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30 Cards in this Set
- Front
- Back
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What is a hordeolum also known as? |
Stye |
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Pathophysiology hordeolum |
Acute bacterial infection of the follicle of an eyelash and adjacent sebaceous gland or sweat gland.
Occur when a gland in or on the eyelid becomes plugged or blocked. |
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Pathophysiology hordeolum |
It is located at the lash line and has the appearance of a small pustule at the margin of the eyelid.
This can occur if the gland's opening is obstructed by scar tissue or a foreign substance (makeup, dust), or if there is thickening of the substance produced by the gland, causing the material to flow sluggishly or not at all. |
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Clinical presentation hordeolum |
-Hordeolum often presents with pain, edema and erythema of the eyelid -Looks like a small pustule, and can be at the lash line or on the inner surface of the tarsal plate (internal hordeolum-meibomian gland assoc). |
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Common management strategies hordeolum |
-A non-infected hordeolum will resolve on its own
-Warm compresses -Erythromycin ophthalmic ointment -Removal of the offending eyelash -Antibiotics (cellulitis) -Incision and drainage (opthalmologist) |
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Pathophysiology conjunctivitis |
Condition that causes inflammationand erythema of the conjunctiva
Can be bacterial, viral, allergic It is usually of viral nature, benign and self limiting. Care has to be taken to sort out occasional more serious conditions (bacterial and corneal herpetic involvement) that could cause vision loss. Pink eye |
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Causes of bacterial conjunctivitis |
-Viruses, bacterial infections, fungal infections, parasitic, toxic, chemical irritants and allergies may all be causes.
-Caused by Staphylococcus / Streptococcus pathogens |
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Clinical presentation bacterial conjunctivitis |
-Painless unilateral / bilateral mucopurulent discharge. (causing adherence of eyelids upon awakening).
-Injected Conjunctiva(redness of the eye) -Cornea is clear -Chemosis (edema of the conjunctiva) |
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Common management strategies bacterial conjuctivitis |
-HMA may perform fluorescein stain of the cornea (to check for ulcers, corneal abrasion or hepetic dendrite)
-Culture C&S of discharge is severe cases -Topical ocular antibiotic QID for 5-7 days -Patient education about disposing of disposable contact lenses and wearing glasses until antibiotic is complete. |
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Pathophysiology viral conjunctivitis |
-is highly contagious -Usually caused by adenovirus -Cold symptoms or preceded by URI |
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Clinical presentation viral conjunctivitis |
-Usually begins as one eye then moves to both
-Complaint of “red eye” -Mild to moderate watery discharge -Usually painless -Unilateral or bilateral conjunctiva injection -Occasional chemosis -Preauricular lymphadenopathy -Small subconjunctival hemorrhages |
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Common management strategies viral conjunctivitis |
-HMA may perform fluorescein stain and use the slit lamp to rule out other causes and herpetic dendrite involvement -Only symptomatic treatment is used: 1. Cool compresses 2. Ocular decongestants (as directed) 3. Artificial tears -Patient education on frequent hand washing -Antibiotic may be prescribed if unsure if etiology is viral or bacterial -Duration: 1-3 weeks |
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Pathophysiology allergic conjunctivitis |
-Caused by allergens, known or unknown
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Clinical presentation allergic conjunctivitis |
-Watery discharge -Red and itchy eyes (swollen eyelids) -Injected and edematous conjunctiva (irregular mounds of tissue with a central vascular tuft) |
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Common management strategies allergic conjunctivitis |
-Cool compresses & topical drops
-Mild Sx- treated with artificial tears -Moderate Sx- may additionally require antihistamines or decongestant drops -Severe Sx- HMA may consult for the requirement and the use of topical steroids |
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Common management strategies conjunctivitis |
- To reduce the chance of spreading infectious, those affected should avoid touching the eye area and wash their hands frequently, particularly before applying medications to the eye area. Sharing of towels, washcloths, cosmetics, or eye drops can also spread the infection. Impress upon the Pt the importance of not cross contaminating. Provide patient education on all these precautions. Instruct pt’s to follow up as required or if sx persist or worsen, or if vision changes.
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What is a ruptured globe? |
-A ruptured globe occurs when sudden elevation of intraocular pressure causes the globe to rupture typically at the thinnest point of the sclera, the limbus, and at the insertion of the extra ocular muscle, or due to a penetrating eye injury.
-Globe rupture is a vision threatening emergency -Consult Ophthalmology immediately |
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Mechanism of injury of a ruptured globe |
-Blunt trauma can include a direct blow such as from a fist or impact to the orbital rim at a high velocity such as a ball
-Penetrating trauma can be from anything ranging from a bullet, a knife, a dart, or even a small piece of metal launched from a grinder |
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Clinical presentation ruptured globe |
-An obvious ruptured globe usually presents with a large subconjunctival hemorrhage that is easily recognized. A penetrating wound may not present as clearly, a high level of suspicion is required.
Other signs and symptoms include: -Eye pain; -May or may not have decreased VA; -Edema to the eyelid; -PHx of ocular injury / surgery may predispose to a ruptured globe. |
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Common management strategies ruptured globe |
-Determine tetanus status
-Do not manipulate the eye -Cover eye with rigid shield -Elevate the head of the bed -Consult Ophthalmologist ASAP -HMA will consult for medications -Analgesic and sedation for pain, antiemetic to prevent vomiting and an increase in intraocular pressure |
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Common management strategies in a pre-hospital and / or operational environment for a ruptured globe |
In a pre-hospital and / or operational environment follow the Med Tech CF protocol 3.8 which will be taught in PO 015; (Transport immediately to hospital)
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Define OD (Oculus Dexter) |
Right Eye
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Define OS (Oculus Sinister) |
Left Eye |
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Define OU (Oculus Uterque) |
Both Eyes |
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What are some of the indications for use of ophthalmic anaesthetic?
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Used to give the patient some comfort prior to irrigating the eye or trying to remove a foreign body.
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When can a QL3 Med Tech administer Tetracaine? |
A medical order is needed to administer these types of drops; however The QL3 Med Tech IAW protocol 3.8 can administer Tetracaine independently in a pre hospital setting. In a primary care setting they will follow an MD’s orders.
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What is the procedure for eye irrigation in the event of an emergency? |
In the case of emergencies, such as a chemical splashes into the eye, irrigation is not delayed to remove contact lenses.
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How to remove a soft lens contact? |
Grab it between the thumb and index finger |
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How to remove a hard lens contact? |
Place finger on outer portion of pt's eye, and draw back the skin. Ask patient to open eye wide open and blink. If it didn't pop out, press lower lid up against the edge of the lens. |
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Storage techniques for lenses |
Using 1-2 drops; index finger (soft) and pinky finger (hard); rub lenses 20-30 sec. Put in containers labeled L/R; rigid are stored face up. |
