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Urgencies > Treatment/advice > Flashcards

Treatment/advice Flashcards

1
Q

GPC

A 
Replace damaged contact lens
Reduce wearing time
Optimum hygiene
2-4 week protein removal 
Different lens edge design
Different lens material

Topical mast cell stabilisers can help

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2
Q

Interstitial keratitis

What is is?
Cause?
Tx?

A

Stromal inflammation without epithelial loss
Red/watery/photophobia /reduced VA if visual axis crossed
Cause..Immune reaction to trapped antigens in eye

Tx…topical steroids

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3
Q

Chlamydial conjunctivitis
Signs?
Referral/tx?

A

Follicles, more in inferior than superior fornix
Superficial punctuate keratitis
Can have irregular subepithelial infiltrates after several weeks

Systemic antibiotics..GP?
Referral to sexual health clinic..

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4
Q

Bacterial keratitis

Tx?

A

Corneal scrape, antibiotics, cycloplegia..pain

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5
Q

Dacryocystitis

A

Can be acute or chronic

Unilateral red eye, tearing, blurred vision, discharge, abyss of lacrimal sac

Chloramphenicol
Systemic antibiotics

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6
Q

Dacryoadneitis

A

Inflammation of lacrimal sac

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7
Q

Acute allergic conjunctivitis

Tx?

A

Cold compresses
Topical and systemic mast cell stabilisers
Topical antihistamines

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8
Q

Endophthalmitis

Tx?

A

Same day

Vitreous can be removed

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9
Q

Bell’s palsy

Tx?

A

Can be associated with latent virus

Most improvement seen in first 3 weeks

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10
Q

Photokeratitis

A 
Painkillers
Don’t pad eye
Cold compresses
Sunglasses
Rest with eyes closed
Should self resolve 24-48 hours

Review next day
Mild photophobia and blurring may last 1 week

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11
Q

BRVO/CRVO

Tx?

A

Laser photocoagulation
Steroids
Anti Vegf if CMO

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12
Q

CRAO

Tx?

A

Ocular massage

Co2 brown paper bag

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13
Q

AION arteritic

Tx?

A

Steroids, aspirin

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14
Q

HZO

Signs?

A

Hutchinson’s tip of nose…may indicate ocular involvement

Antivirals, topical steroids
Avoid elderly/children/those with depressed immune system

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15
Q

HSV

Tx?

A

Antivirals, topical steroids

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16
Q

Bacterial conjunctivitis

Tx?

A

Can self resolve
Hygiene
Chloramphenicol

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17
Q

Anterior uveitis

Tx.

A

Cyclopentolate

Topical steroids

18
Q

Pre-septal cellulitis

Tx

A

Antibiotics oral

19
Q

Adenovirus also conjunctivitis

Tx

A 
Artificial tears
Cold compresses
Review 5-7 days for keratitis
Hygiene
Time off work 2 weeks

Refer if severe pain/visual loss but inform hospital

20
Q

Allergic conjunctivitis

Tx

A

Cold compresses
Topical antihistamines effective in combination with vasoconstrictors
Mast cell stabilisers
Avoid allergen

21
Q

Marginal keratitis

Signs

Tx

A

Flat or elevated Infiltrates smaller than 1.5mm just inside limbus usually 4 and 8 o clock, islands (gao btw)
Pannus possible

Refer if not sure..concerned

Topical steroids
Lid scrubs
Topical antibiotics to lid margins

22
Q

Acanthoemba

Tx

A

Refer

Tell ox to bring cl case

23
Q

Angle closure

Tx

A

Pilocarpine (miotic)

24
Q

What defence mechanisms does cornea have?

A

UV
Tight cell junctions epithelium, epithelium expresses immune receptors Bowman layer and descemets membrane act as barrier
Epithelial cell quick turnover displace bacteria

Tears…immunoglobulin A and lactoferrung

25
Q

P E D A L?

A 
Pain
Epithelial defect
Discharge
Anterior chamber reaction
Location
26
Q

What causes RRD and what does it stand for?

A

rhegmatogenous retinal detachment

Fluid from vitreous enters the space between the RPE and neurosensory retina through a hole or tear

Usually occurs superior temporally

27
Q

What is exudatitive detachment?

A

Fluid from choroid seeps sub retina through damaged RPE or blood retinal barrier

Cause choiroidal malignant melanoma or subretinal neovascular membrane

28
Q

Wet AMD tx options

VA criteria

A

Ranibizumab/lucentis
Aflibercept/ eyelea

PDT
Verteportin/visudyne (takes up by CNVM) and then low power laser

6/12 to 6/96

29
Q

What causes AMD

A

Oxidative stress

Accumulation of metabolic debris and lipofusin

30
Q

What questions with visual field loss?

A 
How rapidly was the vision lost?
How long did the vision loss last for?
What was the extent of the vision loss?
How did the vision loss appear to You?
Was it in one eye or both?
31
Q

What anterior conditions have pain?

A

Corneal infection
Acute anterior uveitis
Acute angle closure haemorrhage

32
Q

What could be the causes of a red eye with no ocular pain or discomfort?

A

Conjunctivitis
Sub conjunctival haemorrhage
Episcleritis

33
Q

Which has conjunctivitis has papillae which have follicles?

A

Papillae
Bacterial
GPC

Follicles
Viral

34
Q

Pupils in
Angle closure
Anterior uveitis

A

Fixed mid dilated

Miotic

35
Q

What questions to ask with red eye?

A 
When was the onset of the symptoms?
Any pain?
Other sensations?
Vision loss?
Haloes/photophobia?
History of trauma?
Cl wearer?
Discharge?
Previous history of similar?
36
Q

What questions to ask with floaters? flashes

A

Are they new or have they always been there?
What do the look like?
How many are there?

When do you notice them?
How long do they last?

37
Q 
Optic neuritis
What does the nerve look like in the following 
Neuroretinitis?
Papillitis?
Retrobulbar neuritis?
A

Swollen, hyperamic also star shaped hard exudates around macula

Swollen, hyperaemic

Normal/pale

38
Q

Why is papilloedema different to optic neuritis?

A

BES as due to raised intracranial pressure

39
Q

What does no RAPD indicate?

A

Severe optic nerve disease

Severe retinal disease

40
Q

What does LIPCOF stand for

A

Lid parallel conjunctival folds

41
Q

What is normal tear meniscus nd breaks up time

A

0.2mm or more

10 sec

Urgencies (2 decks)

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