Section 1
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Treatment for orbital cellulitis
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Date created
Mar 14, 2020
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Section 1
(50 cards)
Treatment for orbital cellulitis
IV, broad spectrum antibiotic. surgical drainage needed for a large abscess.
Treatment for bacterial keratitis
topical antibiotic drops
Symptoms of bacterial keratitis
cornea is hazy with a central ulcer and adjacent stromal abscess. hypopyon is visible
Signs and symptoms of herpes simplex keratitis
patients will experience irritation, light sensitivity, and redness. pain is either mild or does not occur at all. most cases are unilateral and mild conjunctival injection. with advanced disease, stromal scarring may occur and patients may have a decreased corneal sensation
What are the symptoms of blepharitis?
burning, irritation, excessive tearing (epiphora), photophobia, and occasional blurred vision.
What are the signs and symptoms of a chalazion?
patients present with a firm nodule just below the lid margin, and usually a grayish discoloration on the conjunctival surface. Patients are usually free of symptoms or have minor tenderness of the nodule on the lid
Etiology of chlamydial conjunctivitis
ocular inoculation results from infection of the genitalia. follicular response is present
Etiology or orbital cellulitis
a URI or sinusitis . most common organisms being streptococcus, s. aureus, and mixed flora. lid trauma, infections (stye or impetigo), conjunctivitis, and dacryocystitis can lead to cellulitis
Signs and symptoms of chlamydial conjunctivitis
more commonly unilateral. acute redness, foreign body sensation, tearing, and photosensitivity
What is glaucoma?
group of diseases with progressive optic nerve damage and visual field loss. usually the IOP is above the normal range
Treatment for viral conjunctivitis
patients are treated with cold compresses, artificial tears, antihistamine if itching is severe. very contagious, but self-limiting
Treatment of bacterial conjunctivitis
broad spectrum abx given 4-6 times per day. drop are better than ointment
What is seborrhea blepharitis associated with?
dandruff
Signs and symptoms of bacterial conjunctivitis
symptoms include redness, irritation, adhesions of the lids. mucopurulent exudate is found in the fornix and lid margin. erythema and edema of the lids is also sometimes seen
Etiology of bacterial conjunctivitis
any bacteria can cause conjunctivitis, but S.aureus, Haemophilus species, moraxella, and streptococcus pneumonia are the most common
Three types of blepharitis
seborrhea, staphylococcal, meibomian gland dysfunction
Posterior uveitis
vitrifies, retinitis, and choroiditis are inflammation in the posterior eye
Symptoms of fungal keratitis
cornea has multiple stromal abscesses and little epithelial loss. intraocular infection is also common
What is uveitis?
inflammatory condition involving the uveal tract
When evaluating a hordeolum, what should be included in your differential diagnosis?
chalazion, inclusion cyst, lid tumor
Treatment for conjunctivitis caused by Neisseria species?
eye should be irrigated with saline and topical antibiotics should be applied 4-6 times a day. ceftriaxone is injected IM in adults.
Anterior uveitis
iritis and iridocyclitis describe inflammation of the it iris and iris-ciliary body complex
Etiology of viral conjunctivitis
adenovirus is usually the cause
What is the etiology of a hordeulum?
usually they are caused by a staphylococcal infection of a sebaceous gland of the lid
What are the treatment options for a chalazion?
early treatment (first 5 days) involves frequent application of warm compresses to the gland. after the first 2-3 weeks, injection of triamcinolone may prove useful
Signs of gonococcal conjunctivitis
hyper acute conjunctivitis with a lot of mucopurulent discharge. organism can rapidly invade the cornea and cause tissue destruction and ocular perforation
Parts of the uveal tract
iris, ciliary body, choroid
Treatment for allergic conjunctivitis
systemic allergy evaluation should be performed and antihistamines should be givven
Signs and symptoms of allergic conjunctivitis
itching, bilateral with mild injection and a stringy mucoid discharge
What are the signs of blepharitis?
erythema of the lid margin, dandruff like spots on the lashes, scales around lashes, lash loss, and thick secretions can be elicited from the meibomian glands with digital pressure to the lid
Treatment for acute dacryocystitis
oral broad spectrum antibiotics (Augmentin), if a large abscess has formed, I&D
Treatment for chlamydia conjunctivitis
oral tetracycline or doxycycline. topical application of erythromycin ointment should be given 2-4 times a day for 3 weeks
What is meibomian gland dysfunction associated with?
chalazia
What is the usual cause of fungal keratitis
occurs after a corneal injury involving plant material in the eyes, and in patients who were contact lenses
What glands are affected with a hordeolum?
its a staphylococcal infection of a sebaceous gland of the lid
Most common cause of posterior uveitis
toxoplasmosis
Signs and symptoms of orbital cellulitis
warm, erythematous, tender swelling of the lids that may extend over the nose to the opposite side. orbital involvement can lead to vision loss or double vision. patients may have a low grade fever and elevated WBC count. proptosis, restricted mobility and sluggish pupillary reflex are seen as well
What glands are affected with a chalazion?
due to chronic lipogranulomatous inflammation of a meibomian gland
Treatment of herpes simplex keraittis
topical antiviral medications. use of topical corticosteroids can result in tissue loss and ocular perforation
Causes of eyelid tumors
usually benign, basal cell carcinoma is the most common malignant tumor. squamous cell carcinoma, meibomian gland carcinoma, and malignant melanoma also occur.
