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54 Cards in this Set
- Front
- Back
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how do you dx adult clamydial infxn of the eye
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PCR for DNA
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what do you treat adult chlamydial infxn with
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topical erythromycin or tetracycline
systemic azithromycin or doxycycline |
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what are the sign of adult chlamydial infection
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Watery or mucopurulent d/c
Large follicles on the underside of the lid Peripheral corneal infiltrates (2-3 wks after initial px) Preauricular lymphadenopathy TTP |
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how do you dx meningococcal conjunctivitis
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acute conjunctivitis with subconjunctival hemorrhage, tender periauricular lymphadenopathy, ***keratitis in 30% can lead to ulcer and perforation
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how do you tx meningococcal conjunctivits
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topical PCN or ceftriaxone gtts (or cipro)
-close contact with dz give cipro |
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how is trachoma transmitted
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flies, poor hygiene
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what serotypes of chlamydia trachomatis cause infxn
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A, B, Ba, C
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what is the number one cause of preventable blindness in the world
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chlamydia trachomatis
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what are sx of active trachoma
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mized follicular and papillary with mucopurulent d/c, shallow depression in upper limbus, looks kinked, pannus formation
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what is the tx for trachoma
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azithromycin erythromicin, topical tetracycline, surgery to maintain lid closure
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what does chronic trachoma look like
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Linear/stellate scars on the conjunctiva or broad confluent scars (Arlt lines) in severe disease
Involves the entire conjunctiva but mostly the upper limbus |
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what are the major offenders involved in neonatal conjunctivitis
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n gonorrhea, and c trachomatis
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what do we use in the US for prophylaxis of neonatal conjucntivits
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topical erythromicin right after birth
other coutries use providine iodine or tetra |
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b/l lid edema 3-19 days after birth, with seroanguineous ten mucopurulent d/c, psuedomembranes,
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neonatal conjucntivitis
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what do you do to dx neonatal conjunctivits
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gram stain
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which stains test for gonococcal infxns
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gram, chocolate, PCR
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which stains test for chlamydia
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gimsa, immunoflouresence, PCR
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what is tx for chlamydia
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oral ees, and topical erythromycin or tetra
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what is tx for gonococcal
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IV/IM ceftriaxone, or ceftaxime
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what are signs of allergic conjunctivitis
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Conjunctival injxn, large cobblestoned pattern under upper eyelid (sometimes)
Chemosis (edema of the bulbar conjunctiva that forms swelling about the cornea) Visual acuity preserved |
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what is the only nasal steroid approved for allergic conjunctivitis
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veramyst
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what is giant papillary conjunctivitis caused by
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bad allergies, contacts
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how long do you flush a chemical n your eyee
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at leadt 15 mins unless it gets better before then
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Major cause of corneal scarring around the world!!!
Most common infectious cause of blindness in developed countries!!! |
herpes keratitis
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what are sx of herpes keratitis
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mild discomfort, blurry vision, watering
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signs of herpes keratitis in chronological order
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Opaque epithelials arrange in a stellate or course punctate pattern
Central desquamation results in a dendritic ulcer (usually in the middle of the eye)>Ulcer has terminal buds & stains well with fluroscein Decreased corneal sensation (thankfully)>After healing, there may be epithelial erosions which impair vision |
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what are topical tx of herpes keratitis
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Trifluorothymidine
Acyclovir Vidarabine Gancyclovir |
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what are common causes of blepharitis
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seborrheic dermatitis, rosacea or infection
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what are the major offending organisms of bacterial orbital cellulitis
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S. pneumonia
S. aureus S. pyogenes H. influenza |
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Rapid onset of fever, orbital/eye pain, visual impairment & severe malaise,U/L tender, warm & erythematous periorbital edema
ProptosisForward displacement & entrapment of the eye Can be obscured by lid edema Painful ophthalmoplegia Paralysis of 1+ eye muscles Usu lateral & down Optic nerve dysfxn |
bacterial orbital cellulitis
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what do you do every four hours after admitting someone for bacterial orbital cellulitis
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check optic nerve fxn
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how do you treat bacterial orbital cellulitis
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Ceftazidime (Fortaz), Metronidazole
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how is preseptal cellulitis diff than bacterial oribital cellulits
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Proptosis absent
Chemosis absent Visual acuity is unimpaired Pupillary rxns are unimpaired EOMI |
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how is preseptal cellulitis usu caused
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skin trauma
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Infxn of the subcutaneous tissues anterior to the orbital septum
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preseptal celluliits
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what is tx preseptal cellulitis
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amoxicillin-clav
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who usu gets rhino mucomycosis
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DM, DKA, or immunosupressed
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Hyphae can invade vasculature causing occlusive vasculitis with ischemic infarcts
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rhino orbital mucormycosis
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Black eschar, Ischemic infarction superimposed on septic necrosis, Can develop on palate, turbs, nasal septum, eyelids, skin
Ophthalmoplegia Slower progression than bacterial orbital cellulitis |
rhino orbital cellulitis
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tx of rhino orbital mucormycosis
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IV amphotericin, Daily packing & irrigation of infected areas with amphotericin, Wide excision of necrotic & devitalized areas
Hyperbaric O2 maybe helpful Correct underlying metabolic defect |
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localized area of inflam of eye
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episcleritis-- tx with artificial tears
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Inflammation of intraocular structures including the uveal tract, the retina, the retinal vessels, the vitreous, the iris (iritis), or the entire eye. sudden onset
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uveitis
limited <3 mo |
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what is imp to know ab someone that has uveitis
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what is the fam hx? arthritis,JRA, reiters
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combination of urethritis, arthritis and uveitis
“Can’t see, can’t pee, can’t climb a tree” |
reactive arthritis (reiters)
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turning out of lower eyelid
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ectropion
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inturning of the eyelide, can cause ulcerations
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entropion
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what is tx of chalazion
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1/3 resolve spontaneously
Surgery Steroid injxn Systemic tetracycline (esp with assoc rosacea) |
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Acute Staph Abscess of a lash follicle & its Gland of Zeis
More common in kids Tender swelling in the lid margin Can be multiple lesions |
external hordeolum
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A U/L PAINFUL RED EYE ASSOC WITH VOMITING IS ACUTE
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angle closure glaucoma
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who gets tunnel visioon
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open angle glaucoma
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Bleeding from iris or cilliary body
Generally caused by blunt trauma Like a racquetball |
hyphema- observe for secondary hem- can occur up to 7 days after trauma
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___ and __ cause hemorhagic conjucntivitis
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enterovirus and coxsackie
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Nml vision, Nml pupillary response and size, diffuse injection (redness), preauricular lymphadenopathy
Mild/no pain, diffuse hyperemia (increased blood flow), gritty feeling (occ), mild itching, watery or serous d/c, uncommonly photophobia (can be u/l or b/l) |
viral conjunctivitis
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Acute profuse discharge (purulent)
Severe eyelid edema & tenderness Conjunctival hyperema, chemosis, profuse purulent d/c Pseudomembrane formation (bad) Ulceration Perforation Lymphadenopathy |
gonococcal keratoconjunctivitis
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