Ocular Conditions and Management Quiz
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Questions and Answers

What is the primary cause of anterior blepharitis?

  • Dry eye syndrome
  • Staphylococcal infection (correct)
  • Meibomian gland dysfunction
  • Rosacea

Which symptom is NOT commonly associated with blepharitis?

  • Flaky eyelid skin
  • Severe vision loss (correct)
  • Burning sensation
  • Tearing

Which of the following is a risk factor for developing blepharitis?

  • Hordeola or chalazia (correct)
  • High protein diet
  • Contact lens use
  • Regular exercise

What is a recommended nonpharmacologic management option for blepharitis?

<p>Eye lid margin scrubs (D)</p> Signup and view all the answers

When might oral antibiotics be considered for treating blepharitis?

<p>In cases resistant to topical treatments (A)</p> Signup and view all the answers

What is the primary cause of hordeolum?

<p>Staphylococcus aureus (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of a chalazion?

<p>Involves the eyelashes (B)</p> Signup and view all the answers

What is the recommended nonpharmacologic management for a hordeolum?

<p>Warm, moist compresses (D)</p> Signup and view all the answers

In the case of dacryostenosis, persistent symptoms beyond how many months typically warrant a referral?

<p>9-12 months (A)</p> Signup and view all the answers

Which of the following conditions can lead to an ocular discharge in newborns?

<p>Dacryostenosis (B)</p> Signup and view all the answers

Which of the following symptoms is associated with dacryocystitis?

<p>Redness and pain over the inner aspect of the lower eyelid (C)</p> Signup and view all the answers

What might be a serious underlying issue if a chalazion persists in the same location?

<p>Sebaceous gland carcinoma (B)</p> Signup and view all the answers

What is the primary pharmacological treatment for acute hordeolum?

<p>Erythromycin ophthalmic ointment (D)</p> Signup and view all the answers

Which condition is commonly associated with an obstruction in tear drainage?

<p>Dacryostenosis (A)</p> Signup and view all the answers

What is a common differential diagnosis for red eye?

<p>Corneal ulcer (A)</p> Signup and view all the answers

What is a common clinical presentation of gonococcal conjunctivitis in newborns?

<p>Copious purulent discharge (C)</p> Signup and view all the answers

What does a Wood's lamp use to detect bacterial or fungal skin infections?

<p>Black light (A)</p> Signup and view all the answers

Which treatment is considered first-line for conjunctivitis in contact lens wearers?

<p>Fluoroquinolones eye drops (C)</p> Signup and view all the answers

What is the most appropriate action for a patient who has experienced an eye injury involving thermal materials?

<p>Refer to an ophthalmologist (B)</p> Signup and view all the answers

What does fluorescein staining help to confirm in the assessment of corneal abrasion?

<p>Epithelial disruption (A)</p> Signup and view all the answers

Which of the following symptoms indicates a need for urgent referral to an ophthalmologist?

<p>Blood in the anterior chamber (A), Acute painful red eye (D)</p> Signup and view all the answers

In cases of allergic conjunctivitis, which symptom is typically most pronounced?

<p>Severe itching (D)</p> Signup and view all the answers

What is a key patient education point for managing viral and bacterial conjunctivitis?

<p>Wash linens daily (C)</p> Signup and view all the answers

What is a common cause of subconjunctival hemorrhage?

<p>Sudden sneezing or coughing (B)</p> Signup and view all the answers

Which of the following conditions is characterized by blood trapped beneath the conjunctiva?

<p>Subconjunctival hemorrhage (C)</p> Signup and view all the answers

Which of the following is NOT an appropriate treatment for allergic conjunctivitis?

<p>Topical steroid drops (B)</p> Signup and view all the answers

Why are pressure patching methods no longer recommended for eye injuries?

<p>They may lead to ulcerative keratitis. (C)</p> Signup and view all the answers

Which condition requires referral to an ophthalmologist?

