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85 Cards in this Set
- Front
- Back
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Myopia (nearsighted) is a condition where the light rays are focused where on the retina?
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In front of the retina enabling clear vision for a short distance.
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Hyperopia (farsighted) is a condition where the light rays are focused where on the retina?
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Behind the retina due to the flatting of the globe of the eye or of an error in refraction.
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What is a defect of vision associated with advancing age and loss of accomodation?
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Presbyopia.
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What is the usual age of onset for presbyopia?
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Between 40-45.
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What affects the Zeis glands or glands of Moll ate the edge of the lid?
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External Hordeolum (Sty).
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This is a localized, purulent inflammatory staph infecton of one or more sebaceous gands of the eye lids
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Hordeolum.
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If an abrasion is suspected but cannot by seen what can be used and what would be seen?
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Fluorescein stain, area of abrasion will stain a deeper green than surrounding cornea.
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This may develop at any age usually following minor trauma, straining, sneezing, or coughing?
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Subconjunctival Hemmorrage.
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Subconjuctival Hemmorrage rarely occur spontaneously or may indicate what?
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Systemic coagulopathy or sysemic hypertension.
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What should be tested both before and after treatment of an ocular foreign body?
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Visual Acuity
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What is used to remove an ocular foreign body?
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Sterile, wet CTA
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Which types of foreign body will occasionally leave a rust ring?
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Steel
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Fine silk is used to repair what type of lid lacerations?
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Minor lid laceration.
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Major lacertions involving the lacrimal apparatus should be repaired by who?
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Ophthalmic surgeon.
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Destruction of the corneal epithelium by ultraviolet light is known as what?
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Actinic Keratitis, ultraviolet keratitis (Flash Burn).
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Ultraviolet burns of the cornea are usually caused by what?
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Use of sunlamp with eye protection, exposure to a welding arc, or exposure to the sun when skiing.
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What is the treatment for flash burn?
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Bilateral patching for 24 hours, instillation of 1-2 gtts short acting cycloplegics, use of ophthalmic antibiotic, provide systemic analgesics for pain. Recovery in 12-36 hours.
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Blood in the anterior chamber is called what?
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Hyphema
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What is the immediate treatment for hyphema?
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Bedrest with head elevated at 60 degrees. Sedate patient with both eyes covered.
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What is given if IOP is increased with hyphema?
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Acetazolamide 250mg P.O. q6 hours or other carbonic anhydrase inhibitors (methazolamide)
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What medication is used for total hyphema?
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IV mannitol 20% 250-500 ml over 2-3 hours.
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What products are contraindicated in hyphema?
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Products containing aspirin.
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What is essential in the disposition of hyphema?
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Acute care by an ophthalmologist, including exam of the optic nerve head.
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What is the difference between penetrating and perforating eye injury?
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Penetrating - disruption of outer coat of eye (sclera) without interupting anatomic continuity thus preventing prolapse.
Perforating - complete anatomic disruption. |
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What is the treatment for an ocular penetration wound?
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Relieve pain, preserve or restore vision, achieve good cosmetic result.
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Why should a patient with a rupture of the ocular globe be NPO?
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Pending surgery.
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What is medication used to relieve pain of an rupture of the ocular globe?
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Morphine 2-4mg IV or SC PRN.
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What is use to avoid inadvertant pressure that could extrude contents in a rupture of the ocular globe?
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Binocular eye patch and a metal shield.
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What medications can be given to prevent further injury with a rupture of the ocular globe?
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Antiemetics.
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In a blowout fracture this gives way because it is the weakest component of the orbit.
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The orbital floor.
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What confirms ocular muscle entrapment as a result of a blowout fracture?
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Diplopia and restricted upward gaze.
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What may be present due to laceration of the roof of the maxillary sinus with a blowout fracture?
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Epistaxis
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Unrepaired blowout Fx may result in what?
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Permanent diplopia, disfiguring enopthalmos, and herniation of orbital contents into the antrum.
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What are two most common predisposing factors of retinal detachment?
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Cataract extraction and myopia.
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What might a pt complain of in retinal detachment?
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Painless decrease in vision, Hx of flashes of lights or sparks.
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What are the two types of lens dislocation?
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Partial (subluxation) or complete.
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Dislocation of the lens may result from what 2 things?
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Hereditary or result from trauma.
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A partial dislocation that stays behind the iris plane resulting from zonular damage or zonular irregularity is also called what?
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Subluxation.
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What are 2 common complications of dislocation of the lens?
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Iritis and glaucoma.
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What is a complication of surgical removal of the lens?
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Vitreous loss and retinal detachment.
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What is the conjunctiva?
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It is the clear, leathery outer covering of the eye.
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What are the characteristics of conjunctivitis?
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Foreign body sensation
Hyperemia Tearing Exudate Psuedoptosis Chemosis Follicles Preauricular LAD |
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What is the most conspicuous sign of conjunctivitis?
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Hyperemia.
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Copious and purulent exudate is what type of conjuctivitis?
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Bacterial.
