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22 Cards in this Set
- Front
- Back
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Cataract
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Early nuclear cataract-change in prescription of glasses
Small central opacities-pupillary dilation may improve vision Surgical removal of lens with replacement using intraocular lens implant Cataract surgery is not performed with lasers Laser used for “after cataract” |
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Thyroid eye disease
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Mild cases- artificial tears
Moderate to severe- Elevate head of bed –reduce congestion Oral prednisone Orbital radiation Orbital decompression |
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Diabetic retinopathy
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The diabetic control and complications trial has shown that tight glycemic control decreases the progression of diabetic retinopathy, nephropathy, and neuropathy
Prompt referral indicated Laser photocoagulation |
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Diabetic macular degeneration
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Tight glycemic control
Refer Laser photocoagulation to decrease further decline in visual acuity by reducing amount of macular edema (ETDRS) |
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Hypertensive retinopathy
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Treat the underlying hypertension
Treat the systemic vascular disease or renal disorders Chronic does not require specific ophthalmic treatment |
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Retinal Vein occlusion
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Mandatory ophthalmic exam within 48-72 hours of diagnosis
BRVO with macular edema may result in decreased vision-laser photocoagulation Follow up- crvo assessed every month for 6 months by the eye doc Visual prognosis depends on severity |
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age related macular degeneration
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Acute vision changes-refer within 24 hours
Laser photocoagulation Subretinal surgery experimental Low vision aids-magnification Preservision vitamins have been shown to improve patients with moderate to severe AMD Visudyne – a new procedure for wet AMD |
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Otitis Externa
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Treatment: remove debris, antibiotic and steroid drops, keep dry
Acidifying agent +/- hydrocortisone Neomycin/polymyxin-B/hydrocortisone Fluoroquinolone +/- dexamethasone Perforated TM: Floxin otic + PO quinolone Wick insertion |
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Acute otitis media
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Treatment:
Antibiotics: Moderate to severe otalgia Fever > 39c (102.2f) Less than 2 years of age Observation: Improvement: 61% in 24h, 75% in 1 week Antibiotics: First line: amoxicillin (macrolide) Second line: amox/clavulanate, ceph2 PCN allergic: macrolide Auralgan: benzocaine drops Tympanocentesis |
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Otitis media with effusion
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Treatment options:
Antibiotics: first line, limited benefit Antihistamines/decongestants: no benefit Steroids: not recommended Ventilating tubes: initial benefit, limited by one year. No proven effects on language Adenoidectomy: older than 4 y.o. |
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Chronic Otitis media
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Treatment:
Antibiotics: fluoroquinolones Surgery |
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Presbyacusis
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Hearing aid, cochlear implant
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Acoustic neuroma
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Treatment: surgery, radiotherapy
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Menieres disease
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Treatment:
Low salt diet, limit alcohol and caffeine Diuretics, antiemetics, anxiolytics (alprazolam) Surgery |
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Tinnitus
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Treatment:
Reverse underlying cause Treat associated insomnia and depression |
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Vertigo
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anticholinergics, antiemetics, benzodiazepines
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Viral URI
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Treatment:
Antihistamines, decongestants, guaifenesin Antitussives Ipratropium, cromolyn Zinc Vitamin C: no benefit, may help prevent Echinacea: no benefit |
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Acute Sinusitis
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Treatment
First line antibiotics: 7-10 days Amoxicillin Amoxicillin-clavulanate Trimethoprim-sulfamethoxasole Clarithromycin Doxycycline Second line antibiotics: 7-28 days 2nd generation cephalosporin (cefuroxime) Fluoroquinolone (levofloxacin) Treatment: Intranasal steroids: no data Surgery: endoscopic |
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Chronic sinusitis
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Treatment:
Medications: Antibiotics (3-6 weeks) Intranasal steroid sprays Guaifenesin Antihistamines Nasal irrigation Antibiotics: First line: amox-clavulanate, ceph2 PCN allergic: clarithromycin, clindamycin Second line: levofloxacin, moxifloxacin Functional endoscopic surgery (FESS) |
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Allergic Rhinitis
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Treatment
Avoidance: dust, mold, dander, pollen Medications: Intranasal steroids (fluticasone) Antihistamines (first and second generation) Decongestants Leukotriene inhibitors (montelukast) Mast cell stabilizer sprays (nedrocromil) Ipratropium bromide nasal spray: rhinorrhea Allergen injection immunotherapy |
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Rhinitis medicomentosa
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intranasal steroids
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Epistaxis
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balloon tamponade
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