<p>Presence of herpes in the eye (A)</p> Signup and view all the answers

What should be done for a patient with distorted vision after an eye injury?

<p>Refer to an ophthalmologist (C)</p> Signup and view all the answers

What is the earliest onset time frame of chlamydial conjunctivitis in newborns?

<p>5-14 days after birth (A)</p> Signup and view all the answers

What is the most common cause of viral conjunctivitis?

<p>Adenovirus (B)</p> Signup and view all the answers

What is a characteristic sign of hyphema?

<p>Blood in the anterior chamber (B)</p> Signup and view all the answers

Which assessment technique is used to rule out a foreign body during corneal abrasion evaluation?

<p>Invert eyelid (A)</p> Signup and view all the answers

Which of the following should be avoided in managing conjunctivitis in children under 8 years old?

<p>Tetracyclines (B)</p> Signup and view all the answers

Which of the following is NOT a symptom of viral conjunctivitis?

<p>Unilateral herpetic skin vesicles (C)</p> Signup and view all the answers

Which treatment is recommended for symptom relief in viral conjunctivitis?

<p>Artificial tears (D)</p> Signup and view all the answers

What characterizes herpetic conjunctivitis assessment?

<p>Unilateral burning sensation (B)</p> Signup and view all the answers

What is typically observed during a Wood’s Lam or Slit Lamp examination for herpetic conjunctivitis?

<p>Dendritic lesions (C)</p> Signup and view all the answers

Which organism is more commonly associated with bacterial conjunctivitis in adults?

<p>Staphylococcus aureus (C)</p> Signup and view all the answers

What is the primary concern when herpes simplex or varicella zoster is involved in conjunctivitis?

<p>Referral to an ophthalmologist (D)</p> Signup and view all the answers

What symptom is typical of allergic conjunctivitis?

<p>Bilateral injected conjunctiva (A)</p> Signup and view all the answers

What is a common clinical presentation of ocular foreign body?

<p>Red eye with foreign body sensation (A)</p> Signup and view all the answers

Which of the following conditions requires an emergency referral to an ophthalmologist?

<p>Penetrating eye injury (A)</p> Signup and view all the answers

What is a concerning symptom of periorbital edema?

<p>Visual changes and diplopia (A)</p> Signup and view all the answers

Which of these is not a common assessment symptom of retinal detachment?

<p>Severe headache (B)</p> Signup and view all the answers

What should be the immediate action for a suspected case of acute angle closure glaucoma?

<p>Refer to emergency department (D)</p> Signup and view all the answers

Which condition is characterized by blood in the anterior chamber of the eye?

<p>Hyphema (D)</p> Signup and view all the answers

What symptom is commonly associated with traumatic retrobulbar hemorrhage?

<p>Pain with eye movement (C)</p> Signup and view all the answers

Which factor is NOT a risk factor for retinal detachment?

<p>High blood pressure (D)</p> Signup and view all the answers

Flashcards

Blepharitis

Inflammation or infection of the eyelids.

Causes of Anterior Blepharitis

Staphylococcal bacteria, seborrheic dermatitis, or rosacea.

Cause of Posterior Blepharitis

Meibomian gland dysfunction.

Symptoms of Blepharitis

Burning, itching, tearing, eyelid crusting, flaking or scaling of eyelid skin, and red eyes.

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Treatment for Blepharitis

Topical antibiotics and eyelid hygiene using diluted baby shampoo and warm compresses.

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Hordeolum (Stye)

Acute inflammation or infection of the eyelid margin involving the sebaceous gland of an eyelash (external hordeolum) or a meibomian gland (internal hordeolum).

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Etiology of Hordeolum

Commonly caused by Staphylococcus aureus.

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Clinical Presentation of Hordeolum

Sudden onset of localized tenderness, redness, and swelling of the eyelid.

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Chalazion

Acute, benign granulomatous inflammation of the meibomian gland, typically following an occurrence of internal hordeolum.

