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70 Cards in this Set
- Front
- Back
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what are some treatment options for keratoconus
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1. rigid contact lenses
2. corneal collagen crosslinking 3. PKP, in severe cases 4. for acute HYDROPS: pressure patch or soft CL, cyclo, analgesics |
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treatment for corneal erosion...
SEVERE MODERATE MILD |
severe:
Tobrex ung, Atropine 1% (in office), PP RTC: Next Day moderate: Vigamox, IBU and BSCL mild: Azasite, IBU, AT DEBRIDE RAGGED EDGES |
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how do you treat Fuch's Dystrophy
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1. 5% NaCl drops/ointmant qhs and in the morning
2. hair dryer 3. topical beta blocker to reduce IOP |
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what is the treatment for staph bleph
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1. lid hygiene
2. azasite-BID |
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what is the treatment for episcleritis
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OPTIONAL (depends of pts)
1. CC 2. vasoconstrictor 3. NSAIDs (drops/oral) 4. mild/strong steroid 5. 3+ recurrences, systemic workup (co-manage with internist, rheumatologist, PCP) |
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treatment for scleritis
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1. targeted workup
2. Pred Forte q1h 3. Moltrin 800mg q4h 4. co-manage with PCP and rheumatologist |
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what are the absolute contraindications for NO STEROIDS
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1. first day, keratitis w/ ulceration
2. during treatment of fungal infection (and before 2 weeks of treatment) 3. during treatment of acanthamoeba 4. during treatment of active HSV 5. any time cornea is at risk |
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weakest to strongest cycloplegic agents
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1. cyclopentolate 1%
2. homatropine 2% or 5% 3. scopolamine 0.25% 4. atropine 0.5% or 1% |
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what is the treatment for MGD
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1. LID HYGIENE
2. AT 3. doxycycline 100mg BIDx1day then QDx21days 4. steroid |
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treatment for anterior uveitis
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1. address underlying and/or accompany infections (co-manage)
2. ATROPINE 3. PRED FORTE q2h |
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Treatment for Adult Inclusion Conjunctivitis
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Zithromax 1g QD x 1 dose
OR Doxycycline 100mg BID 1st day then 100 mg QD x 21 days |
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Treatment for Neonatal Inclusion Conjunctivitis
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1. Oral erythromycin 50mg/kg/day divided into four doses for 10-14 days
2. NO CYCLINES 3. topical erythromycin ung adj therapy |
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Treatment for Trachoma
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1. Zithromax 1g QD x 1 dose
2. Doxycycline 100mg BID 1st day then 100 mg QD x 21 days |
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Treatment for SLK (mild to severe)
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1. AT, punctal occlusion, PULSE STEROID
2. acetylcysteine drops 3. cromolyn sodium drops 4. mast cell stabilizers 5. 0.5% silver nitrate 6. BSCL 7. thermal cautery and surgery |
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Treatment for Phlyctenulosis
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1. treat staph bleph...LID HYGIENE
2. if TB get CXR (refer out) 3. vasoconstrictor 4. topical steroid (combo if staph bleph) 5. topical cyclosporine A |
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what is the treatment for mixed seb-staph bleph
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1. Lid Hygiene
2. Warm Compress 3. Doxycycline p.o. 4. Vigamox-TID |
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treatment for Gonococcal Ophthalmia Neonatorium
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1. ceftriaxone IV or IM 30-50 mg/kg/day in divided doses
2. topical erythromycin ung 3. frequent lavage |
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treatment for NON Gonococcal Ophthalmia Neonatorium
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DISTINGUISH FROM GONOCOCCAL INFECTION:
1. erythromycin or bacitracin ung for gram (+) 2. gentamicin or tobramycin drops for gram (-) |
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treatment for Herpetic/Viral Ophthalmia Neonatorium
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1. Viroptic 1% q2h
2. taper according 3. treat 3 weeks for SIMPLEX 4. Ilotycin ung QID |
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what is used as a prophylaxis against ophthalmia neonatorium
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MANDATORY
1. erythromycin 0.5% ung 2. Crede's: 1% Silver Nitrate 3. AZASITE |
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treatment for neurotrophic keratopathy?
