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Red Eye - Exam 3 Flashcards

1
Q

**_____ COPIOUS PURULENT DISCHARGE ; eyes can be “stuck shut” in the morning. can be ___ or ____. How is it transmitted?

A

CONJUNCTIVITIS

unilateral or bilateral

TRANSMITTED VIA DIRECT CONTACT
FINGERS, TOWELS, HANDKERCHIEFS, CONTAMINATED EYE DROPS

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2
Q

**_____ is the MC cause of conjunctivitis in adults. ____ in children. ____ who wear contacts.

A

Staph Aureus in adults

S Pneu in children

Pseudomonas in those who wear contacts

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3
Q

What is the treatment of choice for conjunctivitis in NONcontact lense wearers? For severe infection/contact lens use ______

A

erythromycin ophthalmic ointment or trimethoprim-polymyxin B drops (POLYTRIM)

TOPICAL FLUOROQUINOLONE
VIGAMOX OR MOXEZA (MOXIFLOXACIN)
OFLOXACIN OPHTHALMIC (OCUFLOX / FLOXIN)
CIPROFLOXACIN OPHTHALMIC

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4
Q

gonococcal infections in the eye are treated with _____. Chlamydial infections are treated with _____.

A

ROCEPHIN (CEFTRIAXONE) 1G IM – SINGLE DOSE can add ERYTHROMYCIN OR BACITRACIN

1G AZITHROMYCIN PO – SINGLE DOSE

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5
Q

**____ is the MC infectious cause of blindness (preventable blindness)

A

chlamydial

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6
Q

_____ pulls the eyelid inside out

A

Trachoma

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7
Q

USUALLY BILATERAL
COPIOUS WATERY DISCHARGE
FOREIGN BODY SENSATION
TYPICALLY LASTS 10 DAYS
ASSOCIATED WITH PHARYNGITIS, FEVER, MALAISE, PREAURICULAR ADENOPATHY aka flu like s/s

What am I?
What is the MC?
What is the treatment?

A

viral conjunctivitis

MC: adenovirus

supportive care: cold compress to reduce discomfort
pt education on hygiene

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8
Q

ITCHING
TEARING
REDNESS
STRINGY DISCHARGE
OCCASIONALLY PHOTOPHOBIA AND VISUAL LOSS
COBBLESTONE PAPILLAE NOTED ON EXAM
HYPEREMIA (bloodshot look to eye) AND CHEMOSIS (conjunctiva looks bulgy coming out of eye)

What am I?
**What are the 2 slum dunk characteristics?

A

Allergic conjunctivitis

**stringy discharge and cobblestone papillae

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9
Q

What is the treatment for mild-moderate allergic conjunctivitis? Severe?

A

TOPICAL ANTIHISTAMINES
ALAWAY (KETOTIFEN), PATANOL OR PATADAY (OLOPATADINE)
or
topical NSAIDS: diclofenac, ketorolac

severe: topical corticosteroids: LOTEPREDNOL (Alrex, Lotemax)

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10
Q

When would you NOT want to give steroids on a case of allergic conjunctivitis?

A

NO CORTICOSTEROIDS IF H/O OR SUSPECTED HSV
MAY CAUSE EXACERBATION

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11
Q

What does the uvea consist of?

A

the layer and structures of the eye beneath the sclera.

(1) the iris (and pupil)
(2) the ciliary body (secretes the aqueous humor)
(3) the choroid

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12
Q

the _____ is the layer of blood vessels and CT between the sclera and retina

A

choroid

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13
Q

Uveitis: anterior portion consists of ___ and ____.

The posterior portion consists of _____

A

Anterior portion:
Iris
Ciliary Body

Posterior portion:
Choriod

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14
Q

What are the different types of INTRAOCULAR INFLAMMATION OF THE UVEA? **What is the MC type?

A

ACUTE OR CHRONIC

NON-GRANULOMATOUS VS. GRANULOMATOUS

ANTERIOR OR POSTERIOR

ACUTE NONGRANULOMATOUS ANTERIOR UVEITIS

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15
Q

Describe a non-granulomatous uveitis. What is the predominant cell type?

A

Inflammation with no epithelial or giant cells
PRESENTS ACUTELY
UNILATERAL PAIN
REDNESS
PHOTOPHOBIA
VISUAL LOSS

PMN cells

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16
Q

Describe a granulomatous uveitis. What is the predominant cell type?

