Ocular Conditions: Blepharitis and Conjunctivitis

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Questions and Answers

What is the primary focus of non-pharmacological management for blepharitis?

Surgical intervention

Oral antihistamines

Warm compresses and lid hygiene (correct)

Antibiotic eye drops

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

Haemophilus influenzae

Streptococcus pneumoniae

Chlamydia trachomatis

Staphylococcus aureus (correct)

What should a patient with a hordeolum be taught about the condition?

It will usually resolve on its own and may be treated with warm compresses (correct)

Immediate surgical intervention is required

It is a chronic, non-painful condition

It is caused by a viral infection

What condition would warrant a referral to an ophthalmologist for a patient with conjunctivitis?

Vision loss or a red ring around the cornea Signup and view all the answers

Which treatment is effective once a hordeolum evolves into a chalazion?

Intralesional corticosteroid injection Signup and view all the answers

Which of the following is NOT a common risk factor for conjunctivitis?

Presence of a family history of allergies Signup and view all the answers

What is the primary method used to diagnose a suspected bacterial conjunctivitis related to STI or MRSA?

Culture and sensitivity or PCR testing Signup and view all the answers

Which non-pharmacological treatment is recommended for the management of anterior blepharitis?

Daily lid scrubs Signup and view all the answers

What is the main distinguishing feature between blepharitis and conjunctivitis?

Blepharitis leads to swollen, erythematous eyelids. Signup and view all the answers

Which treatment option is most appropriate for bacterial conjunctivitis?

Antibiotics to target the bacterial infection. Signup and view all the answers

What is the recommended initial action when a patient has a painful, swollen eyelid that might indicate hordeolum?

Advise warm compresses and analgeics. Signup and view all the answers

Under which condition should a patient be referred to an ophthalmologist?

Sudden onset of visual distortion. Signup and view all the answers

Which statement regarding the management of herpetic keratitis is accurate?

Antiviral therapy should be initiated promptly. Signup and view all the answers

What symptom indicates a need for urgent referral to an ophthalmologist in someone experiencing floaters?

Sudden increase in floaters or new floaters. Signup and view all the answers

What is a common consequence of steroid use in patients with bacterial conjunctivitis?

Exacerbation of the infection. Signup and view all the answers

Which of the following characteristics is associated with conjunctivitis?

Redness of the conjunctiva and possible discharge. Signup and view all the answers

What is a primary symptom that differentiates blepharitis from conjunctivitis?

Eyelid swelling Signup and view all the answers

Which of the following is considered an appropriate first-line management for bacterial conjunctivitis?

Topical antibiotics Signup and view all the answers

What is an important teaching point for a patient experiencing a hordeolum?

Apply warm compresses to the affected area Signup and view all the answers

When should a patient be referred to an ophthalmologist regarding a hordeolum?

If there is systemic infection or no improvement after 2 weeks Signup and view all the answers

Which of the following is an evidence-based treatment for hordeola?

Incision and drainage Signup and view all the answers

What is a distinguishing characteristic of viral conjunctivitis compared to bacterial conjunctivitis?

More likely to cause itching Signup and view all the answers

What is a common misperception about the treatment of blepharitis?

Oral antibiotics are exclusively needed for treatment Signup and view all the answers

Which of the following symptoms is more commonly associated with conjunctivitis than with hordeolum?

Eye redness and excessive tearing Signup and view all the answers

Study Notes

Blepharitis

Blepharitis is a condition that affects the oil glands, eyelashes and eyelids.
Blepharitis causes ocular burning, pain, foreign body sensation, tearing, photophobia, itching, redness, discharge, and swollen erythematous eyelids, often worse in the morning.
Blepharitis is marked by remission and exacerbations.
Blepharitis management includes:
- Warm compresses for 5 to 10 minutes daily
- Daily lid scrubs
- Erythromycin or bacitracin ophthalmic ointment for anterior blepharitis
Lid hygiene is the mainstay of all blepharitis treatments.

