Q

ACUTE, BILATERAL (ASYMETRIC), follows URI w/ resp sxs (adenovirus/ enterovirus), mild to severe injection, WATERY discharge, preauricular LAD, +/- photophobia, +/- foreign body sensation, BURNING/ SORENESS

A

viral conjunctivitis

67
Q

viral conjunctivitis tx

A

warm compress, supportive, self limits in 2-3 weeks, ophth. referral for concerns (possible antivirals)

68
Q

ACUTE, UNILATERAL/ BILATERAL, MODERATE TO SEVERE injection, thick, MUCOPURULENT discharge, BURNING/GENERAL IRRITATION, ADHERENT LIDS

A

bacterial conjunctivitis

69
Q

bacterial conjunctivitis in kids

A

s. pneumoniae, h. influenza, m. catarrhalis

70
Q

bacterial conjunctivitis in adults

71
Q

bacterial conjunctivitis tx

A

Topical abx (gtts/ ointment): EES op ointment, trimethoprim-polymyxin B op soln, ciprofloxacin op soln, azithromycin op soln

72
Q

treatment for bacterial conjunctivitis lasts

73
Q

patients must avoid ___ until infections is resolved

A

contact with others

74
Q

rare types of bacterial conjunctivitis

A

c. trachomatis and n. gonorrhea

75
Q

how are c. trachomatis and n. gonorrhea conjunctivitis transmitted to adults

A

direct contact

76
Q

how are c. trachomatis and n. gonorrhea conjunctivitis transmitted to peds

A

to neonate via vaginal delivery

77
Q

chronic conjunctivitis (weeks to months), bilateral, keratitits, follicular response, non-tender preauricular LAD

A

c. trachomatis bacterial conjunctivitis

78
Q

dx of c. trachomatis bacterial conjunctivitis

A

giemsa stain, cx, PCR

79
Q

tx of c. trachomatis bacterial conjunctivitis

A

EES op ointment, azithromycin op soln

80
Q

unilateral/ bilateral, extremely profuse & purulent discharge, chemosis, moderate-severe injection, irritation & tenderness, lid swelling, preauricular LAD, severe and sight threatening, hyperacute onset w/in 12 hours of inoculation

A

N. gonorrhea bacterial conjunctivitis

81
Q

dx of N. gonorrhea bacterial conjunctivitis

A

giemsa stain, gram stain

82
Q

tx of N. gonorrhea bacterial conjunctivitis

A

admit, systemic and topical therapy (topical EES ointment + ceftriaxone IV/IM), op consult

83
Q

chronic (seasonal), bilateral, mild injection, CHEMOSIS, STRINGY/ mucoid discharge, ITCHING, hx of: atopy/ seasonal allergy/ specific allergy, MILD TO MODERATE injection

A

allergic conjunctivitis

84
Q

tx of allergic conjunctivitis

A

lubricating eye drops, cool compresses, OTC antihistamine, op anti-histamine drops (gtts)

85
Q

subconjunctival hemorrhage

A

blood in the conjunctiva

86
Q

asymptomatic, pt notices in the mirror/ when someone tells them, can result from trauma

A

sxs of subconjunctival hemorrhage

87
Q

vision unaffected, diffuse red patch (not vascular engorgement)

A

signs of subconjunctival hemorrhage

88
Q

tx of subconjunctival hemorrhage

A

reassurance

89
Q

can be associated with systemic autoimmune disease

A

episcleritis/sclertitis

90
Q

pain or no pain: epsicleritis

91
Q

pain or no pain: scleritis

A

severe pain and photophobia

92
Q

with episcleritis/sclertitis, vision is usually __ and there is focal ___

A

with episcleritis/sclertitis, vision is usually UNAFFECTED and there is focal INJECTION

93
Q

scleritis has a ___ hue and ___ nodule

A

scleritis has a DEEP BLUE hue and +/- nodule

94
Q

tx for epsicleritis

A

refer to op, slit lamp exam, topical lubricants, topical and/or oral NSAIDS, topical corticosteroids

95
Q

tx for scleritits

A

potentially blinding, refer to op, topical lubricants, topical and/or oral NSAIDS, topical corticosteroids, immunosuppressive meds

96
Q

corneal epithelial defect

A

corneal abrasion

97
Q

acute onset of pain, foreign body sensation, epiphora, +/- vision affected, epithelial defect

A

corneal abrasion sxs/signs

98
Q

corneal abrasion tx

A

topical lubricants, topical abx, oral pain meds, NO TOPICAL ANESTHETIC DROPS

99
Q

___ is used to better visualize corneal abrasion

A

fluorescein staining

100
Q

acute pain/ burning, blurred vision, decreased vision, +/- corneal abrasion

A

caustic chemical injury

101
Q

tx for chemical injury

A

IRRIGATE, morgan lens for prolonged irrigation, topical lubricants/ abx, opthalmology on board ASAP

102
Q

“speck in my eye”

A

corneal foreign body

103
Q

corneal foreign body tx

A

determine mechanism of injury, BEWARE of intraocular foreign body, remove via irrigation/ cotton-tipped applicator/ specialized fb removal tool, lubricant, abx drops, +/- refer to ophthalmology

104
Q

corneal ulcer

105
Q

acute onset of pain, mucous discharge, contact lens abuse

A

keratitis sxs

106
Q

decreased vision, white infiltrate, +/- hypopyon

A

signs of keratitis

107
Q

keratitis tx

A

topical abx, refer

108
Q

if keratitis has a dendritic pattern

109
Q

treat HSV keratitis with

A

topical antivirals, NO STEROIDS, refer to op

110
Q

blood in anterior chamber, trauma to iris/ pupil

111
Q

acute onset pain, photophobia, N/V, +/- vision decrease, layered heme

112
Q

hyphema tx

A

treat underlying coagulopathy, treat pain/N/V, eye shield/ bedrest, elevate HOB, refer (potential permanent vision loss)

113
Q

the opthalmologist tx’s hyphema by

A

contraling intraocular pressure, cycloplegics, corticosteroids, short-term topical anesthetic drops

114
Q

minimize cornea/ eyelid rubbing, prevents corneal exposure, good for post op, CAN WORSEN INFXN

115
Q

prevents external pressure on eye, good for post trauma and post op

A

eye shield

116
Q

inflammation of the uveal tissue

117
Q

anterior inflammation of the uveal tissue

118
Q

acute onset but can be chronic, uni/bilateral, caused by trauma, infection, autoimmune dz

A

uveitis/iritis

119
Q

acute onset photophobia, eye pain, blurred vision, +/- vision decrease, ciliary flush, +/- hypopyon

A

uveitis/iritis

120
Q

leukocytic exudate, seen in the anterior chamber, usually accompanied by redness of the conjunctiva and the underlying episclera

121
Q

tx of uveitis/iritis

A

op referral (they will administer corticosteroids/ NSAIDS, cycloplegics), resolves in 6-8 weeks

122
Q

complications of uveitis/iritis

A

cataracts, irregular pupil due to scar tissue, swelling and increased eye pressure

123
Q

good for the exam but do not prescribe

A

topical anesthetics

124
Q

helps everything but temporarily

125
Q

med that can cause glaucoma and cataracts

126
Q

med that can worsen HSV and fungal infxns

127
Q

who should prescribe topical steroids for the eye

A

ophthalmologist

128
Q

with topical abx watch for ___, esp with prolonged use, esp this one:___

A

with topical abx watch for TOXICITY, esp with prolonged use, esp this one: GENTAMICIN

129
Q

your best friend

A

erythromycin (EES)

130
Q

patching is

A

controversial

Unit 2- Clin Med (6 decks)

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