A

inflammation noted with histiocytes
INDOLENT
SLOW GROWING
BLURRED VISION
MILDLY INFLAMED EYE
RECURRENT

macrophages

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17
Q

What are some causes of acute NON-GRANULOMATOUS ANTERIOR?

A

ACUTE = PRIMARILY IMMUNOLOGIC aka autoimmune causes

HLA-B27 RELATED CONDITIONS
ANKYLOSING SPONDYLITIS
REACTIVE ARTHRITIS
PSORIASIS
ULCERATIVE COLITIS
CROHN’S DISEASE

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18
Q

What are some causes of chronic NON-GRANULOMATOUS ANTERIOR?

A

JUVENILE IDIOPATHIC ARTHRITIS

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19
Q

What are some causes of GRANULOMATOUS ANTERIOR uveitis?

A

SARCOIDOSIS
TOXOPLASMOSIS
TUBERCULOSIS
HIV
SYPHILIS
“SALT AND PEPPER” FUNDUS
HERPES
OCULAR TRAUMA

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20
Q

**“INFLAMMATORY CELLS AND FLARE” (proteins) WITHIN THE AQUEOUS is classic _____. How do you dx it? What will you see in severe cases?

A

anterior uveitis

slit lamp exam

SEVERE CASES = HYPOPYON
PUS IN THE ANTERIOR CHAMBER

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21
Q

In uveitis, CELLS MAY ALSO BE SEEN ON THE CORNEAL ENDOTHELIUM, what are they known as? in granulomatous you see _____. In non-granulomatous you seen _____

A

KERATIC PRECIPITATES (KPS) aka inflammatory cellular deposits

GRANULOMATOUS = LARGE KPS
IRIS NODULES MAY BE SEEN

NON GRANULOMATOUS = KPS ARE SMALLER
NO IRIS NODULES

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22
Q

in posterior uveitis, INFLAMMATORY LESIONS MAY BE PRESENT IN THE ____ or ____. What will new lesions look like? old lesions?

A

RETINA OR CHOROID

NEW LESIONS:
YELLOW WITH INDISTINCT MARGINS
RETINAL HEMORRHAGES

OLD LESIONS:
DEFINITE MARGINS
COMMONLY PIGMENTED

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23
Q

GRADUAL VISUAL LOSS—-SLOWER IN ONSET
MAY BE DUE TO VITREOUS HAZE AND OPACITIES
CAN PRESENT WITH FLOATERS AS WELL
BILATERAL INVOLVEMENT COMMON

What am I?
What is the cause?

A

posterior uveitis

idiopathic
autoimmune
pars planitis
infectious causes

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24
Q

What is pars planitis?

