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54 Cards in this Set

  • Front
  • Back
what are the RED FLAGS of conjuctivitis
photophobia
visual loss
fixed pupil
Jane complains of red, watery eyes with itching and swelling and states that it occurs around the same time each year what does she have?
allergic conjuctivitis
how do you treat allergic conjuctivitis
avoid allergen
Naphazoline/pheniramine (OTC) - Napcon-A/Opcon-A

H1 antagonist: azelastine, emedastine
Mast cell stabilizer: cromolyn, lodoxamide, nedocromil
NSAID - Ketorolac
aside from redness, watery tearing, and mucus discharge what else may you see with Viral Conjuctivitis
pharyngitis
fever
malaise
how do you treat viral conjuctivitis
cold compress
artificial tears
NO STEROIDS
empirically treat with gentamicin/sulfacetamide to prevent 2ndary infections
Jane is in kindergarten and has Pink Eye her mother asks you when she can return to school
she can not return to school until tearing stops (viral conjuctivitis)
what are the possible pathogens for bacterial conjuctivitis in:
neonates
children
sexually active adults
adults
neonates - S. pneumoniae, P aeruginosa, Chalmydia, S. aureus
Gonorrhea

Children - S. pneumonia, S. aureus, P aeruginosa


sexually active adults - gonorrhea, chlamydia

adults - S. aureus, S. pneumoniae
what eye infection presents with Mucopurelent discharge (white, yellow, green) with complaints of eyelashing sticking together, crusting
bacterial conjuctivitis
what conjuctivitis has a lose in visual acuity and NO photophobia
bacterial
Jane is suffering from a bacterial conjuctivitis due to a S. aureus infection her mom wants to know when she can return to school
students can return to school once antibiotics start
how do you treat bacterial conjuctivitis
can resolve without ABX
warm compress
no eye patches
what topical antibacterial agents can be used to treat bacterial conjuctivitis
bacitracin - good against S. aureus
Erythromycin/Sulfacetamide - good against gram + but increase staph resistant
Fluroquinolones - if suspected pseudomonas or corneal ulcers
Tobramycin/Gentamicin - gram - infections
what is the cause of Inclusion Chlamydial conjuctivitis
new born infected with chlamydia via birthcanal
sexual transmission with concurrent genital infection
what is the cause of Trachoma Chlamydial conjuctivitis
non sexual chalmydial infection in developing countries that involves the eyelid turning inward (eyelid scarring) and rubbing against the cornea which can lead to blindness (#1 cause of blindness in some countries)
Jane has an eye infection that presents with redness of conjuctiva the gram stain comes back with a gram negative diplococci what does she have
gonococcal conjuctivitis
how does gonococcal conjuctivitis present
profuse mucopurelent discharge
"fountain of pus"
what systemic antibiotics can be used to treat Gonococcal or Chlaymdial conjuctivitis
Chlamydial - ceftriaxone
Gonococcal
- erythromycin for neonates and children < 8 and <45 lbs
- azithromycin for children <8 but >45 lbs
-daptomycin or azithromycin for everyone >8
what eye infection is due to a obsctruction of the nasolacrimal system
dacryocystitis
Jane presents to the pharmacy complaining of redness of lacrimal sac, swelling, and purulent material what eye infection does she have
dacryocystitis
what are the causes of acute and chronic dacryocystitis
acute: s. aurea, streptococcus
chronic: s. pneumoniae, gram - bacteria, candida
how can you treat Dacryocystitis
warm compress
topical/oral antibiotics: cephalexin
which eye infection occurs as inflammation of the eyelids
blepharitis (may be chronic)
Jane complains of a gritty sensation in her eyes and of a buildup of debris on eyelashes, and thickened eyelids what eye infection does she have
blepharitis
how do you treat blepharitis
lid hygeine
clean eyelashes with baby shampoo and clean washcloth
warm compress
Topical abx (erythromycin, bacitracin)
what is the causative bacteria in Hordeolum
s. aureus
infection of lash follicle and sebaceous gland: internal or external hordeolum
external hordeolum
infection of meibomian gland: internal or external hordeolum
internal hordeolum
how do you treat external hordeolum
warm compress
how do you treat internal hordeolum
community acquires MRSA - SMZ/TMP
nosocomial acquired MRSA - Linezolid
MSSA - PCN
what eye infection is due to the inflammation of meibomoion gland due to clogging of pores
chalazion
Internal Hordeolum and Chalazion are both due to inflammation of meibomion gland but how are they different
internal hordeolum:
pain ful

chalazion
painless
how do you treat Chalazion
warm compress and lid scrubs
-if ineffective invert eyelid for incision and drainage
Jane has just undergone eye surgery and has come down with a nasty eye infection what is it?
endophthalmitis (complication of open eye surgery (cataracts) or injury)
what are the cases in which Endophthalmitis can occur
post op
post traumatic
hematogenous spread
what eye infection presents with hypopyon
endophthalmitis
corneal ulcers
if endophthalmitis is due to hematogenous spread what do you do
empiric IV antibiotics for meningitis
what eye infection presents as inflammation of cornea
keratitis
Jane is complaining of a painful eye with foreign body sensation and photophobia what does she have
keratitis (painful eye with froeign body sensation, photophobia, tearing, vision changes)
or
corneal abrasion
how do you treat Keratitis
topical antibiotic or antifungal
Jane is complaining of a pain in cornea with foreign body sensation and photophobia what does she have
corneal abrasion
how do you treat corneal abrasions
aggressive lubrication
remove foreign body
eye patch for 1st 24 hrs
which eye infection can you cover with an eye patch and can't cover with an eye patch
corneal abrasion - can cover with eye patch within 1st 24 hrs

bacterial conjuctivitis - can't cover with eye patch
contact lens infections are more likely due to what bacteria
pseudomonas
Jane got hit in the eye with a tree branch what is the most likely causative agent
fungal
how do you treat corneal ulcers
empiric topical antibiotics (most often FQ)
antifungal if trauma due to vegetative matter
Jane just got over a cold and now her eyelid has swollen what does she have
preseptal cellulitis
-due to upper respiratory infection, sinus infection, skin infection, trauma
Jane is suffering from eyelid edema but everything else is normal what does she have
preseptal cellulitis
Jane has just had a tooth removed and now her eyelid is swollen what does she have
post septal (orbital) cellulitis
what eye complications can result from sinusitis
pre and post septal cellulitis
how do you treat stage 1 (preseptal cellulitis) postseptal orbital cellulitis
oral antibiotics outpatient
how do you treat stage 2 (edema, proptosis, CT with mucosal swelling) postseptal orbital cellulitis
IV antibiotics immediately for 10-14 dyas
how do you treat stage 3 (occasional visual loss, abscess on CT, globe displacement, extraocular muscle involvement) postseptal orbital cellulitis
IV antibiotics ASAP
surgical drainage if no improvement in 24 hrs
how do you treat stage 4 (vision loss, CT shows proptosis, abscess formation, rupture) postseptal orbital cellulitis
IV antibiotics immediately and surgical management
what infections can be treated with warm compress
bacterial conjuctivitis
dacryocystitis
blepharitis
external hordeolum
chalzion