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56 Cards in this Set

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What structures compose the outer layer of the eye?
Sclera and cornea.
What structures compose the middle layer of the eye?
Choroid, ciliary body, and iris.
What structure composes the inner layer of the eye?
Retina.
What structure maintains the shape of the eye?
Sclera.
What is the only part of the eye with pain receptors?
Cornea.
What chamber is filled with aqueous humor?
Anterior chamber.
What cells form the lens?
Crystalin
What fills the posterior chamber?
Vitreous humor.
What membrane covers the sclera and lines eyelids?
Conjunctiva.
Lacrimal caruncle contains what glands?
Modified sweat and sebaceous glands.
Where are cones most densely concentrated?
Central fovea
Where is vision the sharpest?
Fovea
The pigment in receptors are called what?
Rhodopsin (visual purple)
Vitamin A deficiency can lead to what?
Night blindness
Most common etiology of blepharitis.
staphylococcal infection most common, streptococcal, Moraxella, herpes simplex and herpes zoster.
Nonbacterial causes of blepharitis.
Seborrheic dermatitis, rosacea, dr eye, and meibomian gland dysfunction.
Laboratory test for blepharitis.
eyelid cultures and antibiotic sensitivity testing when patient fails to respond to initial treatment regimen.
Treatment for blepharitis.
Firm massage of the lid margins to enhance the flow of secretions from glands, followed by cleansing of the lids with cotton-tipped applicators dipped in 50:50 mixture of baby shampoo and water.
Bacitracin and erythromycin topical 1 - 4 times daily.
When do you refer blepharitis?
when patient fails to respond to local therapy.
What do you do if a patient presents with you with a orbital blowout fracture?
immediate referral to hospital for surgery.
What are the Le Fort classification of midface fractures?
I: only the lower maxilla
II: the infraorbital rim
III: complete detachment of the midface from the skill
How do you diagnose facial fractures?
a fine-cut CT scan is obtained in axial and coronal planes.
At what point is enophthalmos apparent?
2 mm
What are some clinical presentation of an orbital blowout fracture?
decreased visual acuity, blepharoptosis, binocular vertical or oblique diplopia, epistaxis and eyelid swelling following nose blowing.
What is the most common cause of treatable blindness?
Cataracts
What workup would you do for for cataracts?
complete eye examination, including slit lamp examination, funduscopic examination, and brightness acuity testing.
When is surgery indicated with cataracts?
when corrected visual acuity in the affected eye is >20/30 in the absence of other ocular disease.
What are the most common etiologies of conjunctivitis?
Staph or strep; viral
What kind of compresses are used for infective conjunctivitis?
warm compresses
What kind of compresses are used for irritative or allergic conjunctivitis?
cold compresses
What are some antibiotics you can use for conjunctivitis?
levaquin, ofloxin, cipro, or gentamicin drops.
When is a good time to use mast cell stabilizers in conjunctivitis?
when its chronic because of the delayed reaction
When do you follow-up after initiation of treatment for conjunctivitis?
after two weeks to make sure secondary complications do no occur.
What are some physical findings of corneal abrasions?
Haziness of the cornea, redness, infection, pain, and light sensitivity.
How do you diagnose corneal abrasions?
Fluorescein staining
Treatment of corneal abrasions
warm compresses, removal of foreign bodies, topical antibiotics like ofloxacin 0.3% 2 gtt qid, and topical NSAIDS
When do you follow-up after initiation of treatment for corneal abrasion?
in 24 hours and then every 3 days until abrasion has cleared and vision has returned to normal
What do you do if a patients experience no relief from corneal abrasion within 24 hours?
ophthalmologic referral
Signs and symptoms of acute dacryoadenitis
unilateral, severe pain, redness, and pressure in the supratemporal region of the orbit with rapid onset
Signs and symptoms of chronic dacryoadenitis
can be bilateral, painless enlargement of the lacrimal gland present for more than a month; it's more common than acute
Physical finds of acute dacryoadenitis
chemosis, conjunctival injection, mucopurulent discharge, erythema of eyelids, lymphadenopathy, and fever can be present with systemic manifestations.
Etiology of Dacryoadenitis
Viral (most common) - mumps, EBV, herpes zoster, mono, CMV
Bacterial - staph, strep, gonorrhea, mycobacterium
Lab Studies for Dacroadenitis
Culture - do before treatment because it can turn chronic and require return visits. Patients can be prone to reinfection due to damage to the lacrimal system.
Treatment for Dacryoadenitis
Viral - self-limiting, supportive measures (warm compresses, oral NSAIDS)
Bacterial - Keflex 500 mg qid; Cefazolin 1g IV q8h
What is a chalazion?
a slowly enlarging nodule on the eyelid formed by inflammation of the meibomian gland or Zeis sebaceous glands.
At what age does the risk of developing chalazia increase?
aged 30-50
What are the signs and symptoms of chalazia?
painless swelling
possible impaired vision, double vision, discomfort
What can cause chalazion?
seborrhea
acne rosacea
chronic blepharitis
high blood lipid concentration
What is the typical progression of uncomplicated chalazion?
resolution within 1 month
How do you treat chalazion?
apply warm compresses for 15 minutes
excision of chalazion
What is indicated for chronic chalazion?
tetracycline
What is an external hordeolum?
an acute inflammatory process affecting the eyelid and arising from the Zeis glands
What is the etiology of an external hordeolum?
often infectious and usually caused by staphylococcus aureus
What are the physical finding of an external hordeolum?
abrupt onset with pain and erythema of the eyelid
localized, tender mass in the eyelid
points toward the skin surface of the lid and may spontaneously drain
How do you treat an external hordeolum?
usually responds to warm compresses
bacitracin or topical erythromycin opththalmic ointment applied to the lid two or four times daily
dicloxacillin 500 mg PO qid for refractory cases
What are the signs and symptoms of blepharitis?
eye irritation, burning, tearing, foreign body sensation, crusty debris (in the lashes, in the corner of the eyes or on the lids), dryness and red eyelid margins