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Etiology of Chalazion

Obstruction of the meibomian gland.

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Clinical Presentation of Chalazion

May appear the same as a stye, but is a painless lesion that does not involve the lashes. Palpable mass or lid edema.

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Dacryostenosis

Blocked lacrimal sac (tear duct), most common cause of ocular discharge in newborns.

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Dacryocystitis

Infection of the lacrimal sac due to obstruction.

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Clinical Presentation of Dacryostenosis

Persistent overflow of tears (epiphora).

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Clinical Presentation of Dacryocystitis

Pain, redness, and swelling over the inner aspect of the lower eyelid, and watery eyes (epiphora).

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Conjunctivitis (Pink Eye)

Inflammation of the conjunctiva, the thin transparent membrane that lines the inside of the eyelids and covers the white part of the eye.

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Viral Conjunctivitis

Caused by a virus, most commonly the adenovirus.

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Viral Conjunctivitis Symptoms

This type of conjunctivitis usually starts in one eye and then spreads to the other eye within 24 to 48 hours. Symptoms include excessive tearing, watery mucus discharge, burning or gritty feeling, and possible fever or swollen lymph nodes.

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Bacterial Conjunctivitis

A type of conjunctivitis caused by bacteria, often Staphylococcus aureus in adults and Pseudomonas in contact lens wearers.

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Allergic Conjunctivitis

This type of conjunctivitis is often caused by allergies and may involve both eyes. Symptoms include itching, redness, and watery discharge.

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Herpetic Conjunctivitis

Herpes simplex or zoster requires urgent referral to an ophthalmologist.

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Herpetic Conjunctivitis Symptoms

Conjunctivitis caused by herpes simplex or zoster can affect a single eye and may be accompanied by skin blisters. It is important to seek prompt medical attention because these viruses can damage the eye.

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Herpetic Conjunctivitis Treatment

This type of conjunctivitis requires urgent referral to an ophthalmologist. Treatment includes oral acyclovir and topical antiviral medications.

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Chlamydial Conjunctivitis

A sexually transmitted infection that can cause conjunctivitis in newborns. Occurs 5-14 days after birth. Discharge progresses from watery to mucopurulent. Conjunctival and eyelid erythema and edema are present. Follicular response is absent.

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Gonorrheal Conjunctivitis

A sexually transmitted infection that can cause conjunctivitis in newborns. Occurs rapidly within 24-48 hours after birth. Discharge is copious and purulent. Diffuse eyelid and conjunctival edema are present.

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Conjunctivitis

Inflammation or infection of the conjunctiva, the clear membrane that covers the white part of the eye. Can be caused by bacteria, viruses, allergies, or other irritants.

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Corneal Abrasion

A tear in the epithelial layer of the cornea (the outer layer of the eye).

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Gritty Feeling

A common symptom of corneal abrasion. Patient describes a feeling of a foreign body in the eye, like a grain of sand.

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Fluorescein Staining

A diagnostic test for corneal abrasion. A dye is instilled in the eye, and areas of epithelial disruption fluoresce green under a Wood's lamp.

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Fluoroquinolone Eye Drops

A common treatment for bacterial conjunctivitis. Eye drops can be administered multiple times per day.

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Ointment for Conjunctivitis

Recommended for treating bacterial conjunctivitis in infants. Parents may prefer ointments to eye drops.

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Itching

A common adverse effect of conjunctivitis. Itchiness in the eyes, can be caused by bacterial, viral, or allergic conjunctivitis.

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What is a Wood's lamp used for?

A handheld device that uses black light to visualize skin conditions. It can detect fungal or bacterial infections, skin pigment disorders, and abrasions.

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What is a subconjunctival hemorrhage?

A broken blood vessel in the eye's conjunctiva that traps blood, causing a red patch in the white of the eye. Usually painless, vision is unaffected, and resolves within 2 weeks.

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What is a hyphema?

