NBEO Part 3 - PEPS: Questions & A+ Solutions
Save Groups
Terms in this set (296)
Corneal Foreign Body - Testing NaFl, Lid eversion, Retroillumination
Corneal Foreign Body - Treatment Remove foreign body with cotton-tipped applicator,
or instill Proparacaine and remove with instrument,
remove rust ring with Alger brush, place BCL if large
epithelial defect, Moxifloxacin 0.5% qid x1 wk,
Ketorolac 0.5% qid if pain, frequent PFATs
Corneal Foreign Body - FU 1 day if BCL, otherwise 1 wk
Corneal Foreign Body - Education You have a piece of metal in your that we have
removed. We placed a bandage lens on your eye to
help your cornea heal, so you need to return
tomorrow so that we can remove it. We've given you
an antibiotic to use 4x per day, and we also rcmnd
using PFATs 6-8x throughout the next several days. In
the future, it is important to remember to wear safety
glasses when working with metal.
RCE/EBMD - Testing NaFl, Lid eversion
RCE/EBMD - Treatment Propraracaine and debride 1-2mm beyond lesion,
Place BCL if not a previous CL wearer, Moxifloxacin
0.5% qid x1 wk, Nacl 5% soln qid x2 wk then taper to
qhs for 3 months, frequent PFATs
RCE/EBMD - FU 1 day for BCL, Otherwise 3-4 weeks
,RCE/EBMD - Education You have a condition called EBMD, in which the top
layer of your cornea does not adhere well to the
bottom layers. Sometimes, this can lead to the top
layer of the cornea being ripped off, leaving a large
abrasion. (OR - Because of a past trauma to your eye,
the top layer of your cornea has difficulty staying
adhered to the bottom layers). We removed some of
the top layer of your cornea so that it can heal
properly, and placed a bandage lens to speed up the
healing process. We also gave you an antibiotic to
prevent any infection while this heals, and a drop that
helps to dehydrate the cornea. This drop can help to
prevent this from happening again, but may need to
be continued for the next few months. If this recurs,
you should return to our office.
Chemical Burn - Testing Irrigation for 15 mins, lid eversion and
irrigation/swabbing of fornices, Testing PH with
litmus paper after 5 minutes (normal is 7-7.4), NaFl
Chemical Burn - Treatment Debridement of any loose epithelium, Moxifloxacin
0.5% qid x1 week, Prednisolone Acetate 1% qid x1
week then taper, frequent PFATs
Chemical Burn - FU 1 day
Chemical Burn - Education You have gotten a chemical into your eye which has
burned a layer of your cornea. I've removed all of the
loose corneal tissue to help the corneal heal better. I
have given you an antibiotic drop to prevent any
infection, as well as a steroid to help with swelling
and inflammation. You should use PFATs 6-8x per day
while this heals. I'd like to see you tomorrow to make
sure your eye is healing well. In the future, it is
important to use safety eye wear while dealing with
dangerous chemicals.
IIH - Testing RNFL OCT, VF (enlarged BS), FAF (r/o ONH drusen),
Red cap, BP, Order urgent MRI/MRV and LP with CSF
analysis
,IIH - Treatment MRI & MRV of brain and orbit ASAP, LP if MRI/MRV
normal, and oral CAIs. Refer to PCP/OBGYN to
discuss weight loss and d/c of birth control.
IIH - FU 3-4 weeks
IIH - Education You have IIH, which is a condition in which there is
increased pressure inside the brain. This also puts
pressure on the optic nerve, causing it to swell and
leading to visual changes, headaches and nausea.
This increased pressure may be due to being
overweight, or due to your birth control. First, it is
important that we rule out any other causes of
increased pressure in the brain, so I am referring you
for an urgent MRI and LP. I am also referring you
back to your PCP who can offer different treatments
to help bring down the pressure and may
recommend you d/c your birth control. I'd like to see
you back in about a month to make sure your nerve
swelling is returning to normal.