What are the three types of keratitis?
bacterial, herpes simples, fungal
Signs and symptoms of dacryocystitis
tearing and a swollen lacrimal sac, symptoms include tearing, pain and mucopurulent drainage (from lacrimal sac)
Different types of conjunctivitis
viral, bacterial, allergic, chlamydial, and gonococcal
What are the signs and symptoms of a hordeulum?
a painful, erythematous, pointed nodule present on the skin surface (external stye) or conjunctival surface (internal stye). symptoms would be the subacute onset of a painful nodule or pustule on the eyelid.
Treatment for chronic dacrycocystitis
dacryocystorhinostomyy or dacryocystectomy
Etiology of allergic conjunctivitis
season and occur in patients with a history of atopic disease. animal dander, dust, pollen, ragweed, mold, are some of the causes of the conjunctival swelling
Signs and symptoms of viral conjunctivitis
acute onset with redness, watering, soreness, and the second eye is usually involved 3-7 days after the first. Diffused injection of the conjunctiva with a watery discharge. erythema, edema, and a follicular response. pre auricular adenopathy is common.
Treatment for blepharitis
lid margins should be scrubbed daily with a cotton-tupped applicator in baby shampoo, massage of the lid margins can help express concretions
Risk factors for bacterial keratitis
contact lens wear, especially overnight, surgery
What is keratitis?
inflammation of the cornea
Section 2
(50 cards)
Signs of corneal abrasion
conjunctival hyperemia, swollen eyelids, tearing. slit lamp examination or fluorosceine dye may be used to evaluate the patient. immediate relief with topical anesthesia confirms the diagnosis
Signs and symptoms of open angle glaucoma
usually don't have symptoms besides a decrease in vision late in the course of disease. IOP will be elevated and optic nerve cupping does occur
What is a cataract?
opacity in the crystalline lens
Treatments to lower IOP in patients with glaucoma
topical beta-blockers decrease aqueous production as do carbonic anhydrase inhibitors and alpha-2 agonists. medications that improve aqueous outflow include topical mitotic agent (pilocar, pilostat, pilagan) and epinephrine
Central retinal artery occlusion
may cause ischemia to the macula resulting in vision loss. usually presents with sudden, painless unilateral loss in vision and visual fields. amaurosis fugax implies this.
What is exudative macular degeneration?
neovascularization origination from the choroidal vasculature grows under the retina, leaks fluid, lipids, and sometimes blood
Treatment for acute angle closure glaucoma
emergency, immediate referral to ophthalmologist
Treatment for retinal detachment
immediate referral to ophthalmology. surgical intervention is often necessary to prevent blindness in the affected eye
Differences between conjunctivitis and scleritis
both may cause a red eye. conjunctivitis is usually the entire conjunctiva and is not associated with pain, but does have some discharge. Episcleritis and scleritis usually involve a section of the eye. no discharge with these
Signs and symptoms of proliferative diabetic retinopathy
may have good visual acuity and be unaware of any symptoms. vision may decrease suddenly or more slowly. floaters and blind spots are common. pre retinal hemorrhage, cotton wool spots, neovascularization, and loss of red reflex may be observed.
What is proliferative diabetic retinopathy?
results from retinal ischemia. as perfusion to the retina decreases, retinal tissue releases angiogenic factors and neovascularization occurs
Branch of the central retinal artery occlusion
sudden, painless, visual field loss. horizontal hemifield. amaurosis fugax implies this
What are the different types of retinopathies?
diabetic (proliferative and non proliferative), HTN, and AIDS
Signs and symptoms of hypertensive retinopathy
double vision, decrease vision or a blind spot may occur. A:V crossing, cotton wool spots, micro aneurysms, retinal edema and lipid exudates may be observed as well
Factors/diseases associated with open angle glaucoma?
more prevalent in AA and in patients with a FH. increases with increasing age
Treatment for cataracts
change in eyewear prescription may improve vision. surgical removal of the lens and placement of an intraocular lens implant
What are the two types of retinal artery occlusion?
central retinal artery or a branch of the central retinal artery
What is open angle glaucoma?
eye has a structurally normal outflow pathway.
Treatment for scleritis
referral. systemic evaluation is needed. initial treatment includes NSAIDs or systemic corticosteroids. for advanced disease, cytotoxic agents may be needed.
