NURS 5433 Module 1 Questions &
Answers Solved 100% Correct!!
Blepharitis
nonulcerative form associated w/ seborrhea
• commonly seen in those w/ trisomy 21
• tends to affect people w/ psoriasis, seborrhea, eczema, allergies, and lice
infestations
• contributing factors: chemical or environmental irritants, use of eye makeup and
contact lenses
ulcerative form
• involves lash follicle and meibomian glands of eyelid
• may be pustules at base of hair follicles that may crust or bleed
• lashes become thick and break easily
Blepharitis RF
• dry eye
• frequent hordeola or chalazia
• facial or scalp seborrhea
• immunocompromised state
• acne
• DM
• isotretinoin
Blepharitis assessment finding
ulcerative
• itching, tearing, chalazia, recurrent styes, photophobia, small ulcerative at
eyelid margin, broken or absence of eyelashes
,seborrheic
• chronic inflammation of eyelid, erythema, greasy scaling of anterior eyelid,
loss of eyelashes, seborrheic dermatitis of eyebrows and scalp
Blepharitis Management (pharm/nonpharm)
• warm moist compresses
• lid scrubs w/ baby shampoo
• lid massage to empty meibomian glands
• remove contact lids and disinfect
pharm management
• bacitracin, erythromycin, quinolone ointments
• consider oral atbx for resistant infections
• doxycyline 100 mg po BID
• tetracycline 250 mg po QID
Hordeolum (stye)
erythematous, tender lump within eyelid
• external hordeolum: inflammation/infection of eyelid margin affecting hair
follicles of eyelashes
• internal hordeolum: inflammation/infection of meibomian glands
Chalazion
• granulomatous infection of a meibomian gland
• painless swelling on eyelid
• may be tender and erythematous before evolving into a nontender lump
• blepharitis is frequently associated w/ chalazia
Chalazion Treatment
, • warm moist compresses
• intralesional steroid injection
• lid massage
• lid scrubs
Conjunctivitis (red eye)
inflammation of conjunctiva covering the front of eye
common causes
• bacterial, viral, or fungal
• sexual transmission and ophthalmia neonatorum
• HSV 1
• trachoma
• toxicity (from an inciting agent of some sort)
• allergy
• viral
• adenoviruses, Coxsackie virus, varicella, HSV, herpes zoster virus
Conjunctivitis assessment
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy
discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash
mattering; edema; hyperemia; preauricular adenopathy only w/ hyperacute
disorder
VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body
sensation; preauricular adenopathy; hyperemia; chemosis; watery discharge; classic
dendritic corneal lesion present w/ herpes simplex; periocular lesions present w/
herpes zoster opthalmicus
Conjunctivitis diagnostics
, • snellen
• visual acuity
• dilated pupil exam for proptosis, optic nerve dysfunction, decreased visual
acuity, diplopia, or anterior chamber inflammation
• fluorescein staining to rule out corneal involvement or keratitis
• blue penlight illumination to see corneal scratches, corneal dendrites, or
corneal ulcerations
Conjunctivitis red flags
• diminished visual acuity, photophobia, severe foreign body sensation
preventing pt from keeping eye open, corneal opacity, fixed pupil, severe
headache w/ nausea
• refer to ophthamologist
conjunctivitis management
allergic
• topic decongestant antihistamine combos (OTC)
• naphazoline hydrochloride 0.025% (Naphcon- A)
• naphazoline-antazoline 0.3% (vasocon-A)
• levocabastine hydrochloride 0.05% (Livostin)
• emedastine 0.05% (emadine)
• mast cell stabilizers
• olopatadine 0.1% (patalol)
• azelastine 0.05% (Optivar)
Bacterial
• sulfacetaminde 10% (Bleph-10, Isopto CEtamide, or Sodium Sulamyd)
• Tobramycin
• Ciprofloxacin 0.3%
• ofloxacin 0.3%
Answers Solved 100% Correct!!
Blepharitis
nonulcerative form associated w/ seborrhea
• commonly seen in those w/ trisomy 21
• tends to affect people w/ psoriasis, seborrhea, eczema, allergies, and lice
infestations
• contributing factors: chemical or environmental irritants, use of eye makeup and
contact lenses
ulcerative form
• involves lash follicle and meibomian glands of eyelid
• may be pustules at base of hair follicles that may crust or bleed
• lashes become thick and break easily
Blepharitis RF
• dry eye
• frequent hordeola or chalazia
• facial or scalp seborrhea
• immunocompromised state
• acne
• DM
• isotretinoin
Blepharitis assessment finding
ulcerative
• itching, tearing, chalazia, recurrent styes, photophobia, small ulcerative at
eyelid margin, broken or absence of eyelashes
,seborrheic
• chronic inflammation of eyelid, erythema, greasy scaling of anterior eyelid,
loss of eyelashes, seborrheic dermatitis of eyebrows and scalp
Blepharitis Management (pharm/nonpharm)
• warm moist compresses
• lid scrubs w/ baby shampoo
• lid massage to empty meibomian glands
• remove contact lids and disinfect
pharm management
• bacitracin, erythromycin, quinolone ointments
• consider oral atbx for resistant infections
• doxycyline 100 mg po BID
• tetracycline 250 mg po QID
Hordeolum (stye)
erythematous, tender lump within eyelid
• external hordeolum: inflammation/infection of eyelid margin affecting hair
follicles of eyelashes
• internal hordeolum: inflammation/infection of meibomian glands
Chalazion
• granulomatous infection of a meibomian gland
• painless swelling on eyelid
• may be tender and erythematous before evolving into a nontender lump
• blepharitis is frequently associated w/ chalazia
Chalazion Treatment
, • warm moist compresses
• intralesional steroid injection
• lid massage
• lid scrubs
Conjunctivitis (red eye)
inflammation of conjunctiva covering the front of eye
common causes
• bacterial, viral, or fungal
• sexual transmission and ophthalmia neonatorum
• HSV 1
• trachoma
• toxicity (from an inciting agent of some sort)
• allergy
• viral
• adenoviruses, Coxsackie virus, varicella, HSV, herpes zoster virus
Conjunctivitis assessment
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy
discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash
mattering; edema; hyperemia; preauricular adenopathy only w/ hyperacute
disorder
VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body
sensation; preauricular adenopathy; hyperemia; chemosis; watery discharge; classic
dendritic corneal lesion present w/ herpes simplex; periocular lesions present w/
herpes zoster opthalmicus
Conjunctivitis diagnostics
, • snellen
• visual acuity
• dilated pupil exam for proptosis, optic nerve dysfunction, decreased visual
acuity, diplopia, or anterior chamber inflammation
• fluorescein staining to rule out corneal involvement or keratitis
• blue penlight illumination to see corneal scratches, corneal dendrites, or
corneal ulcerations
Conjunctivitis red flags
• diminished visual acuity, photophobia, severe foreign body sensation
preventing pt from keeping eye open, corneal opacity, fixed pupil, severe
headache w/ nausea
• refer to ophthamologist
conjunctivitis management
allergic
• topic decongestant antihistamine combos (OTC)
• naphazoline hydrochloride 0.025% (Naphcon- A)
• naphazoline-antazoline 0.3% (vasocon-A)
• levocabastine hydrochloride 0.05% (Livostin)
• emedastine 0.05% (emadine)
• mast cell stabilizers
• olopatadine 0.1% (patalol)
• azelastine 0.05% (Optivar)
Bacterial
• sulfacetaminde 10% (Bleph-10, Isopto CEtamide, or Sodium Sulamyd)
• Tobramycin
• Ciprofloxacin 0.3%
• ofloxacin 0.3%