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1. mild: lubricant only
2. corneal defect: antibiotic drops, SCL, cyclo 3. if sterile ulcer gets infects, treat as infectious ulcer 4. tarsorrhaphy (suture outsides of lids together) |
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treatment for UV keratopathy
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1. Atropine
2. BSCL 3. Vigamox TID *bandage SCL one eye, pressure patch the fellow eye if one eye is worse than the other *pressure patch both eye is ideal |
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treatment for thygeson's superficial punctate keratopathy
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1. Alrex QID
2. discontinue CL 3. antibiotics NOT NECESSARY |
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what are the definitive diagnosis for syphilis?
treatment: |
1. FTA-ABS: (+) if pt has ever had syphilis
2. VDRL 3. RPR treatment: IV or IM Penicillin with probenecid |
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what is the treatment for internal hordeolum
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1. mild: hot compress QID
2. mod-sev: ORAL AB w/ hot compress 3. surgery |
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management of a lid lacerations
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1. betadine scrub: injury and surrounding tissue
2. irrigate the wound with sterile saline 3. topical antibiotic ung 4. cover wound 5. referral optional |
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management of conjunctival abrasion and laceration
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1. lavage w/ sterile saline
2. small: vigamox TID and AT 3. large: antibiotic ung and PP |
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management of corneal abrasion
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1. debride
2. cycloplege 3. <50%: vigamox TID 4. >50%: BCL and vigamox TID *RTC: next day |
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management of corneal laceration/perforation
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1. FOX SHIELD
2. PHOTODOCUMENTATION 3. REFER IMMEDIATELY |
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what is the treatment for external hordeolum
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1. let disease run course
2. hot compress 3. epilate lash 4. puncture w/ sterile syringe 5. top AB ung (gentamicin) |
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management of hyphema
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1. NO ASPIRIN NOR IBU
2. bedrest, angle head at 30deg 3. FOX SHIELD 4. ATROPINE in office 5. Pred Forte QID |
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management of lens subluxation
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1. monitor vision and lens position
2. low conc. Pilocarpine (decrease diplopia and stabilize refraction due to pinhole effect) 3. cataract surgery |
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management of lens dislocation
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anterior chamber:
1. endothelial, corneal edema and opacification risk is HIGH 2. DILATE PUPIL 3. RECLINE PATIENT 4. chronic low conc. Pilocarpine |
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what is the treatment for chalazion
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1. let run course
2. hot compress QID for 4-6wks 3. steriod injection to site 4. surgery |
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what is the treatment for preseptal cellulitis
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1. hot compress
2. oral AB 3. culture to identify 4. suspect meningitis: hospitalize + lumbar puncture + IV AB |
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what are the FIVE drugs that are used off label for corneal ulcers?
what is the dosing? |
1. Besivance
2. Moxeza 3. Vigamox 4. Zymar 5. Zymaxid dosing: q1-2h after loading |
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what is the treatment for coloboma
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1. lubricate
2. Abx ung 3. >75% missing lid=surgery |
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how would you prescribe viroptic?
what does it doe to the virus? |
Q2h up to 9x/day, TAPER, max 21days
1. Trifluridine 1% 2. inhibits DNA synthesis in virus and host cell 3. average healing time 6-8 for dendritic lesions |
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how would you prescribe zirgan?
what is it used to treat? |
5x/day until the ulcer heals, then TIDx7days
-Ganciclovir Gel 0.15% -DENDRITIC HSV -anything else will be OFF LABEL |
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GENERIC NAME:
Blephamide |
1. sodium sulfacetamide 10%
2. pred acetate 0.2% 5/10ml solution, 3.5g tube |
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what is the treatment of distichiasis
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1. none
2. mild: lubricate 3. advance: epilate lash 4. severe: cryotherapy |
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GENERIC NAME:
Cortisporin |
1. neomycin 0.35%
2. polymixin B 10000u/ml 3. hydrocortisone 1% 7.5ml suspension |
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GENERIC NAME:
Maxitrol |
1. neomycin 0.35%
2. polymixin B 10000 u/ml 3. dexamethasone 0.1% 5ml solution, 3.5g tube |
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GENERIC NAME:
Pred-G |
1. Gentamicin 0.3%
2. pred acetate 1% 10ml solution/3.5g tube |
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GENERIC NAME:
Zylet |
1. tobramycin 0.3%
2. loteprednol 0.5% 5/10ml suspension |
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what is the dosing for Acyclovir?
HSV and HZV? |
Acyclovir:
HSV: 400mg HZV: 800mg 5x/day (active) x7-10days |
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what is the dosing for Valtrax?
