Questions and Answers
What is the primary treatment for a pterygium that has encroached on the cornea?
What condition is characterized by a triangular, pinkish, vascular mass on the conjunctiva?
What is the primary diagnostic test used for dry eyes?
What is a common treatment for a hordeolum (stye)?
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Which of the following is associated with chronic inflammation of the meibomian gland?
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What is the most critical disease associated with red eye syndrome that can affect vision?
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What symptom is typically associated with acute angle closure glaucoma?
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Which treatment is commonly used for bacterial conjunctivitis?
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What is typically observed in a patient suffering from keratitis?
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What characteristic is most prominent in the presentation of uveitis?
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What should not be expected in a case of viral conjunctivitis?
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What therapeutic options are available for managing acute glaucoma?
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Which of the following is a common sign of keratitis?
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What is the primary treatment for Entropion?
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What condition is characterized by drooping of the upper eyelid?
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Which condition is associated with the collection of foamy histiocytes due to hyperlipidemia?
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Which eyelid condition may result from misdirection of eyelashes poking the cornea?
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Which condition involves an inability of the eyelids to close properly and can lead to exposure keratitis?
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Study Notes
Red Eye Syndrome
- Most common chief complaint in ophthalmology.
- Commonly referred to as "sore eyes" or conjunctivitis.
- Differential diagnoses include uveitis, keratitis, and glaucoma.
Glaucoma
- Acute angle closure glaucoma is critical for preserving vision.
- Symptoms include unilateral severe headache, nausea, vomiting, sudden visual loss, and seeing halos.
- Physical examination reveals hazy cornea, shallow anterior chamber, and increased intraocular pressure (IOP).
- Treatment options: beta blockers, ACE inhibitors, laser iridotomy, trabeculoplasty, and filtering surgery.
Conjunctivitis
- Inflammation of the conjunctiva classified as viral (watery), allergic (mucinous), or bacterial (purulent).
- Severe bacterial infections require gram stain and culture.
- Viral infections often present with pre-auricular lymphadenopathy; bacterial infections may show post-auricular and submandibular lymphadenopathy.
- Treatment involves topical antibiotics.
Uveitis
- Inflammatory condition involving the uveal tract (iris, ciliary body, and choroid).
- Symptoms include conjunctival, episcleral, and scleral hyperemia, primarily at the circumlimbal area.
- Other signs: blurred vision, presence of flares and cells in the anterior chamber, photophobia, and eye pain.
- Treatment typically includes steroids and cycloplegic agents.
Keratitis
- Inflammation of the cornea leading to disruption of the epithelial layer.
- May appear as a hazy cornea; vision loss is significant if central axis is affected.
- Associated with photophobia due to ciliary spasm.
- Treatments include cycloplegics and steroids (avoid steroids with epithelial defects).
Corneal Scarring and Pterygium
- Pterygium characterized by elastotic degeneration of the conjunctiva; presents as a triangular, vascular mass encroaching the cornea.
- Common in individuals exposed to chronic UV light and dryness (outdoorsmen, pigmented races).
- Treatment: surgical excision.
Pinguecula and Hordeolum
- Pinguecula: a pterygium not encroaching on the cornea.
- Hordeolum (stye) involves infection of a hair follicle.
- Treatment for hordeolum includes incision and curettage, along with topical antibiotics.
Chalazion and Foreign Body
- Chalazion involves chronic inflammation of the meibomian gland; treated with incision and curettage.
- Foreign body injuries (e.g., projectile trauma, welding) require removal along with rust ring removal and topical antibiotics.
Dry Eyes
- Often associated with aging and autoimmune diseases; diagnosed with Schirmer’s test.
- Treatment includes artificial tears and lubricants.
Tearing
- Excessive lacrimation due to autoimmune response or obstruction in the lacrimal apparatus.
- Jones test is used for diagnosis; treatment includes irrigation and DCR (dacryocystorhinostomy).
Blepharitis
- Infection of the lid margins results in dandruff-like flakes and matting of eyelashes.
- Treated with antibiotic ointments and lid scrubs.
Nevus and Xanthelasma
- Nevus refers to a benign accumulation of pigment in any part of the eye that may only need observation.
- Xanthelasma appears as yellow-brown pigment on eyelids, linked to hyperlipidemia. No treatment necessary but requires referral to an internist.
Lid Wart, Entropion, and Ectropion
- Lid wart (verruca vulgaris) treated with excision or cautery.
- Entropion involves inward eyelid turning, while ectropion refers to outward turning; both require surgical repair.
Trichiasis, Ptosis, and Lagophthalmos
- Trichiasis entails misdirection of eyelashes potentially harming the cornea; treated by pulling off hairs or using cryotherapy.
- Ptosis is the drooping of the upper eyelid needing surgical repair.
- Lagophthalmos is the inability of eyelids to close, potentially causing exposure keratitis; seen in Bell’s palsy; treated with tear lubrication and surgery if necessary.
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Description
This quiz covers the most prevalent outpatient department issues related to eye health, including Red Eye Syndrome and conjunctivitis. It also discusses differential diagnoses such as uveitis, keratitis, and glaucoma, specifically within the context of ophthalmological practice.