NAION - Testing RNFL OCT, VF (altitudinal or central), Pupils (APD),
Red cap (reduced), ESR/CRP/CBC with diff (r/o
GCA), BP, EOM (r/o neuritis)
NAION - Treatment Refer to PCP for management of BP/BS/Cholesterol
NAION - FU 1-2 months
, NAION - Education You have a condition called NAION, in which blood
supply to your optic nerve has been cut off. This is
often due to systemic issues like uncontrolled high
BP, BS, or cholesterol. First, I want to refer you
urgently for blood work to make sure that this was
not caused by inflammation in the body. I also want
to refer you to your PCP to help get your BP/BS
under control as there is a risk of this happening to
the other eye as well. Up to 40% of patients show
mild improvement in vision over 3 to 6 months in
some studies. I'd like to see you back in 1-2 months
after you've seen your PCP.
AAION - Testing RNFL OCT, VF (altitudinal or central), Pupils (APD),
Red cap (reduced), Palpation of temporal artery, TA
biopsy, ESR/CRP/CBC with diff
AAION - Treatment Refer to ER for blood work and IV
methylprednisolone, Switch to oral steroids if (+) TA
biopsy and cont for 6-12 months
AAION - FU 3-4 wks
AAION - Education You have AAION/GCA. This condition leads to
inflammation of the medium and large blood vessels
in the body, leading to your fever, headaches, and
jaw pain. This inflammation is also affecting the blood
supply to your optic nerve, leading to vision loss.
Unfortunately, there is only a small chance the vision
loss you are experiencing will return. The primary
goal is to prevent this from happening in the other
eye. I am referring you for urgent blood work, as well
as steroids at the hospital. They will likely keep you
on steroids for 6-12 months after this to keep
inflammation in your body low. I'd like to see you
back in about a month.
Optic Neuritis - Testing RNFL OCT, VF (central or arcuate), Pupils (APD), Red
cap (reduced), EOM (pain), Urgent MRI and LP
Save Groups
Terms in this set (296)
Corneal Foreign Body - Testing NaFl, Lid eversion, Retroillumination
Corneal Foreign Body - Treatment Remove foreign body with cotton-tipped applicator,
or instill Proparacaine and remove with instrument,
remove rust ring with Alger brush, place BCL if large
epithelial defect, Moxifloxacin 0.5% qid x1 wk,
Ketorolac 0.5% qid if pain, frequent PFATs
Corneal Foreign Body - FU 1 day if BCL, otherwise 1 wk
Corneal Foreign Body - Education You have a piece of metal in your that we have
removed. We placed a bandage lens on your eye to
help your cornea heal, so you need to return
tomorrow so that we can remove it. We've given you
an antibiotic to use 4x per day, and we also rcmnd
using PFATs 6-8x throughout the next several days. In
the future, it is important to remember to wear safety
glasses when working with metal.
RCE/EBMD - Testing NaFl, Lid eversion
RCE/EBMD - Treatment Propraracaine and debride 1-2mm beyond lesion,
Place BCL if not a previous CL wearer, Moxifloxacin
0.5% qid x1 wk, Nacl 5% soln qid x2 wk then taper to
qhs for 3 months, frequent PFATs
RCE/EBMD - FU 1 day for BCL, Otherwise 3-4 weeks
,RCE/EBMD - Education You have a condition called EBMD, in which the top
layer of your cornea does not adhere well to the
bottom layers. Sometimes, this can lead to the top
layer of the cornea being ripped off, leaving a large
abrasion. (OR - Because of a past trauma to your eye,
the top layer of your cornea has difficulty staying
adhered to the bottom layers). We removed some of
the top layer of your cornea so that it can heal
properly, and placed a bandage lens to speed up the
healing process. We also gave you an antibiotic to
prevent any infection while this heals, and a drop that
helps to dehydrate the cornea. This drop can help to
prevent this from happening again, but may need to
be continued for the next few months. If this recurs,
you should return to our office.