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Exudate is stringy in what type of conjuctivitis?
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Allergic.
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What strongly suggest acute hay fever conjunctivitis?
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Chemosis (conjunctival edema).
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What is seen in most viral conjunctivitis and all chlamydial conjunctivitis and may be recognized as an avascular white or grey round structure?
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Follicles.
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What is an important sign that occurs in: HSV conjunctivitis, Epidemic keratoconjunctivitis, Inclusion conjunctivitis, Trachoma.
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Preauricular LAD.
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In gonococcal conjunctivitis what is given in regards to corneal involvement?
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If not involved: Single dose Ceftriaxone 1g IM.
If involved: 5 day course IV ceftriaxone 1-2g. |
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Trachoma is caused by what?
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Chlamydia trachomatis serotypes A-C.
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What is a major cause of blindness worldwide?
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Trachoma, which is spread by direct familial contact.
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What is caused by chlamydia serotyopes D-K, acquired through contact with infected genital secretions, and frequently in sexually active adults.
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Inclusion conjunctivitis (Blenorrhea).
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What describes inflammation of the cornea?
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Keratitis
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When does a pt with an ocular forgien body need to follow up?
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24 hours
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What is Blepharitis?
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A chronic bilat inflammation of the lid margins with redness, thickening, and often the formation of scales and crust or shallow marginal ulcers.
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Anterior blepharitis involves what structures?
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eyelid skin, eyelashes, and associated glands
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Ulcerative Ant. Blepharitis is usually due to?
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Staph. infection
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Seborrheic blepharitis is almost always associated with what?
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Seborrhea of the scalp, brows, and ears.
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Describe how scales present in a staphylococcal blepharitis infections?
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Dry
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Describe how scales present in a seborrheic blepharitis infection?
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Greasy
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Two complications of blepharitis are?
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Hordeolum and/or Chalazion
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Uncomplicated corneal ulcers resolve with in what time frame?
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2-3 weeks
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What begins as a dull, grayish circumscribed superficial infiltration and subsequently necroses and suppurates?
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Corneal Ulcer
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What are the TX for the following in a corneal ulcer?
Gram Pos. Cocci Gram Neg. Bacilli |
Ceflasporin (cefazolin 100mg/ml
Aminoglycosides (gentamicin 10mg/ml) |
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In HSV Keratitis what is he most characteristic lesions?
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Dendritic lesion
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Trifluridine (viroptic) or idoxuridine (herplex, stoxil) used every 2 hours during the day is tx for what?
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HSV Keratitis
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This is a meibomian gland abscess, marked by swelling on the conjunctival surface of the lid, it may point to the skin or the conjunctival surface>
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Internal Hordeolum
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This is a localized small infection of the glands, normally found on the lid margin always points to the skin?
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External hordeolum (sty)
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Dacryocystitis is usually bilat or unilateral?
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Usually unilateral
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What is the tx of Dacryocystitis
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Frequent application of hot compress, Cephalexin 500mg po q6 for mild cases or Cefazolin 1gm IV for severe cases
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A common granulomatous inflammation of a meibomian gland that may follow an internal hordeolum.
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Chalazion
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The onset of this disease is insidious with the pt. complaining of blurred vision, severe photophobia, and headache or ocular pain
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Iritis
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What is the etiology of Acute Angle Closure Glaucoma?
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A sudden increase in the IOP from the blockage of the outflow channels in the anterior chamber of the eye
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What are the characteristics for glaucoma?
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Blurred vision, localized extreme pain, rainbow colored halos, N/V, increase IOP, shallow anterior chamber, edematous (steamy) cornea, decrease VA, dilated or fixed pupil, ciliary injection.
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What medications are given prior to surgery to reduce IOP?
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Glycerin 1g/kg body weight
PO. Pilocarpine 1-2% eye drops. 2 gtts q15 min for 2-3 hrs. Mannitol 20% 250-500ml IV over 2-3 hrs Acetazolamide 500mg IV followed by 250mg PO QID. |
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In 2-5 days untreated acute glaucoma will result in what?
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Permanent vision loss.
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This is an insidious disease that causes slow progressive loss of peripheral vision by damaging the optic nerve.
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Open angle glaucoma.
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What meds are avoided in open agle glaucoma due to the potential for causing acute narrow angle glaucoma?
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Cycloplegics and Mydriatics
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What meds are used for the treatment of open angle glaucoma?
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Pilocarpine 1-4%
Timolol |
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What percentage of the population presents with essential anisocoria?
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20%
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This is caused by lesions affecting the sympathetic or parasympathetic pathways or local iris disease.
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Patholgical anisocoria
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Lesions of what visual system do not cause anisocoria?
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Afferent visual system
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What is the disposition for a pt with TM perf involving severe vertigo or complete hearing loss?
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Hospitalization and obtain emergency otolarygeal consultation.
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Is hospitalization required for a patient who has recieved chricothyrotomy?
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Yes
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If tinitis is sever and/or persistant that interferes with sleep or ability to concentrate what is done?
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Refered to higher level of care.
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