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Clin Med I > Red eye X2 > Flashcards

Red eye X2 Flashcards

1
Q

Posterior chamber

A

the area behind the irs on the sides of the lens

- the fluid drains out of the trabecular meshwork

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2
Q

Limbus

A

Where the sclera meets the iris

- usually a dark circle around the aris

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3
Q

Chemosis

A

swelling of the conjuctiva

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4
Q

Hypopyon

A

leukocyte exudate in the anterior chamber of th eye

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5
Q

Clilliary flush

A

dialated conjunctival and episcleral vessals adjacent and curcumferential to the corneal

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6
Q

Tonometry

A

tool that measures of intraocular pressure

normal is 8-21

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7
Q

Blepharitis Present

A 
Eyelid indlammation due to meibomian gland disfunction
- chronic itching or bruning, scratching
- worse in the morning
- not vision decrease 
erythema, scales, debris
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8
Q

Blepharitis tx

A

Warm ompress and baby shampoo lid scribs
Abx:
- Bacitracin opthalmic ointment
-Erythromycin or Azithromycin ointment

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9
Q

Dry Eye present

A 
* can be caused by blephritis, autoimm, hormonal changes, ectropian, meds 
Pres: chronic itching burning scratching
tired eyes especially in the PM 
- Vision fluctuation!
-poor tear film
- punctate epithelial erosions 
\+ schirmer test (>10cm)
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10
Q

Dry Eye Managment

A

-artificl tears/oinments
- opthamology referal
- topical cyclosporing
+/- topical glucocorticoids
punctal plugs

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11
Q

Hordeolum

A

Caused by infected eyelash root
Painful swelling
Tx: warm compress, abx if needed, steroid inection or surgery (refer)!

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12
Q

Chalazion

A

Presetn: clogged meiobian gland
usually not painfull
usually doesnt make the entire lid well
Tx: warm compress, abx, steroid or surgery

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13
Q

Dacryoadenitis

A

Pres: inlfamation of lacrimal gland
- pain in area of swelling, epiphoria
acute: viral or bacterial source
Chronic: non infectious inflmmatory disorders or orbitaltumor,

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14
Q

Pinguecula

A

clear thin tissue that covers part of the sclera
- can be assoaiated with aging usually do not cause vision loss
Tx: lubricating drops and sunglass use and possible surgery

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15
Q

Pterygium

A

thickening of the bulbar conjuctiva which grows slowly but can progess across cornea

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16
Q

Preseptal Cellulitis

A 
Present: eyelid pain and they may or may not have erythema but will have swelling 
- no proptosis 
-no imparement of vison
- not pain with oular movement 
- chemosis is rare 
Dx: CT with contrast or MRI
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17
Q

Preseptal Cellulitis Tx

A

Outpatient
Tx: clindamycin or Trimethoprim/sulfamethoxazole
and sugmentin or
cefpodoxamine
*refer to opth
Inpatient: for people under two years of age, inability to differentate presebtal from orbital cellulitis > vancomycin+ceftriaxone+metronidazole

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18
Q

Oribital Cellulitis

A

Presentation: eyelid swelling, erythema, fever common, propotosis common, impaired and painful *occular movement, optic nerve involvment
+/- impared vision, chemosis, leukocytosis

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19
Q

Oribital cellulitis Dx/Tx

A

Dx- CT with contrast or MRI
Tx: vancomycin and cetriaxone and metrinidozol
opthalmology consult, hospital admin, surgery if abscees forms or needs to be decompressed

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20
Q

Conjunctivitis

A

inlfmation of the conjuctive

etiology: viral, allergic, or bacterial, vision usally unaffected

21
Q

Viral Conjunctiva present

A

Present: acute following a URI often

  • severe injection, watery discharge, preauricular lymphadenopthy
  • may feel like they have something in their eye
22
Q

Viral conjuctiva managment

A

Warm compress, supportive, self limiting 2-3 wks, opth consult if think its herpes or immunocomp

23
Q

Bacteril COnjunctiva pres

A

s. aureus

Presentation: usually unilateral, moderate injection, thick mucopurulent discarge

24
Q

Bacterial conjuctivitis tx

A

Topical abx

  • erythromycin
  • trimethoprim-polymyxin B
  • ciprofloxacin
  • azithromycin
  • no contact use*
25
Q

Conjunctivitis

c. tachomatis

A

Rare- adults by direct contact and peds neonatally
Present: can develope chronic conjunctivitis- weeks to months
- may be ass with keratitis and non tender preauricular adenopathy
Dx: culture and PCR
Tx: erythromycin 500mg qid 7d
azithromycin 1g po x 1