Bleeding inside the front chamber of the eye, between the iris and cornea. This is a serious condition requiring immediate attention.

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What are some common causes of a subconjunctival hemorrhage?

A sudden or severe sneeze, cough, heavy lifting, straining, vomiting, or vigorous eye rubbing can cause a subconjunctival hemorrhage.

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When should you refer a patient with a subconjunctival hemorrhage to an ophthalmologist?

A red, painful eye, loss of vision, pain with eye movement, a history of HSV keratitis (eye infection) and a red eye, blood collecting in the eye (hyphema), and penetrating foreign bodies require immediate ophthalmologist referral.

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When should you refer a patient with subconjunctival hemorrhage for urgent care?

Any eye symptoms that aren't improving with treatment should be referred to an ophthalmologist within a week or ten days.

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What is the first-line treatment for contact lens wearers with corneal abrasions?

Topical antibiotics are the first-line treatment for contact lens wearers with corneal abrasions. Fluoroquinolones are the preferred antibiotic for this group.

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Is pressure patching recommended for corneal abrasions?

Pressure patching is no longer recommended for corneal abrasions due to the risk of ulcerative keratitis and infection.

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Ruptured Globe/Laceration

A serious eye emergency where the eyeball is punctured or torn, potentially causing damage to internal structures. Requires immediate referral to an ophthalmologist.

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Hyphema

Blood in the anterior chamber - the space between the cornea and iris. This condition may cause blurred vision, pain, red eye. Requires evaluation by an ophthalmologist due to the risk of vision loss.

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Chemical Eye Injury

An injury caused by a corrosive substance, such as acid or alkali. This can lead to severe eye damage, immediate flushing with copious amounts of water is critical, followed by urgent ophthalmic consultation.

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Orbital Blow-Out Fracture

A fracture of the orbital bone, the bony structure surrounding the eye. This fracture can cause double vision, bulging of the eye, and limited eye movement. Requires prompt ophthalmology evaluation, especially if vision is affected.

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Traumatic Retrobulbar Hemorrhage

Bleeding in the space behind the eyeball. This can result in sudden loss of vision, bulging of the eye, and pain. Immediate ophthalmology referral is necessary for diagnosis and potential surgical intervention.

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Acute Angle-Closure Glaucoma

A sudden, severe increase in intraocular pressure (pressure inside the eye) that can cause eye pain, red eye, blurred vision, halos around lights, and nausea. This condition requires immediate emergency department referral for prompt treatment.

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Ischemic Optic Neuropathy

A condition where the optic nerve (connecting the eye to the brain) is damaged due to a lack of blood supply. It can cause sudden, painless vision loss in an eye with an affected nerve, requires urgent ophthalmology referral.

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Optic Neuritis

Inflammation of the optic nerve that can cause sudden vision loss, usually involves only one eye, and may be associated with pain, and a loss of color vision. Requires immediate ophthalmology referral and treatment, as it can result in permanent vision loss without prompt intervention.

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Study Notes

Acute Eye Conditions in Primary Care

  • Anatomy of the Human Eye:
    • The eye has various parts, including the sclera (white part), cornea (clear front part), iris (colored part), pupil (opening in the center), lens (focuses light), retina (light-sensitive tissue), optic nerve (carries signals to brain), choroid (vascular layer), and vitreous body (gel-like substance).
    • The anterior chamber contains aqueous humor.
    • The posterior chamber contains aqueous humor.
    • The ciliary body is associated with the lens.
    • Conjunctiva lines the eyelids and surface of eye.