A

disease of the eye between the iris and choroid

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25
What is the treatment for anterior uveitis?
refer to ophthalmology **topical corticosteroids dilation of the pupil to relieve discomfort: reduces painful spasms of ciliary muscles
26
What is the treatment for posterior uveitis?
systemic steroids pupil dilation NOT needed if infectious, treat with appropriate abx
27
______ is inflammation of the cornea. What are the different types?
keratitis bacterial viral acanthomoeba fungal
28
**____ are at the highest risk of developing bacterial keratitis. What is an additional cause? What is the MC pathogens?
contact lens wearers (especially those who wear them overnights) corneal trauma **PSEUDOMONAS MORAXELLA STAPHYLOCOCCI (INCLUDING MRSA) STREPTOCOCCI
29
PT WILL COMPLAIN OF FOREIGN BODY SENSATION TROUBLE KEEPING EYE OPEN CORNEA APPEARS HAZY WITH ULCER AND ADJACENT STROMAL ABSCESS HYPOPYON OFTEN PRESENT What am I? How do you dx? What is the treatment?
bacterial keratitis ULCER IS SCRAPED TO RECOVER MATERIAL FOR GRAM STAIN AND CULTURE refer to ophthalmology EMPIRICALLY WITH FLUOROQUINOLONES DROPS: OFLOXACIN 0.3%, CIPROFLOXACIN 0.5%, VIGAMOX, MOXEZA HOURLY (DAY AND NIGHT) FOR THE FIRST 48 HOURS Then tailor tx based on culture results
30
What are some causes of viral keratitis? Why is it dangerous?
PRIMARY OCULAR HERPES SIMPLEX-> can cause blindness can cause blindness->TRAVELS TO SENSORY GANGLIA WHERE LATENCY DEVELOPS, VIRUS CAN COLONIZE THE TRIGEMINAL GANGLION
31
RED EYE PHOTOPHOBIA FOREIGN BODY SENSATION WATERY DISCHARGE REACTIVATED VIRUS ENTERS CELLS OF CORNEA PRIMARY INFECTION MAY MANIFEST AS EYELID, CONJUNCTIVAL, AND CORNEAL ULCERATION DENDRITIC (BRANCHING) CORNEAL ULCER What am I? What is the slam dunk s/s? How do you dx it?
Herpes simplex keratitis **DENDRITIC (BRANCHING) CORNEAL ULCER CORNEAL ULCERS IDENTIFIED WITH FLUORESCEIN STAIN
32
What is the treatment for HERPES SIMPLEX keratitis?
URGENT REFERRAL TO OPHTHALMOLOGIST TOPICAL AND/OR ORAL ANTIVIRALS: treat until 1 week after lesions heals ACYCLOVIR 400MG FIVE TIMES DAILY ACYCLOVIR 3% OINTMENT
33
MALAISE FEVER HEADACHE PERIORBITAL BURNING AND ITCHING Rash hutchinson sign involves the OPHTHALMIC DIVISION OF THE TRIGEMINAL NERVE What am I? What is the tx?
HERPES ZOSTER OPHTHALMICUS urgent referral to ophthalmology HIGH DOSE ORAL ANTIVIRAL ACYCLOVIR 800 MG FIVE TIMES A DAY VALACYCLOVIR 1G TID
34
____ INVOLVEMENT OF THE TIP OF NOSE OR THE LID MARGINS PREDICTS INVOLVEMENT OF THE EYE
hutchinson sign
35
WHEN TREATING VIRAL KERATITIS, AVOID PRESCRIBING ____ . Why? What happens if you stop abruptly?
CORTICOSTEROIDS IT CAN WORSEN OR PROLONG VIRAL INFECTION CAUSE AN ACUTE REBOUND INFLAMMATORY REACTION
36
What are some causes of fungal keratitis?
AFTER CORNEAL INJURY WITH PLANT MATERIAL, OR IN AGRICULTURAL SETTING, AS WELL AS TRAUMA TO EYE
37
Name some common pt populations that you might see fungal keratitis?
AGRICULTURAL SETTING UNDERLYING EYE DISEASE/IMMUNOCOMPROMISE CONTACTS MULTIPLE STROMAL ABSCESSES LITTLE EPITHELIAL LOSS: corneal infiltrate feathery edges with “satellite lesions”
38
LITTLE EPITHELIAL LOSS: corneal infiltrate feathery edges with “satellite lesions”. Need to associate with ____. How do you dx? **What is the tx?
fungal keratitis CORNEAL SCRAPING AND CULTURE FOR FUNGI **NATAMYCIN 5%, AMPHOTERICIN 0.1-0.5%, VORICONAZOLE 1% TREATMENT MAY LAST FOR 6 MONTHS
39
