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64 Cards in this Set
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- Back
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Naso Lacrimal Duct Occlusion |
“NLDO” Most common Congenital abnormality Sign/Sx- one eye will be swollen and tearing/ glassy look Tx- can resolve on its own or you can do downward strokes 10X daily when the baby is feeding MUST Tx infection if presented |
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True or False, NLDO ALWAYS need Tx such as 10X downward stroke or antibiotics when infection shows? |
False, Sometime they just naturally open up on their own |
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Dacryostenosis |
Narrowing of the Canaliculus Sx- EPIphoria UNIlaterally Use the Jones tests to see whether it is completely closed or not. Then do Dilation and Irrigation to see where the closure is at |
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Blepharitis |
Causes Staph Epi/Aur and Demodex Sx: Chronic itching and burning and Foreign body sensation, Lash crusting with occasional Flare ups DRY EYES |
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Types of Bleph |
Bacterial Seborrhea Mixed Allergic |
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Chronic Bleph |
can lose lashes and cause severe dry eye |
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Meibomian Glands |
40 on upper and 30 on lower |
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Blinks |
we blink every 2-10seconds |
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Blepharitis Asso DIseases |
Associated with skin conditions such as ocular rosacea, dandruff, eczema and psoriasis |
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Seborrhea Bleph |
Pt have dandruff, Sx are generally are not severe. Margains will be a greasy flaking They will have "Scurfs" |
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Which type of bleph will have Scurfs and what other sx will they have |
Seborrheic Bleph will have greasy flakes "scurfs" as well as dandruff |
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TX for sebo Bleph |
Lid Scrubs and Tea Tree shampoos |
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Mixed Bleph |
Sebo and Staph |
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Acute Ulcerative Bleph |
Will have red tender lid margins with ULCERATIONS at the base of the lashes *Typically Young Pts* STAPH infections ***Could lead to Keratoconjunctivitis |
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True or False A Pt with Ulcerative Bleph is common to get Keratoconjunctivitis |
True |
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Angular Bleph |
Cracking and swelling along the lateral canthi |
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Tx for Angular/ ulcerative Bleph |
Lid hygeine Hot Compress 2-4x daily Antibiotics hours or 4 times daily ** Ointment to lid margin for 3-4 weeks especially if chronic Drops for secondary Conjunctivitis If theres a sknin condition causing the bleph, you must treat the skin condition first |
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What is the Tx for Angular and Ulcerative Bleph? |
Lid hygiene, Topical ointment and antibiotic drops if secondary conjunctivitis is present FU in a few days to a week depending on the severity |
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If a patient presents with Ulcerative bleph with a lot of dandruff around the eyes, What would you do? |
First I would treat the seborrhea with over the counter shampoos. Then after treating the Skin condition, I would then go after the blepharitis I would first assess whether or not the patient has any secondary Conjunctivitis. If so I would use an Antibiotic drop then a lid ointment for 3-4 weeks |
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What is the steps to take when treating Blepharitis |
1. Treat any underlying skin conditions first 2. treat and secondary conjunctivits 3. Treat the Bleph and have them follow up in 1- 7 days depending on the severity |
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Staph Bleph |
Sx: Collarettes 'rings' Broken/lost Eyelashes Corneal infiltrates on the inferior portion of the cornea HALF the pt with Staph Bleph will have dry eye
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Treatment for Staph Bleph |
Have patient clean eyelids with warm water daily and cleanse with over the vounter eyelid cleaners or diluted baby shampoo Might want to use Omega 3s fatty acid supplement *Hypochlorous Acid |
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MGD due to Bleph |
Bleph resulting in the blockage of the meibomian glands YOU WILL SEE Decreased TBUT YOU WILL SEE CAPPED GLANDS Sx: Irritation burning and mild conjunctival hyperemia |
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Tx for Bleph with MGD |
Lid scrub, Warm Compress, in office gland expression, Lid massage If secondary infection occurs prescribe some antibiotics FU in 2-4 Weeks |
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Hordeolum |
External- Zeiss Glands Internal- meibomian glands |
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Internal Hordeolum |
Staph Areus infection in the meibomian glands Sx: Red hot swollen painful lump in the lid YOU MUST Palpate to reveal focal area generally presents in 24-48 hours You must check for preseptal cellulitis Tx- Hot sokes qid Antibiotic ointment (polysporin) bid or tid IF SIGNS OF PRESEPTAL CELLULITIS use oral antibiotic ERYTHROMYCIN 250mg qid, Tetracycline 250mg qid or Augmentin 250mg q6h ***FU: 3-7days, if you suspect compliance issues then follow up in 24-48 hours*** |
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What are the drugs to treat internal Hordeolums? |
For just internal hordeolum Polysporin- Antibiotic Ointment If signs of preseptal cellulitis * Erythromycin 250mg qid * Tetracycline 250mg qid * Augmentin 250 mg q6h |
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Which one of these medications would you not use to treat internal hordeolums with possible signs of Preseptal cellulitis in a child? |
A. Tetracycline 250mg qid
B. Augmentin 250mg q6h C. Erythromycin 250mg qid D. All of the above A. NEVER USE TETRACYCLINE ON KIDS when treating thes patients the F/U should be 3-7 days unless non compliance (24-48hours) |
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Preseptal Cellulitis |
Red Swollen lid warm tender *A FEVER mAY Develope Tx with Oral antibiotics (Augmentin) |
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Orbital Cellulitis |
Pain in the eom common with a sinus infection Must be treated with IV antibiotics |
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Chalazions |