26
Q

N. Gonorrhea bacterial conjunctivitis

A 
Present:
Unilateral or bilateral
sever profuse, purulent discharge 
-chemosis 
- lid swelling
- moderate to severe injection
*severe and sight threatening 
- sx occur within 12 hrs of inoculation
27
Q

Gonorrhea conjuctiva Dx/Tx

A

Dx: giemsa stain, gram stain,
Tx: admit to hosp, ceftiazone 1gm IM x 1
opthalmology consult

28
Q

allergic conjuctivits

A

Pres: chronic sx, bilateral, mild injection, stingy discharge, itching
Tx: lubricating drops, cool compress, OTC antihistamines, antihistaine drops

29
Q

Subconjunctival Hemorrhage

A

Sx: acute, spontaneous, asymptomatic
blood in the conjunctiva
Signs: visions usually not affectuve
Tx: reassurance

30
Q

Scleritis cause

A

inflam or autoimm dis or the sclera particularly vasculitis

- can be acute or chronic > potentially blinding !

31
Q

Anterior Scleritis pre/dx

A

Present:
- severe constant eye pain, worse in am
- pain radiates to face and periorbital region
- pain increase with EOMs
- HA
-epiphoria
- hyperemia
Types: diffuse (most common), nodular, necroizing
Dx: violaceous redness, pain with pressure, scleral edema (c slit lamp)

32
Q

Posterior scleritis pres/dx

A

no hyperemia unless associated with anterior scleritis
- milder sx
- slid light exam can show disk edema
Dx: orbit may appear normal, slit lamp will show inflammation

33
Q

Scleritis tx

A

refer to opth and rheum

  • slit lamp exam
  • tral NSAIDs, oral gluccocorticoids
34
Q

Episcleritis present

A 
Abrupt, F>M
Pres: bright red epirscleral discoloration 
irritation
epiphora
vision not affected pain 
typically not pain 
-normal sclera on slit exam
35
Q

Episcleritis Dx/ Tx

A

Dx: clinical and normal appearing underlyign sclera
Tx: Refer, slit lamp exam, top lubricants, topical or oral NSAIDs, topical glucocorticoids, assess for other disease

36
Q

Corneal Abraisons pres

A

Acute onset of pain, foreign body sensation, epihora +/ vision affected

37
Q

Corneal abrasion tx

A

fluorecien stain, topical lub, top abx, oral pain meds, NO patching
** do not give topical anesthetic drops**

38
Q

Chemical Injury presentation

A

Caustic Chemical exposure
- acute pain/ burning/ blurred vision/ vision decreased
+/- coneal abrasion

39
Q

Chemical Injury Tx

A

Immediate irrigate
Morgans lens for prolonged irrigation
topical lubricants/antibiotics
Get opthalmology

40
Q

Corneal Foreign Body

A

Pres: acute onset of foreign body sensation usually with associated event
-vision usually unaffected with visual foregin body

41
Q

COrneal Foregin body Managemt

A

determien mechanism of injury
Remove> irrigation> cotton tipped applicator > specialized fb removal tool
lubricant/antibiotic drops

42
Q

Keratitsis/corneal ulcer

A

Present: acute onset of pain, mucous discharge, contact lense abuse, vision usually decreased, white infiltrate
+/-hypopyon
Tx: intensive topical antobiotics, opthamology referall

43
Q

Keratitis- HSV

A
  • will have a dendritic pattern
    when stained
  • refer an treat with topical antivirals
44
Q

Hyphema

A

Blood in naterior chamber
Present: acute onset of pain, photohobia, nausea/vomitin
+/- vision decrease

45
Q

Hyphema managment

A
  • correct underlying coagulopathy
  • treat pain N/V
  • evalate head of bed
  • refer to opthal
    control intracoular pressure, cycloplegics, glucocorticoids, short term topical anesthetic
46
Q

Uveitis

A

inflammation of the uveal tissue
- anterior or posterior chroid can be affected
- can occur as an isolated process, immune mediated response of drug resonse
Ant: inflamamtion of the iris and cilliary body
Post: inflammation posterior to the lens
Panuveitis: inlfammation in the anterior/posterior

47
Q

Uveitis Presentation

A

Ant: pain, cilliary flsuh (white circle around), photophobia, hypopyon, blurred vision, increased tearing
Post: painless, floaters, blurred vision

48
Q

Uveitis dx/tx

A

ds: clinical and slit lanp
Tx: opthalmology referal, topical glucocoriticoids/NSAIDs, cycloplegic grios if IOP
Comp: cataracts, irregular pupil due to scar tissue, swelling and increased eye pressure

Clin Med I (14 decks)

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