CAUSED BY SINGLE CELLED ______ FOUND IN RIVERS, LAKES, STREAMS, AIR, SOIL COOLING SYSTEMS, SEWAGE SYSTEMS OTHERWISE HEALTHY PEOPLE CONTACT LENS WEARERS USUALLY SEVERE PAIN: RARE BUT SERIOUS swimming, sitting in hot tub, NOT washing hands before changing contacts RED EYE TEARING BLURRED VISION SENSITIVITY TO LIGHT can proceed to vision loss What am I? Where does it like to invade? How do you dx?
ACANTHAMOEBA KERATITIS INFILTRATES IN THE CORNEAL STROMA likely invade THROUGH CORNEAL OPENING DIAGNOSED WITH CULTURE USING SPECIALIZED MEDIA
40
What is the treatment for ACANTHAMOEBA keratitis?
TOPICAL BIGUANIDE (POLYHEXAMETHYLENE OR CHLORHEXIDINE) for 6 months to 1 year
41
WELL-CIRCUMSCRIBED AREA OF HEMORRHAGE UNDERNEATH CONJUNCTIVA NORMAL VISUAL ACUITY NORMAL PUPIL RESPONSE What am I? What is the cause? What is the treatment?
SUBCONJUNCTIVAL HEMORRHAGE VALSALVA, COUGHING, SNEEZING SYSTEMIC HTN ANTICOAGULANT MEDICATIONS **self limiting: should reabsorb within 2 weeks
42
What is DACRYOADENITIS?
INFLAMMATION OR INFECTION WITHIN THE LACRIMAL GLAND SWELLING, PAIN, REDNESS AT LACRIMAL GLAND supratemporal region
43
What is DACRYOCYSTITIS? What is it due to?
INFECTION OF THE LACRIMAL SAC / DUCT USUALLY DUE TO OBSTRUCTION OF THE NASOLACRIMAL SYSTEM (CONGENITAL OR ACQUIRED: INFANTS/PEOPLE OVER 40) inframedial region
44
What does ACUTE DACRYOCYSTITIS INFECTION PRESENT like? chronic?
Acute: PAIN, SWELLING, TENDERNESS, AND REDNESS IN TEAR SAC AREA PURULENT MATERIAL MAY BE EXPRESSED chronic: TEARING AND DISCHARGE MAY HAVE SOME MUCUS OR PUS
45
What is the primary cause of DACRYOADENITIS?
inflammatory: autoimmune disease: Sjogren viral: mumps can be bacterial
46
**What are the causes of DACRYOCYSTITIS?
INFECTION IN LACRIMAL DUCT generally d/t blocked tear duct can be caused by organisms: acute:**STAPHYLOCOCCUS AUREUS** chronic: **STAPHYLOCOCCUS EPIDERMIDIS** STREPTOCOCCI
47
**What is the treatment for autoimmune DACRYOADENITIS? viral? bacterial?
Autoimmune: Tx underlying cause/steroids VIRAL: SUPPORTIVE CARE Bacterial: SYSTEMIC ANTIBIOTICS I&D IF NECESSARY
48
**What is the treatment for acute DACRYOCYSTITIS? What about is there is mucopurulent discharge WITHOUT other signs of infection? Purulent discharge WITH other signs of infection (erythema and/or swelling)
Lacrimal Sac Massage without: topical abx: tobramycin sulfate 0.3% or moxifloxacin 0.5% with: SYSTEMIC ANTIBIOTIC THERAPY: AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN)
49
What is the treatment for chronic dacryocystitis?
Sx: DACRYOCYSTORHINOSTOMY: EXPLORATION OF LACRIMAL SAC AND FORMATION OF FISTULA INTO THE NASAL CAVITY
50
_____ CHRONIC INFLAMMATORY CONDITION OF THE LID MARGINS. Can be ____ or _____
BLEPHARITIS anterior or posterior
51
**anterior blepharitis involves _____, _____ and ____. May be _____ or ______
EYELID SKIN EYELASHES ASSOCIATED GLANDS ulcerative or seborrheic
52
What is anterior ulcerative blepharitis associated with? seborrheic?
ulcerative: STAPHYLOCOCCI seborrheic: ITCHY RASH WITH FLAKY SCALES
53
posterior blepharitis is inflammation of the _____ AT INNER PORTION OF EYELID. Can be ____ or ____ or _____
MEIBOMIAN GLANDS bacterial or PRIMARY GLANDULAR DYSFUNCTION or chronic skin conditions
54
_____ are MODIFIED SEBACEOUS GLANDS RESPONSIBLE FOR EYE LUBRICATION SECRETES OILY LAYER FOR TEARS THIS HELPS TO REDUCE EVAPORATION OF TEARS HELPS SPREAD TEARS
meibomian glands
55
What kind of blepharitis is "red rimmed" and scales are commonly seen in lashes?
anterior blepharitis
56