Tx hot sokes qid FU in 1 month then 3-6 months If this leeps showing up in the same locatoin send in for biop sy **Pos Sebaceous Gland carcinoma Steroidal injections Triamcinolone 1-2ml |
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ACNE Rosacea |
Caused by the unknown etiology causes hypertrophy of the sebaceous glands often asso with meibomitis and blepharitis Tx: * Tentracycline 25omg qid x 1 month * Doxycycline 100mg bidx 1 mo; then 100mg qd X 6 months * Topical Metrogel |
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Which one of these is not a Tx for Acne rosacea |
A. Augmentin 250mg qid X 1mo B. Tetracycline 250mg qid X 1 mo then 250mg qd x 6 mo C. Metrogel D. Doxycyxline 100 mg bid X 1 mo then 100mg qd x 6mo A. Augmentin is not a given Tx for ACNE rosacea |
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What dose of Tetracycline would you give for rosacea? |
250mg qid x 1 Mo; then 250mg qd X 6mo |
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What dose of Doxycyline would you give for ACNE rosacea? |
100mg bid x mo; then 100mg qd X 6mo |
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Which drug for Acne Rosacea would be 100mg bid x 1 mo; then 100mg qd x 6mo |
Doxycycline |
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What dose of Tetracycline would you give for someone with acne rosacea? |
250mg qid x 1 month; then 250mg qd for 6mo |
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Impetigo Contagiosa |
Most common skin infection in kids crusts over skin caused by bacterial infection or trauma. treatmen in body hygiene |
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True or false 90-95% of adults over 45 will have a demodex infestation |
True |
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Tx for mites. |
Topical medications iF mites are deep in the glands you might want swab ether on the skin to get them to come up to the surface of the skin and then do scrubs for 5 minutes |
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Phthirisis Palpebarum |
CRABS Tx- Bland ointment qs-bid x 7-10 days Must treat the hair with OTC Treatment (Kwell) |
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DOC for Herpes? |
Oral Acyclovir *will also reduce scarring from VZV if used ithin the first 24-48hrs |
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What is Verrucae? |
Viral warts appear as papillomas |
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What is the TX options for dacryostenosis |
Treat any infectionss first. remove the obstruction (D and I) Refer the elderly |
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Dacryoadenitis |
Inflammation of the lacrimal gland. Most common in kids and young adults ***ASSO WITH MONO*** |
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Sx of Dacryoadenitis |
Dull pain pain over outer 1/3 of upper eye tearing HA DIPLOPIA on superior gaze S shaped lid preauricular node |
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Causes of DacryoADENITIS |
Bacterial STAPH and STREP Viral Mumps Zoster and MONO |
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When you think of Dacryoadenitis what associated disease is common with it? |
MONO |
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Tx for Dacryoadenitis |
* Hot comp qid * Antibiotic drops 10-14 days * Systemic Antibiotics 10-14 days * if suspicion of Viral refer to internest |
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Dacryocystitis |
Infection of the Lacrimal gland Caused by BUGS (Stap strep or G-) |
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Dacryocystitis |
UNILATERAL Acute inflammation over the sac area Signs Epiphora mucopurulent discharge |
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Tx for Dacryocystitis |
* Hot soaks * Antibiotics drops qid * Systemic antibiotic drops for 10days Drugs: Dicloxacillin 250mg qh6 Cephalexin 250-500mg q6h Augmentin 125-250mg q8h once sx resolve, D and I massage sac FU- 3-5 days |
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X |
X |
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Jones Tests |
1st- NaFl run through the nose= NEGATIVE 2nd- Irrigate the System and see where the NaFl goes (should wash out of nose because there shouldn’t be ANY complete blockage normally) |
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H |
B |
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Irrigation and Dilation |
If the second Jones tests pools then you must irrigate and Dilate the Punctum 1st Anesthetize the eye and Punctum and then dilate the Punctum using ur dilator tool Then you irrigate the Punctum and see where the Saline goes |
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Outcomes of the D and I |
1- Pt should taste the saline because it should drain to the back of the throat *this means there’s a blockage in the canaliculus 2- The pt doesn’t report the taste and the saline drains into the other canaliculus * This means there’s a blockage in the Lacrimal sac or the Common Canaliculus |
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Tx for Dacryostenosis |
-Treat any infections -try and remove the Blackfeet with irrigation or if it’s mucous blockage use WARM Compress -If there any possibly sign of a tumor send them to an OculoPlastic surgeon |
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Who most likely gets Dacryostenosis and why? |
Elderly people are more common to have Dacryostenosis because they generally have mechanical issues or are on multiple different medications that could cause this |
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Daryoadenitis |
Inflammation of the Lacrimal Gland Signs -Kids with MONO -Ptosis -Dull pain, HA -Possible Proptosis |
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Causes of Dacryoadenitis |
Bacterial -Staph or Strep Viral -Mumps -Zoster -MONO |
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Tx for Dacryoadenitis |
Warm compresses Antibiotic Drops qid for 10-14d Systemic antibiotics 10-14 days (CT if Proptosis to rule out tumor) If suspicion of Viral etiology send them to an internist |
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True or False Dacryoadenitis can be treated with only Systemic Antibiotics and Antibiotic drops? |
NO This is the tx for bacterial but first you must rule out any tumors by getting an CT Can possibly be a viral infection so you would have to send them to an internist |
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T/F the treatment for Dacryostenosis is System/Drop of Antibiotics qid 10-14 days? |
False, Dacryostenosis is the narrowing of the canaliculus. This would be the Tx for Dacryoadenitis -Antibiotic drops qid 10-14d -Systemic antibiotics 10-14 days -Warm compresses -Poss viral infection send them to an internist |