HSV and HZV? |
Valtrax:
HSV: 1g BID x 7-10days HZV: 1g TID x 7 days |
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which steroid comes in SUSPENSION
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1. Prednisolone acetate
2. Dexamethasone alcohol 3. Loteprednol etabonate 4. Fluorometholone alcohol 5. Fluorometholone acetate 6. Medrysone alcohol |
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which steroid comes in SOLUTION
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1. Prednisolone sodium phosphate
2. Dexamethasone sodium phosphate |
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which steroid comes in an OINTMENT
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1. Dexamethasone sodium phosphate
2. Fluorometholone alcohol |
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what are CONTRAINDICATION to systemic steroid use
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ABSOLUTE:
1. peptic ulcers 2. osteoporosis 3. psychoses 4. drugs known to interact with steroids RELATIVE: 1. diabetes mellitus 2. infectious disease 3. chronic renal failure 4. CHF |
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what are the strong steroids compared to the weak steroids
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strong:
1. pred forte 2. lotemax 3. durezol 4. pred sodium phosphate weaker: 1. alrex 2. FML 3. pred mild |
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how do you treat a fungal infection
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1. DEBRIDEMENT
2. Natamycin 5% q1h (awake) and q2h (sleep) -TAPER 3. ATROPINE 4. CC 5. Vigamox TID |
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what should you use as adjunctive antibiotics for a fungal infection
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conjunctivitis dose:
1. neomycin 2. vigamox |
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what is the treatment for acanthamoeba keratitis
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1. debride
2. PHMB and CHX q1h x 1 day then q3h x 3 days (TAPER) 3. Voriconazole 1% q1h 4. treat for 6-12 months 5. ATROPINE and CC 6. PKP NO STEROIDS unless infection is under control |
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how do you treat adenoviral conjunctivitis
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LIMIT SPREAD OF INFECTION
1. wash hands 2. dont share bedding 3. use then discard tissues 4. DISCARD CLs SUPPORTIVE TREATMENT: 1. AT 2. vasoconstrictors 3. cool compress 4. NSAIDs betadine and Zirgan (off label) |
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TREATMENT: EKC
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1. supportive
2. with PEK-polytrim q3h AVOID steroids if possible |
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how do you treat HSV (active epithelial disease)
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1. debridement
2. zirgan 5x/day 3. atropine 4. CC 5. RTC: NEXT DAY |
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what will you do if the patient does not want drops for HSV
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1. debridement
2. oral: acyclovir 400mg 5x/day 3. NO STEROID 4. FOLLOW DAILY |
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how would you treat HZV
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1. TOPICAL STEROID (oral may be used if the symptoms are bad enough)
2. ORAL ANTIVIRALS -acyclovir 800mg 5x/day for 7-10 days -valtrex 1g TID Supportive Therapy: 1. AT, topical NSAIDs, vasoconstrictors. 2. TCA, opiates, and anticonvulsants considered for post herpetic neuralgia |
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Herpetic Interstitial Keratitis Treatment
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1. Viroptic QID
2. Pred Forte QID for non-herpetic IK just PRED FORTE QID |
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which steroid comes in SUSPENSION
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1. Loteprednol etabonate
2. Dexamethasone alcohol 3. Medrysone alcohol 4. Fluorometholone alcohol 5. Fluorometholone acetate 6. Prednisolone acetate |
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which steroid comes in SOLUTION
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1. Prednisolone sodium phosphate
2. Dexamethasone sodium phosphate |
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which steroid comes in an OINTMENT
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1. Dexamethasone sodium phosphate
2. Fluorometholone alcohol |
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what are the 11 systemic effects of corticosteroid therapy
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1. Adrenal insufficiency
2. Cushing's syndrome 3. Peptic ulceration 4. Osteoporosis 5. Hypertension 6. Muscle Weakness/atrophy 7. Growth Inhibition 8. Diabetes 9. Infection 10. Mood changes 11. Delay wound healing |
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what are the advantages and disadvantages of TOPICAL steroid
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Advantage:
1. Local application 2. Simple to apply 3. Can treat uniocular disease 4. Avoids most systemic effects Disadvantages: 1. Adrenal suppression 2. Aggravation of dendritic ulcer 3. White residue 4. Epithelial keratopathy from frequent application 5. Occasional conjunctival infections |
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what are the ADVANTAGES of Periocular application of steroids
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1. Local application
2. Treat one eye and use other as control 3. Treat worse of two eyes 4. Treat uniocular diseases 5. Avoid most systemic effects 6. Used when patient can't take medication 7. Prevent flare-up during surgery |
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what are the DISADVANTAGES of Periocular application of steroid
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1. adrenal suppression
2. discomfort with injection 3. white residue 4. subconjunctival adhesion 5. allergy to diluent 6. infection 7. papilledema 8. exophthalmos and rugae in fundus 9. ulceration of conjunctiva after repeated injections if not given behind the eye |
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what are the advantages and disadvantages of systemic steroids
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Advantages:
1. easy administration of tablets 2. better at reaching all parts of eye Disadvantages: 1. adrenal suppression 2. systemic side effect |
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when do you use a steroid
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1. anterior uveitis
2. trauma 3. Thygesons 4. interstitial keratitis 5. phlytenulosis 6. scleritis/episcleritis |