Causes of cataracts
congenital, old age, diabetes, trauma
Signs and symptoms of retinal vein occlusion
sudden or gradual, unilateral, painless blurry vision or loss of vision occurs. severe unilateral pain and redness are present. dilated and tortuous veins are observed and a place shaped hemorrhage. vitreous hemorrhages, cotton wool spots, macular edema and exudates
What is angle closure glaucoma?
blockage of aqueous flow between the lens and it is causes a shift of the iris forward and a closure of the anterior chamber angle. have more acute symptoms of severe pain and blurred vision. chronic angle closure will have a slow rise in IOP and no symptoms
Etiology of hypertensive retinopathy
chronic HTN results in thickening of the vascular wall with narrowing of the lumen of the vessel
Treatment for corneal abrasion
cycloplegia. abx ointment. firm pressure patch may be applied for 24 hours if the abrasion is large or the patient is experiencing severe pain. topical anesthetics should not be prescribed or given to the patient
What is involved in the workup of an ocular contusion?
general eye exam should be performed on both eyes. Red reflex should be evaluated and a plain X-ray film of the orbit is needed if orbital fx is suspected. entrapment of orbital soft tissue in an orbital blow out fracture is often seen on a CT
Treatment for retinal vein occlusion
referral. laser photocoagulation helps correct macular edema and the neovascular complication seen in patients with BRVO.
Central retinal vein occlusion
involve all four quadrants of the retina. more common in the elderly. probably due to a thrombus that occurs in the venue at the exit site from the eye within the optic nerve
Types of retinal vein occlusions
central retinal vein or a branch of the central retinal vein
Types of macular degeneration
exudative and atrophic
Signs and symptoms of acute angle closure glaucoma
vision will be blurred and halos are seen around the lights. intense pain and photophobia. diaphoresis and N/V are possible. mid-dilate pupil will be seen and injection and lid edema observed. IOP will be elevated (60-80 mmHg)
Signs and symptoms of cataracts
patients will express a slowly progressing visual loss or blurring. glare become problematic and double vision often occurs. fixed spots in the patient's visual field and opacification of the lens
Branch central retinal vein occlusion
involve one quadrant and have an arcuate pattern that corresponds to the vein's area of drainage. more commonly in the elderly. usually occur at the site of an arteriole-venue crossing
What is episcleritis?
inflammation of the episclera (fascial sheath that encases the eye). mild pain
Treatment for episcleritis
referral. most cases are self-limited, cold compresses and/or topical vasoconstrictor are used initially. may prescribe topical corticosteroids or oral NSAIDs
Why do patients with diabetes develop retinopathies?
injury to retinal vasculature occurs
Leading cause of blindness in the Western world in people under 50
diabetic retinopathy
Signs and symptoms of episcleritis
acute onset of redness. pain is a dull ache around the eye and visual acuity is normal, episceral vessels will be engorged and no discharge or corneal involvement is present
Symptoms of corneal abrasion
history of mild trauma to the eye, photophobia, injection, blepharospasm, pain, and foreign body sensation
What is scleritis?
inflammation of the sclera (collagen and elastic fibers that cover and protect the eye). more likely associated with systemic disease, more severe pain
Etiology of retinal artery occlusion
carotid atherosclerotic disease, cardiac valvular disease, giant cell arteritis, thrombosis, IV drug abuse, sickle cell anemia, and DICs
Signs and symptoms of scleritis
gradual onset and the patient presents with severe pain that may radiate to the temple or jaw. photophobia, tearing, and decreased vision occurs as well. The globe will be tender to palpation and corneal and intraocular inflammation may also be present
How does retinal detachment occur?
occurs when fluid separates the retina from the underlying retinal pigment epithelium. vitreous may separate from the retina causing a tear or break. often occurs in highly nearsighted patients or after surgery or trauma
Signs of a retinal artery occlusion
embolus may be seen at the level of the optic nerve in pts with central retinal artery occlusion. embolus may be present at a branch point of an arteriole in patients with BRAO. cherry red spot would suggest ischemia and edema of the posterior retina, within several hours of occlusion
Treatment for conjunctival foreign body
if globe penetration is suspected, referral and shield should be applied. if foreign body is superficial and no ruptured globe, it may be removed under topical anesthesia with saline solution wash or forceps. topical abx after removal
Treatment for a retinal artery occlusion
emergency ophthalmologic consultation. for an ocular massage, the clinician should use gentle but firm digital pressure on the globe with the patient's eyelids closed for 10-15 seconds. Rapid release in the pressure creates a decrease in intraocular pressure that may dislodge the embolus. topical beta blocker (timolol). sublingual Nitroglycerin. anterior chamber paracentesis, IV or oral Diamox
What are some symptoms of retinal detachment
often preceded by acute flashes or floaters. loss of visual field or a curtain covering their line of vision
Three forms of diabetic retinopathy
proliferative, diabetic macular edema, ischemia of the macula
Treatment for an ocular contusion
cool compresses. patients with hyphema should be referred
Sign and symptoms of ocular contusion
may relay a history of trauma to the eye or periorbial region. erythema or ecchymosis is found around the eye and there should be minimal pain. edema is usually present and the eye should show full motility with slight pain on eye movement
Two types of glaucoma
open angle glaucoma and angle closure glaucoma. Most cases are open angle
Section 3
(33 cards)