treatments Flashcards
presbyopia
(aging eyes)
corrective lenses
chronic glaucoma
progressive optic nerve damage
prostaglandin analog drops (latanoprost, travoprost)
topical beta blockers
laser treatment/surgery: trabeculoplasty
acute angle glaucoma
(damage to optic nerve from pressure)
emergent optho referral
reduce IOP
- IV acetazolamide
- oral acetazolomide
- timolol maleate (topical)
- topic pilocarpine (once pressure begins to fall)
amblyopia
brain can’t mesh two images so it turns off one
occlusion therapy
atropine
amaurosis fugax
transient emboli to retinal artery
treat like stroke until proven otherwise
retinoblastoma
retinal tumor of childhood
opthalmology and oncology
optic neuritis
inflammatory demyelination of optic nerve
IV steroids and refer
papilledema
optic disk swelling
reduce ICP
weight loss and acetazolamide
shunting
viral conjunctivitis
inflammation of mucous membrane that line surface of eyeball and inner eyelids
cold compress and artificial tears
HSV, shingles, chickenpox viral conjunctivitis
topical ganciclovir 0.15 gel
and or oral acyclovir
optho consult/ follow up
bacterial conjunctivitis
trimethoprim with polymyxin B, azithromycin
contact wearers: ciprofloxacin
gonoccocal conjunctivitis
IM cefrtiaxone 1g as single dose
erythromycin/ bacitracin may be added
chlamydia conjunctivitis: inclusion
doxycycline
chlamydia conjunctivitis: trachoma
oral azithromycin single 1 g dose
improve hygiene living conditions
allergic conjunctivitis
antihistamine: levacobastine, emedastine
mast cell stabilizer: cromolyn
combined antihistamine and mast cell stabilizer: olopatadine
systemic antihistamine: loratadine
avoid triggers
keratoconjuncivitis sicca
dry eyes
artificial tears
preservatives can mimic dry eyes
stop trying medications
use humidifier
cataracts
opacities of lens
refer to opthalmology
lens replacement
corneal ulcer
refer emergently to optho
initiate antibiotics with close follow up
corneal abrasion
scratch to cornea
bacitracin-polymyxin/erythromycin ophthalmic ointment
contact lens wearers: ciprofloxacin and don’t wear contacts for 1 week
large corneal abrasions
cycloplegic drops
foreign body cornea
bacitracin-polymyxin/erythromycin ophthalmic ointment
keratitis bacterial
infection of cornea
see optho emergently
topical antibiotic under direction of optho
fluoroquinolone given hourly
keratitis viral
(HSV)
self limited
reduce symptom duration with antivirals and topical corticosteroids
refer
keratitis fungal
diagnosis often delayed and treatment difficult
pinguecula
no treatment required
artificial tears may help
pterygium
artificial tears and topical NSAIDs
episcleritis
resolves spontaneously
uveitis
inflammation of any component of uveal tract
refer
scleritis
REFER
systemic NSAIDS and or topical steroids
anterior blepharitis
eyelid hygiene, massage with baby shampoo
posterior blepharitis
regular meibomian gland expression and warm compress
if conjunctiva and cornea inflamed: long term low dose oral antibiotic therapy
hordeolum
warm compress
incision
erythromycin/bacitracin
chalazion
initial: warm compress
incision and curettage
entropian
can monitor
if lashes scratch Cornea; surgery
botulinum toxin injections
ectropion
keep eyes moist OTC
acute dacryocystitis
systemic oral antibiotics with gram pos coverage: amoxicillin- clavulanate, cephalexin, ciproflox
follow up with optho
chronic dacryocystitis
latent with systemic antibiotics
dacryocystorhinostomy
dacryostenosis
supportive treatment
gentle massage with downward motion 3-4x daily
congenital dacryocystitis
resolves spontaneously
balloon dilation
dacryoadentitis
cephalexin
severe: IV nafcillin
macular degeneration
vitamins and stop smoking
dry ARMD
pegcetocoplan and avancincaptad pegol injections
wet ARMD
VEGF injections
- ranibizumab
retinal detachment
close retinal holes and tears
- laser photocoagulation
- cryopexy
- pneumatic retinopathy
diabetic retinopathy
get control of blood glucose and examine every 3-4 months
macular edema: VEGF
hypertensive retinopathy
control HTN
central/branch retinal artery occlusion
urgent referral to ER for stroke workup
lay patient flat, ocular massage, high concentrations of inhaled oxygen, IV acetazolamide, anterior chamber paracentesis
retinal vein occlusion
macular edema: VEGF
neovasculariaztion: pan retinal laser photocoagulation
periorbital cellulitis
oral antibiotics
- amox/clavulanic acid or 1st gen cephalosporin
hot packs
orbital cellulitis
nafcillin plus:
metronidazole or clindamycin
MRSA: vancomycin
globe rupture
bandage eye and cover with shield that rests on face not eye
HOB elevated to 30-45 degrees
remain still and don’t move eye
IV antibiotics: vancomycin + ceftazidimide
surgey= NPO
hyphema
prevent rebleed and intraocular hypertension
elevate HOB to 30-45
consult optho
- antifibrinolytic agents
- corticosteroids (systemic and topical)
subconjunctival hemorrhage
monitor
reassurance
resolves in 2 weeks
orbital fracture
optho or plastic surgery
orbital fracture into sinus: cephalexin
oral corticosteroids for swelling
bullous subconjunctival hemorrhage
monitor
reassurance
resolves in 2 weeks