Chemical Burn - Testing Irrigation for 15 mins, lid eversion and
irrigation/swabbing of fornices, Testing PH with
litmus paper after 5 minutes (normal is 7-7.4), NaFl
Chemical Burn - Treatment Debridement of any loose epithelium, Moxifloxacin
0.5% qid x1 week, Prednisolone Acetate 1% qid x1
week then taper, frequent PFATs
Chemical Burn - FU 1 day
Chemical Burn - Education You have gotten a chemical into your eye which has
burned a layer of your cornea. I've removed all of the
loose corneal tissue to help the corneal heal better. I
have given you an antibiotic drop to prevent any
infection, as well as a steroid to help with swelling
and inflammation. You should use PFATs 6-8x per day
while this heals. I'd like to see you tomorrow to make
sure your eye is healing well. In the future, it is
important to use safety eye wear while dealing with
dangerous chemicals.
IIH - Testing RNFL OCT, VF (enlarged BS), FAF (r/o ONH drusen),
Red cap, BP, Order urgent MRI/MRV and LP with CSF
analysis
,IIH - Treatment MRI & MRV of brain and orbit ASAP, LP if MRI/MRV
normal, and oral CAIs. Refer to PCP/OBGYN to
discuss weight loss and d/c of birth control.
IIH - FU 3-4 weeks
IIH - Education You have IIH, which is a condition in which there is
increased pressure inside the brain. This also puts
pressure on the optic nerve, causing it to swell and
leading to visual changes, headaches and nausea.
This increased pressure may be due to being
overweight, or due to your birth control. First, it is
important that we rule out any other causes of
increased pressure in the brain, so I am referring you
for an urgent MRI and LP. I am also referring you
back to your PCP who can offer different treatments
to help bring down the pressure and may
recommend you d/c your birth control. I'd like to see
you back in about a month to make sure your nerve
swelling is returning to normal.
NAION - Testing RNFL OCT, VF (altitudinal or central), Pupils (APD),
Red cap (reduced), ESR/CRP/CBC with diff (r/o
GCA), BP, EOM (r/o neuritis)
NAION - Treatment Refer to PCP for management of BP/BS/Cholesterol
NAION - FU 1-2 months
, NAION - Education You have a condition called NAION, in which blood
supply to your optic nerve has been cut off. This is
often due to systemic issues like uncontrolled high
BP, BS, or cholesterol. First, I want to refer you
urgently for blood work to make sure that this was
not caused by inflammation in the body. I also want
to refer you to your PCP to help get your BP/BS
under control as there is a risk of this happening to
the other eye as well. Up to 40% of patients show
mild improvement in vision over 3 to 6 months in
some studies. I'd like to see you back in 1-2 months
after you've seen your PCP.
AAION - Testing RNFL OCT, VF (altitudinal or central), Pupils (APD),
Red cap (reduced), Palpation of temporal artery, TA
biopsy, ESR/CRP/CBC with diff
AAION - Treatment Refer to ER for blood work and IV
methylprednisolone, Switch to oral steroids if (+) TA
biopsy and cont for 6-12 months
AAION - FU 3-4 wks
AAION - Education You have AAION/GCA. This condition leads to
inflammation of the medium and large blood vessels
in the body, leading to your fever, headaches, and
jaw pain. This inflammation is also affecting the blood
supply to your optic nerve, leading to vision loss.
Unfortunately, there is only a small chance the vision
loss you are experiencing will return. The primary
goal is to prevent this from happening in the other
eye. I am referring you for urgent blood work, as well
as steroids at the hospital. They will likely keep you
on steroids for 6-12 months after this to keep
inflammation in your body low. I'd like to see you
back in about a month.
Optic Neuritis - Testing RNFL OCT, VF (central or arcuate), Pupils (APD), Red
cap (reduced), EOM (pain), Urgent MRI and LP
