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5 Cards in this Set
- Front
- Back
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Episcleritis sector redness |
Mild: 1. artificial tear Artelac qid 2. vasoconstrictor Brimonidine 0.025% qid
Moderate to severe: 1. mild topical steroid e.g. FML 0.1% qid 2. Oral NSAID e.g. Ibuprofen 200 to 600 mg po tid to qid
FU: only AT treatment several week Topical steroid treatment 2-3 weeks |
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Scleritis severe pain and boring eye pain, diffuse redness |
1. Oral NSAID e.g. Ibuprofen 400-600 mg po qid 2. Systemic steroid prednisolone 100mg po qd for 1 week followed by a taper to 20 mg qd over the next 2-3 weeks 3. Cyclosporine - FU: depend on the severity of the symptoms and the degree of scleral thinning |
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Anterior uveitis sign (5) |
1. Cell and flare in anterior chamber
2. Ciliary flush: engorged conjunctival vessels, especially at corneal edge
3. Keratic precipitate (KP): an inflammatory cellular deposit seen on corneal endothelium
4. IOP: can be lower or higher 5. Irregularly-shaped pupil (sometimes) |
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Differentiate diagnose from anterior uveitis |
1. Keratitis: may cause foreign body sensation 2. Angle-closure glaucoma: causes marked elevated intraocular pressure and often cloudy cornea 3. Endophthalmitis: causes hypopyon 4. Scleritis: often causes focal redness of conjunctiva 5. Conjunctivitis: causes no pain or photophobia |
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Anterior uveitis treatment |
1. Cycloplegic - homatropine 5% bid for mild - atropine 1% bid for severe inflammation
2. Topical steroid - Prednisolone acetate 1% gtt q1-6 h - FML ophthalmic ointment at night - need to rule out infection
3. Treat secondary glaucoma No prostaglandins/ pilocarpine
FU: every 1 - 7 days in acute phase Every 1-6 month when stable Anterior chamber reaction and IOP should be monitored Fundus and vitreous examination should be performed for all flare up or when vision is affected or every 3-6 months
Steroid must be slowly tapered The rate should be 1 gtt per day every 3-7 days Qid for 1 week, then tid for 1 week, then bid for 1 week Discontinued following the taper when the AC does not have any cellular reaction No sudden stop: rebound |