Disorders of the Eyelid

  • Blepharitis:
    • Describes inflammation or infection of the eyelids.
    • Anterior blepharitis involves bacteria and associated skin conditions like rosacea and seborrhea Causes include: Staphylococcal, Seborrheic dermatitis, rosacea
    • Posterior blepharitis is related to dysfunction of meibomian glands.
    • Risk factors include frequent hordeola or chalazia.
  • Blepharitis Assessment:
    • Visual acuity testing and examination of eyelids and skin are crucial for diagnosis
    • Staphylococcal blepharitis presents with styes (hordeola), lack of eyelashes, and scarring
    • Seborrheic blepharitis manifest as scales, dry/oily lid margins, and dandruff on eyelids/eyebrows
  • Hordeolum (Stye): Inflammation of an eyelash follicle/meibomian gland
    • Commonly due to Staphylococcus aureus.
    • Sudden onset of localized tenderness, redness, swelling of the eyelid.
    • Usually resolves with warm compresses
  • Chalazion:
    • Benign, granulomatous inflammation of a meibomian gland. Typically results from a blocked meibomian gland.
    • Acute onset, with swelling occurring after a hordeolum. Causes include obstruction of meibomian gland
    • Typically resolves with warm compresses.
  • Dacryostenosis/Dacrocystitis:
    • Blocked tear duct (lacrimal sac) in newborns or an infection of the lacrimal sac
    • Persistent tearing.
    • Acute distension/ inflammation may cause mucus reflux
    • Often resolves within several months
    • Common cause of ocular discharge in newborns
  • Herpetic Conjunctivitis:
    • Herpes simplex or zoster infections High contagiousness Characterized by: burning, unilateral herpetic skin lesions, palpable lymph nodes, common in neonates.
    • Urgent referral to ophthalmologist

Red Eye

  • This section describes various causes of red eyes.

    • Conjunctivitis (pink eye): inflammation of the conjunctiva
    • Corneal abrasion: scratch on the cornea
    • Corneal foreign body: something lodged in eye
    • Corneal ulcer: infection or injury to cornea
    • Trauma: injury to eye structure
    • Acute Angle Closure Glaucoma
    • Anterior uveitis (iritis)
    • Periorbital or orbital cellulitis
    • Entropian
    • Subconjunctival hemorrhage
    • Previous eye surgery

  • Note that this is not an exhaustive list of all possible red eye causes. Further details available for each entity from the text.

  • Bacterial Conjunctivitis:

    • Usually mucopurulent discharge
    • Includes multiple microorganisms.
    • Common causes in adults are Staph aureus Common causes in contacts lens users are Pseudomonas, Strep, pneumoniae, and others

  • Viral Conjunctivitis: Highly contagious High contagious, second eye often infected within 24-48 hours. Adenovirus most common Characterized by: injected conjunctiva, water discharge, burning, and common URI

  • Allergic Conjunctivitis: Causes: IgE or mast cell hypersensitivity; often accompanies allergic rhinitis. Characterized by diffuse redness, severe itching, and tearing.

  • STI Conjunctivitis:

    • Caused by Chlamydia and Gonorrhea
    • Characterized by copious purulent discharge, eyelid and conjunctiva edema
    • Common cause of congenital conjunctivitis.

Eye Conditions (in general overview)

  • Common causes listed, further details available for each from the text.
  • Ocular Foreign Body: A foreign object in the eye; Common cause from improper use of eye protection
  • Retinal Detachment: A serious condition that requires emergent referral and medical evaluation
  • Periorbital Edema: Swelling around the eye, often due to infection/inflammation
  • Glaucoma: High intraocular pressure (IOP) may cause vision loss Common symptoms: sudden vision loss, eye pain, severe headache and nausea, halos around lights.
  • Subconjunctival Hemorrhage: A broken blood vessel in the conjunctiva; less serious than other complications
  • Corneal Abrasion: A complete or partial tear of the cornea's epithelium typically from mechanical or chemical means

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Primary Care 2 Eye Presentation Week 2 PDF

Description

Test your knowledge on various ocular conditions, including blepharitis, hordeolum, and dacryostenosis. This quiz covers causes, symptoms, risk factors, and management options for these conditions. Perfect for medical students and professionals looking to refresh their understanding of common eye disorders.

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