Term
| Contact dermatitis - common |
|
Definition
hypersensativity to topicals
erythematous, leathery, scaly thickening of skin
tx - maybe steroid cream
refer to ophthal if not resolved in 2 wks |
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Term
| Chronic blepharitis - common |
|
Definition
inflammation of eyelids
anterior - Staph aureus
posterior - affecting meibomian glands
tx - warm compress, lid hygeine with baby shampoo, maybe abx (bacitracin ointment or doxycycline oral) |
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Term
|
Definition
focal inflamm of ciliary follicles
painful, tender focal mounding
mild conjunctival hyperemia
tx - warm compress, excision if chalazion develops |
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Term
| Bacterial conjunctivitis - dangerous |
|
Definition
usually immunocomp or hosptial pts
Staph aureus, Strep pneumo, H flu, N gonorrhoeae
tx - observe 24 hrs if mild, topical braod spectrum abx (erythromycin, aminoglycoside, trimethoprim, FQ), IV ceftriazone for N gonorrhoeae
refer if - pus, infant, immunocomp pts, N gonorrhea, contact lens pt, after eye surgery |
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Term
| Ophthalmia neonatorum - dangerous |
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Definition
conjunctivitis bacterial in neonates
silver nitrate prophylaxis (not in US)
Chlamydia, N gonorrhoeae, HSV |
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Term
| Viral conjunctivitis - ddx bact conjunct |
|
Definition
most common cause of red eye
usually adenovirus, self limiting
tx - topical lube, cold compress |
|
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Term
| Chlamydia conjunctivitis - ddx bact conjunct |
|
Definition
trachoma, neonatal inclusion, adult inclusion
tx - oral erythromycin, doxy, azithromycin |
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|
Term
| Allergic conjunctivitis - ddx bact conjunct |
|
Definition
seasonal response - IgE hypersensitivity, mast cell mediated
usually bilateral
tx - systemic antihistamines, OTC vasoconstrictor, H1 blocker, topical NSAIDs |
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Term
| Episcleritis - ddx bact conjunct |
|
Definition
idiopathic focal inflammation of deep subconjunctival tissue
eye pain, focal or diffuse hyperemia
tx - refer to ophthal with severe pain, oral NSAIDs, topical lube |
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Term
| Scleritis - ddx bact conjunct |
|
Definition
focal or diffuse inflamm of sclera
associated with rheumatoid arthritis, Wegener, relapsing polychondritis
severe pain, scleral thinning with dark purple color
tx - systemic immunosuppression |
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Term
| Pingueculum - ddx bact conjunct |
|
Definition
degeneration of collagen in nasal or temporal bulbar conjunctiva, secondary to sun and wind exposure
mild ocular discomfort, focal hyperemia
tx - topical vasoconstrictors |
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Term
| Pterygium - ddx bact conjunct |
|
Definition
fibrovascular prolif of bulbar conjuctiva growing over cornea
hyperemic growth over cornea, blurred vision
tx - surgery |
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Term
| Subconunctival hemorrhage - ddx bact conjunct |
|
Definition
due to sudden inc in intrathoracic pressure
no tx necessary |
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|
Term
|
Definition
inflamm of cornea - infection, dry eyes, contact lens overuse, autoimmune disorders
pain, photophobia, blurry vision, foreign body sensation |
|
|
Term
|
Definition
primary HSV - trigeminal nerve, URI, unilateral follicular blepharoconjunctivitis, vesicular dermatitis, epithelial keratitis, 10% bilat
Recurrent infection - reactivation in sensory ganglia, blepharoconjunctivitis, epithelial keratitis |
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|
Term
|
Definition
Gram pos - localized, round ulceration, grayish-white stromal infiltrate, tx w topical abx (FQ)
Gram neg - acute progression, intense inflamm, P aeruginosa w diffuse central or paracentral ulceration, mucopurulent discharge, edema (ground glass), stromal abscess, perforation, same tx |
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Term
| Anterior uveitis - dangerous |
|
Definition
inflamm of iris and ciliar muscle
autoimmune reaction
pain, photophobia, blurry vision, ciliary flush, irregular pupil
tx - refer to ophthal, topical corticosteroids, cycloplegic |
|
|
Term
| Acute angular closure - dangerous |
|
Definition
sudden inc in intraocular pressure - blockage of outflow of aq humor
periocular pain, naus/vom, headache, photophobia, blurry vision, ciliary flush
tx - topical timolol, oral acetazolamide, urgent referal to ophthal |
|
|
Term
| Endophthalmitis - dangerous |
|
Definition
infection inside eye
pain, vision loss, redness, hazy cornea, hypopyon
tx - refer to ophthal, intraoc fluid culture, abx |
|
|
Term
| Orbital cellulitis - dangerous |
|
Definition
diffuse bacterial infection of periocular tissue secondary to skin infect, paranasal sinusitis (ethmoid sinus in kids)
pain, fever, swelling of lids, reduced ocular motility, proptosis, vision loss
tx - IV abx, imaging, incision and drainage |
|
|
Term
| Orbital tumor - dangerous |
|
Definition
orbital extension
pain, diplopia, proptosis, tearing, visual loss
tx - imaging, refer within 48 hrs |
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|
Term
|
Definition
lens opacity, impairs vision
asymmetric progression
acquired - aging, traumatic, med (prednisone), metabolic (DM), ocular inflamm disease, radiation
painless, progressive visuall dec, glare sx
tx - surgery if significant interference
complications - bleeding, infection, would problems, poor healing, corneal edema, retinal problems, persistent inflamm |
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