Conjunctivitis

Conjunctivitis affects the conjunctiva (thin membrane that covers the white of the eye, and the inside of the eyelid).
Conjunctivitis is typically caused by Viral, Bacterial, or Allergic agents.
Conjunctivitis can be contagious, especially if the patient is tearing.
Viral conjunctivitis is self-limited (5-14 days) and treated with supportive care (artificial tears).
Bacterial conjunctivitis most commonly caused by Staph aureus in adults and H. influenza and strep pneumonia in children.
Common risk factors for conjunctivitis include: contact with infected individuals, poor hygiene, contact lens wear, and allergies.

Hordeolum

Hordeolum is an acute infection and inflammation of one of the glands in the eyelid (stye).
Hordeola are often acute, tender, warm, and erythematous.
Hordeola are not usually treated with steroids or antibiotics, except in cases where it becomes a chalazion.

Chalazion

Chalazion is a chronic, sterile, nontender lipogranulomatosis inflammatory lesion of the meibomian gland (stye).
Chalazion treatment involves intralesional corticosteroid injection, antibiotics are not typically indicated.

Rhinitis

Rhinitis is differentiated from sinusitis by the lack of fever and infection, as well as the presence of allergens.
Rhinitis is typically caused by allergens.
Rhinitis causes symptoms such as clear rhinorrhea, itchy watery eyes, nasal congestion, sneezing, and eyelid swelling.
Rhinitis management includes:
- Nasal steroids
- Avoidance of triggers
- Saline spray
- Environmental control factors
- Use of nasal inhaler
Complications of rhinitis include: asthma, sleep apnea, and sinusitis.

Sinusitis

Sinusitis is a common condition that involves inflammation of the sinuses.
Sinusitis is differentiated from rhinitis by the presence of fever and infection, as well as the lack of allergens.
Sinusitis causes symptoms such as mucopurulent discharge, nasal obstruction, facial pain, and loss of smell.
Sinusitis is often caused by bacterial infection.

Epistaxis

Epistaxis is a nosebleed.
Epistaxis can be caused by dry air, trauma, allergies, blood thinners, or high blood pressure.
Epistaxis management involves:
- Tilting the head forward
- Applying pressure to the anterior portion of the nose for 15 minutes
- Referral to a doctor if bleeding persists after 15 minutes
Frequent epistaxis episodes require patient education on how to manage the condition.
Complications of chronic epistaxis include anemia.

Pharyngitis

Pharyngitis is an inflammation of the pharynx, commonly referred to as a sore throat.
Differential diagnoses for pharyngitis include:
- Infectious mononucleosis
- Tonsillitis
- Allergies
- Thrush
- Peritonsillar cellulitis/abscess
- Pharyngeal abscess
- Epiglottitis
- Upper respiratory infection (URI)
- Sexually transmitted infections (STIs)
- HIV

Emergent Eye Conditions

Patient should be urged to promptly seek ophthalmologist consult if an eye condition meets the following criteria:
- Sudden onset of floaters, flashing lights, black curtain, or decreased vision
- Scleritis - excruciating pain, sensitive to touch, and possibly vision threatening
- Lack of response to treatment
- Suspect a corneal abrasion or ulcer
Any patient reporting new-onset visual distortion or a change in previously noted metamorphopsia should be referred to an ophthalmologist.
If floaters occur suddenly or increase in frequency or quantity, urgent referral to an ophthalmologist is necessary. These symptoms may indicate a posterior vitreous detachment, primary vitreous hemorrhage, retinal tear, or retinal detachment.

Conjunctivitis: Management Guidance

Treatment of bacterial conjunctivitis with steroids may exacerbate the infection.
Steroid use with a corneal abrasion or ulcer can lead to corneal melting and serious visual consequences.
Treatment of herpetic keratitis with an antibacterial may delay appropriate therapy and lead to potentially serious consequences.
Refer patients with conjunctivitis to an ophthalmologist if the vision is affected, a culture reveals MRSA or STI, the patient is a contact lens wearer, the patient is immunocompromised, or a ciliary flush is present.

Conjunctivitis: Diagnostics

Consider culturing and sensitivity testing or PCR if STI or MRSA is suspected.
Otherwise, diagnosis is typically determined by a thorough physical exam and review of the patient's medical history.

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Description

Explore the essential details of two common ocular conditions: Blepharitis and Conjunctivitis. This quiz covers their symptoms, management, and treatments, helping you understand their differences and care strategies. Test your knowledge on the pathophysiology and practices for optimal eyelid and conjunctival hygiene.