What kind of blepharitis are the lid margins red with spider veins (LID MARGINS ARE HYPEREMIC WITH TELANGIECTASIA), meibomian glands are inflamed, lid margin are rolled inward and tears may be frothy or abnormally greasy?
posterior blepharitis
57
RED, SWOLLEN, ITCHY EYELIDS GRITTY OR BURNING SENSATION RED EYES EXCESSIVE TEARING (WHICH CAN BE A SIGN OF DRY EYE) CRUSTING/MATTING OF EYELASHES IN THE MORNING FLAKING OR SCALING OF THE EYELID SKIN LIGHT SENSITIVITY BLURRED VISION (TRANSIENT, USUALLY IMPROVES WITH BLINKING) What am I? What is the tx?
Blepharitis anterior: good eye lid hygiene, wash with baby shampoo, can use BACITRACIN OR ERYTHROMYCIN (anti-staph) ointment with acute exacerbation posterior: REGULAR MEIBOMIAN GLAND EXPRESSION HOT WASH CLOTH WILL HELP WITH EXPRESSION LID MASSAGE
58
If there is blepharitis with inflammation of conjunctivia and cornea, what is the tx?
LONG TERM LOW DOSE ORAL ABX THERAPY (2-4 WEEKS): TETRACYCLINE 250 MG BID, DOXYCYCLINE 100MG DAILY, MINOCYCLINE 50-100 MG DAILY and SHORT TERM TOPICAL CORTICOSTEROIDS PREDNISOLONE 0.125% BID
59
____ is an acute infection, that is localized, red, swollen and TENDER. can be on the upper or lower lid. What is the MC bacteria?
HORDEOLUM STAPHYLOCOCCAL ABSCESS
60
An _____ is smaller and on the margin vs ____ is a meibomian gland abscess, USUALLY POINTS ONTO THE CONJUNCTIVAL SURFACE OF THE LID and MAY LEAD TO GENERALIZED CELLULITIS OF THE LID
EXTERNAL HORDEOLUM INTERNAL HORDEOLUM
61
What is the tx for a HORDEOLUM?
WARM COMPRESS #1, massage and gentle wiping of the eyelid after compress may help with drainage
62
______ COMMON GRANULOMATOUS INFLAMMATION OF A MEIBOMIAN GLAND, HARD, NON-TENDER SWELLING,PAINLESS, LOCALIZED EYELID SWELLING What is the tx?
chalazion will resolve on its own warm compress and massage/lid scrubs if refractory: refer to ophthalmology INCISION AND CURETTAGE CORTICOSTEROID INJECTION
63
What are the differences between a hordeolum and chalazion?
64
______ INFECTION OF THE SOFT TISSUE AND FAT THAT HOLD THE EYE IN ITS SOCKET. Who is the MC pt population?
ORBITAL CELLULITIS children
65
What bacteria is the MC cause of orbital cellulitis? Where do most cases arise from?
STREP. PNEUMONIA, STAPH AUREUS (INCLUDING MRSA) MOST CASES ARISE FROM EXTENSION OF ACUTE SINUSITIS THROUGH THE ETHMOID BONES
66
If orbital cellulitis is present in adults where did it arise from? hx of trauma or animal bite?
OFTEN CHRONIC SINUSITIS ANAEROBIC ORGANISMS MAY BE INVOLVED S AUREUS OR GROUP A B-HEMOLYTIC STREP
67
FEVER PAIN EYELID SWELLING AND ERYTHEMA, DECREASED VISION/DIPLOPIA PROPTOSIS PTOSIS CHEMOSIS PAIN WITH AND LIMITATION OF EXTRAOCULAR MOVEMENTS SLUGGISH PUPILLARY REACTION TO LIGHT OR A RELATIVE AFFERENT PUPILLARY DEFECT INDICATES OPTIC NERVE INVOLVEMENT double vision decreased vision RAPD What am I? Is it life threatening?
ORBITAL CELLULITIS YES!!! can be sight and/or life threatening
68
**What 3 things make orbital cellulites an emergency?
PROPTOSIS PTOSIS PAIN WITH AND LIMITATION OF EXTRAOCULAR MOVEMENTS
69
**What is the immediate treatment for orbital cellulits? After improvement what abx regimen can you switch to?
immediate treatment with IV abx in the hospital INITIAL EMPIRIC TREATMENT IV VANCOMYCIN PLUS EITHER CEFTRIAXONE OR CEFOTAXIME IF ANAEROBIC COVERAGE IS NEEDED POSSIBLY TOGETHER WITH METRONIDAZOLE OR CLINDAMYCIN TRIMETHOPRIM - SULFAMETHOXAZOLE (BACTRIM) PLUS AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN) FLUOROQUINOLONE WITH PENICILLIN ALLERGY
70
