Ophthalmology > VII > Flashcards

VII Flashcards

(68 cards)

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1
Q

Flat anterior chamber = ?

A

Loss of aqueous humor

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2
Q

What may happen to the iris with trauma?

A

Plug, iritis, hyphema

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3
Q

Is a TDaP needed post ocular trauma?

A

Yes

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4
Q

Hammering on metal = ?

A

Intraocular FB

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5
Q

H/o grinding things = ?

A

Corneal FB

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6
Q

H/o welding = ?

A

Corneal UV burn

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7
Q

h/o racquet sports = ?

A

Hyphema

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8
Q

H/o fist fights = ?

A
  • Hyphema
  • BOF
  • ruptured globe
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9
Q

What are the basic exam bits with ocular trauma?

A
  • VA
  • External exam
  • Pupils
  • Motility exam
  • Anterior segment
  • Ophthalmoscopy
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10
Q

What are the two true ocular emergencies?

A

Chemical burns

CRAO

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11
Q

What are the two semi urgent ocular problems?

A
  • Orbital fractures

- Subconjunctival hemorrhages

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12
Q

Which is more serious: alkali or acid burns to the eye?

A

Alkali

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13
Q

What is the immediate treatment for chemical burns?

A

Immediate irrigation

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14
Q

A lack of redness in the eye with chemical burns = ?

A

Ischemic Necrosis and badness

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15
Q

Corneal epithelium is derived from what?

A

Specialized area of the conjunctiva, that dedifferentiate, migrate centrally.

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16
Q

After irrigation, what are the three next steps in the care of chemical burns to the eye?

A
  • Instill topical anesthetic
  • Check for FBs
  • Institute copious irrigation
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17
Q

What (general) amount of fluid is needed for irrigation of the eye? What type of fluid should be used to irrigate?

A

Liters

Anything

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18
Q

What topical agent should be used for chemical burns?

A

Cycloplegic agent and topical abx

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19
Q

Which is an immune privileged site: cornea or conjunctiva?

A

Cornea

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20
Q

What are the s/sx of corneal abrasion?

A
  • FB sensation
  • Pain
  • Tearing
  • Photophobia
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21
Q

What is the classic mimic of corneal abrasions?

A

HSV

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22
Q

How do you treat a corneal abrasion?

A

-Topical abx solution and topical NSAIDs (ketorolac)

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23
Q

What is the role of oral analgesics with corneal abrasions?

A

Ineffective

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24
Q

What is the role of prescribing topical abx for corneal abrasions?

A

Prophylaxis for infection of the eye

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25
When should f/u be done with corneal abrasions?
24 hours
26
When should corneal abrasions be referred to an ophthalmologist?
- Not healed in 24 hours - Abrasion related to contact lens wear - White corneal infiltrate
27
When should patches NOT be used for corneal abrasions? (3)
- Contact lens wearers - Dendritic or stellate epithelial defects - Poor historians
28
What is acanthamoeba?
Keratitis (or encephalitis) causing parasite, often found in contact lens wearers
29
Why are topical anesthetic prescriptions contraindicated with corneal ulcerations?
Corneal toxicity
30
What must be done with rust rings?
Must be taken out in a few days, o/w will not heal
31
Pooling of the aqueous humor =? What should be done?
Full penetration or the cornea Shield the eye and refer
32
What is the best imaging modality for FB in the eye?
head CT
33
True or false: hyphemas should always be assumed as a globe rupture, and be referred
True
34
What are the complications from hyphemas? (2)
- Rebleeding into the anterior chamber | - Glaucoma
35
If the globe is ruptured, what should be done?
Stop exam, shield eye, give TDaP, and refer immediately
36
How do you treat proptosis of the eye 2/2 severe orbital hemorrhage?
Decreased the pressure behind the eye
37
What can severe orbital hemorrhage lead to?
-Blindness 2/2 increase IOP
38
What are the complications from severe orbital hemorrhage?
- Bullous subconjunctival hemorrhage - Proptosis - Corneal exposure
39
What is the treatment for severe orbital hemorrhage?
Emergent lateral canthotomy
40
What is an Emergent lateral canthotomy?
Cutting the canthus to relieve pressure in the eye
41
What are the s/sx of orbital fractures? (4)
- Periorbital edema - Ecchymosis - Diplopia - SQ emphysema
42
What can cause the numbness down to the cheek with orbital fracture?
Irritation from V2
43
What are the two indications for surgery 2/2 orbital fracture?
- Persistent diplopia | - Poor cosmesis (enophthalmos)
44
What is a blow-out fracture?
Muscles extend into the maxillary sinus
45
Young children under 15 need to be fixed within what timeframe? Why?
3-5 days | Need to reduce the scarring and inflammation that occurs. O/w interferes with development
46
Why should you avoid lid retraction with superficial lid lacerations?
Will have tearing their entire lives if tear ducts are involved
47
What should be done to treat superficial lid lacs (3)?
- Remove superficial FBs - R/o deeper FBs - Give TDaP
48
Should you debride tissue with dog bites in the eye?
No--want plastic surgeon to do it
49
What can cause UV keratitis?
- Welder's burn | - Snow blindness
50
What is UV keratitis?
UV rays irritate the superficial corneal epithelium, causing inhibition of mitosis, production of nuclear fragmentation, and loosening of the epithelial layer
51
What are the s/sx of UV keratitis?
- Photophobia - FB sensation - Tearing - Pain
52
What is the treatment fro UV keratitis? (2)
- Cycloplegics | - analgesics
53
What usually causes traumatic optic neuropathy?
Damage to the head to directly to the orbit
54
What are the direct causes of traumatic optic neuropathy?
Lac of the ON, intraorbital hemorrhage
55
What are the indirect causes of traumatic optic neuropathy?
Shear forces on nerve or vascular supply
56
What are the s/sx of traumatic optic neuropathy? (2)
Visual loss is severe and immediate RAPD
57
What is the treatment for traumatic optic neuropathy?
- Orbital or cranial surgery | - Therapy for indirect traumatic ON
58
What is the general treatment for corneal abrasions?
- Topical cycloplegics | - Topical abx ointment
59
White corneal infiltrate around abrasion = ?
It's not a corneal abrasion--it's an ulcer
60
When should ER docs not take out a FB in the eye?
If it is near the pupil or an area that the pupil will cover with dilation
61
What happens can happen to the retina with blunt trauma?
Cracking of the retina, and exposure of the choroid
62
Cherry red spot on fundoscopic exam = ?
CRAO
63
What is the relative platelet count with anterior ischemic optic neuropathy?
Elevated
64
What are the two treatments that must be done with suspected anterior ischemic optic neuropathy?
IV steroids | Obtain temporal artery bx
65
Teardrop pupil and flat A/c = ?
Penetrating injury
66
True or false: you should avoid digital palpation of a traumatic eye
True
67
What must be r/o with FB to the eye before getting an MRI?
Metal FB
68
What are the indication for prescribing a topical anesthetic?
NEVER
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