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54 Cards in this Set
- Front
- Back
what are the RED FLAGS of conjuctivitis
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photophobia
visual loss fixed pupil |
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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?
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allergic conjuctivitis
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how do you treat allergic conjuctivitis
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avoid allergen
Naphazoline/pheniramine (OTC) - Napcon-A/Opcon-A H1 antagonist: azelastine, emedastine Mast cell stabilizer: cromolyn, lodoxamide, nedocromil NSAID - Ketorolac |
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aside from redness, watery tearing, and mucus discharge what else may you see with Viral Conjuctivitis
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pharyngitis
fever malaise |
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how do you treat viral conjuctivitis
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cold compress
artificial tears NO STEROIDS empirically treat with gentamicin/sulfacetamide to prevent 2ndary infections |
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Jane is in kindergarten and has Pink Eye her mother asks you when she can return to school
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she can not return to school until tearing stops (viral conjuctivitis)
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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 |
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what eye infection presents with Mucopurelent discharge (white, yellow, green) with complaints of eyelashing sticking together, crusting
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bacterial conjuctivitis
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what conjuctivitis has a lose in visual acuity and NO photophobia
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bacterial
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Jane is suffering from a bacterial conjuctivitis due to a S. aureus infection her mom wants to know when she can return to school
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students can return to school once antibiotics start
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how do you treat bacterial conjuctivitis
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can resolve without ABX
warm compress no eye patches |
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what topical antibacterial agents can be used to treat bacterial conjuctivitis
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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 |
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what is the cause of Inclusion Chlamydial conjuctivitis
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new born infected with chlamydia via birthcanal
sexual transmission with concurrent genital infection |
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what is the cause of Trachoma Chlamydial conjuctivitis
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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)
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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
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gonococcal conjuctivitis
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how does gonococcal conjuctivitis present
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profuse mucopurelent discharge
"fountain of pus" |
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what systemic antibiotics can be used to treat Gonococcal or Chlaymdial conjuctivitis
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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 |
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what eye infection is due to a obsctruction of the nasolacrimal system
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dacryocystitis
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Jane presents to the pharmacy complaining of redness of lacrimal sac, swelling, and purulent material what eye infection does she have
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dacryocystitis
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what are the causes of acute and chronic dacryocystitis
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acute: s. aurea, streptococcus
chronic: s. pneumoniae, gram - bacteria, candida |
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how can you treat Dacryocystitis
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warm compress
topical/oral antibiotics: cephalexin |
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which eye infection occurs as inflammation of the eyelids
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blepharitis (may be chronic)
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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
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blepharitis
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how do you treat blepharitis
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lid hygeine
clean eyelashes with baby shampoo and clean washcloth warm compress Topical abx (erythromycin, bacitracin) |
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what is the causative bacteria in Hordeolum
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s. aureus
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infection of lash follicle and sebaceous gland: internal or external hordeolum
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external hordeolum
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infection of meibomian gland: internal or external hordeolum
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internal hordeolum
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how do you treat external hordeolum
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warm compress
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how do you treat internal hordeolum
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community acquires MRSA - SMZ/TMP
nosocomial acquired MRSA - Linezolid MSSA - PCN |
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what eye infection is due to the inflammation of meibomoion gland due to clogging of pores
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chalazion
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Internal Hordeolum and Chalazion are both due to inflammation of meibomion gland but how are they different
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internal hordeolum:
pain ful chalazion painless |
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how do you treat Chalazion
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warm compress and lid scrubs
-if ineffective invert eyelid for incision and drainage |
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Jane has just undergone eye surgery and has come down with a nasty eye infection what is it?
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endophthalmitis (complication of open eye surgery (cataracts) or injury)
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what are the cases in which Endophthalmitis can occur
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post op
post traumatic hematogenous spread |
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what eye infection presents with hypopyon
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endophthalmitis
corneal ulcers |
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if endophthalmitis is due to hematogenous spread what do you do
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empiric IV antibiotics for meningitis
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what eye infection presents as inflammation of cornea
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keratitis
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Jane is complaining of a painful eye with foreign body sensation and photophobia what does she have
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keratitis (painful eye with froeign body sensation, photophobia, tearing, vision changes)
or corneal abrasion |
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how do you treat Keratitis
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topical antibiotic or antifungal
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Jane is complaining of a pain in cornea with foreign body sensation and photophobia what does she have
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corneal abrasion
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how do you treat corneal abrasions
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aggressive lubrication
remove foreign body eye patch for 1st 24 hrs |
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which eye infection can you cover with an eye patch and can't cover with an eye patch
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corneal abrasion - can cover with eye patch within 1st 24 hrs
bacterial conjuctivitis - can't cover with eye patch |
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contact lens infections are more likely due to what bacteria
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pseudomonas
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Jane got hit in the eye with a tree branch what is the most likely causative agent
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fungal
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how do you treat corneal ulcers
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empiric topical antibiotics (most often FQ)
antifungal if trauma due to vegetative matter |
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Jane just got over a cold and now her eyelid has swollen what does she have
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preseptal cellulitis
-due to upper respiratory infection, sinus infection, skin infection, trauma |
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Jane is suffering from eyelid edema but everything else is normal what does she have
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preseptal cellulitis
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Jane has just had a tooth removed and now her eyelid is swollen what does she have
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post septal (orbital) cellulitis
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what eye complications can result from sinusitis
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pre and post septal cellulitis
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how do you treat stage 1 (preseptal cellulitis) postseptal orbital cellulitis
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oral antibiotics outpatient
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how do you treat stage 2 (edema, proptosis, CT with mucosal swelling) postseptal orbital cellulitis
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IV antibiotics immediately for 10-14 dyas
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how do you treat stage 3 (occasional visual loss, abscess on CT, globe displacement, extraocular muscle involvement) postseptal orbital cellulitis
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IV antibiotics ASAP
surgical drainage if no improvement in 24 hrs |
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how do you treat stage 4 (vision loss, CT shows proptosis, abscess formation, rupture) postseptal orbital cellulitis
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IV antibiotics immediately and surgical management
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what infections can be treated with warm compress
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bacterial conjuctivitis
dacryocystitis blepharitis external hordeolum chalzion |