_____ BACTERIAL INFECTION SUPERFICIAL TO THE ORBITAL SEPTUM, INFECTION OF THE ANTERIOR PORTION OF THE EYELID. What is is caused by? **What are the 2 MC organisms?
Preseptal cellulitis HORDEOLUM WOUND ANIMAL BITE CONJUNCTIVITIS **STAPH. AUREUS AND STREP. PNEUMONIAE
71
TYPICALLY NO FEVER + EYELID SWELLING + ERYTHEMA NO PROPTOSIS NO LIMITATION OF OR PAIN WITH EXTRAOCULAR MOVEMENTS NO VISION IMPAIRMENT/ DIPLOPIA More common What am I? When should you order imaging?
Preseptal/periorbital cellulitis IMAGING ONLY NEEDED WITH TREATMENT FAILURE OR UNSURE OF DIAGNOSIS
72
What is the treatment for preseptal cellulitis? When do you need to send these pts to the hospital?
ORAL ANTIBIOTICS AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN) OR CEFDINIR (OMNICEF) if PCN allergy PLUS TRIMETHOPRIM-SULFAMETHOXAZOLE or Clindamycin if sulfa allergy IF NO IMPROVEMENT AFTER 24-48 HOURS ADMIT
73
What is the function of the cornea? If you have a corneal ulcer, what does it put you at a higher risk for? why?
CORNEA FUNCTIONS AS A PROTECTIVE BARRIER AND AS A “WINDOW” THROUGH WHICH LIGHT RAYS PASS TO THE RETINA EPITHELIUM = BARRIER TO THE ENTRANCE OF MICROORGANISMS INTO THE CORNEA IF EPITHELIUM IS DEFECTIVE = INFECTION DUE TO A VARIETY OF ORGANISMS
74
**What is a ciliary flush associated with? What is it?
corneal ulcer PATHOGNOMONIC FOR CORNEAL PATHOLOGY RED OR VIOLACEOUS RING SPREADING OUT FROM THE CORNEA
75
GRAY OR YELLOW INFILTRATE AT SITE OF BREAK IN CORNEAL EPITHELIUM SEVERE PAIN TENDS TO SPREAD RAPIDLY BEGINS SUPERFICIAL BUT MAY QUICKLY AFFECT ENTIRE CORNEA CORNEAL PERFORATION AND SEVERE INTRAOCULAR INFECTION EXUDATE MAY HAVE BLUISH-GREEN COLOR **What am I? **What is the tx? **What is the MC pt population? How do you dx?
PSEUDOMONAS AERUGINOSA corneal ulcer fluoroquinolones, aminoglycosides, cephalosporins, and carbapenems MOXIFLOXACIN, GATIFLOXACIN, CIPROFLOXACIN, TOBRAMYCIN, OR GENTAMICI CONTACT LENS WEARERS SCRAPINGS FROM THE ULCER SHOW GRAM-NEGATIVE RODS
76
NO SPECIFIC IDENTIFYING FEATURES SURROUNDING CORNEAL STROMA IS OFTEN INFILTRATED AND EDEMATOUS MODERATELY LARGE HYPOPYON **What am I? **What is the tx? **How do you dx?
GROUP A STREPTOCOCCUS corneal ulcer ANTIBIOTIC EYE DROPS MOXIFLOXACIN (VIGAMOX OR MOXEZA), GATIFLOXACIN, OR CEFAZOLIN SCRAPINGS CONTAIN GRAM-POSITIVE COCCI IN CHAINS
77
HYPOPYON AND SOME SURROUNDING CORNEAL INFILTRATION OFTEN SUPERFICIAL ULCER BED FEELS FIRM WHEN SCRAPED **What am I? **What is the tx? **How do you dx?
STAPHYLOCOCCUS AUREUS / STAPHYLOCOCCUS EPIDERMIDIS corneal ulcer CEFAZOLIN, MOXIFLOXACIN, GATIFLOXACIN MRSA VANCOMYCIN SCRAPINGS SHOW GRAM-POSITIVE COCCI – SINGLY, IN PAIRS, OR IN CHAINS
78
INDOLENT GRAY INFILTRATE WITH IRREGULAR EDGES MARKED INFLAMMATION OF THE GLOBE SUPERFICIAL ULCERATION SATELLITE LESIONS **What am I? **What is the tx? **What organisms?
fungal corneal ulcer AMPHOTERICIN B, VORICONAZOLE, POSACONAZOLE CANDIDA, FUSARIUM, ASPERGILLUS, ETC
79
IRRITATION, PHOTOPHOBIA, TEARING, REDUCED VISION HISTORY OF FEVER BLISTERS OR OTHER HERPETIC INFECTION DENDRITIC ULCER IN THE CORNEAL EPITHELIUM BRANCHING, LINEAR PATTERN WITH FEATHERY EDGES TERMINAL BULBS AT ITS ENDS What am I? What is the slam dunk finding? What is the tx?
Herpes simplex corneal ulcer Dendritic ulcer in the corneal epithelium ORAL ANTIVIRAL ACYCLOVIR TOPICAL ANTIVIRAL IDOXURIDINE, GANCICLOVIR
80
_____ is the M/C CAUSE OF CORNEAL ULCERATION AND CORNEAL BLINDNESS
herpes simplex
81

HEENT (12 decks)

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