EENT NURS 5433 (MOD 1 Study Guide)
• Glaucoma management -prevention (first): IOP measured in yearly eye
exams, avoid OTC vasoconstrictive ocular agents and anticholinergic agents
• Blephatitis definition: inflammation of the eyelid
• Blepharitis Ulcerative form s/s: pustules base of hair follicles that crust
and bleed, lashes can become thick and break easily, itching, tearing,
chalazia, recurrent styes, photophobia, small ulcerations at the eyelid
margin
• Blepharitis Non-ulcerative form associated with: psoriasis seborrhea,
eczema, allergies, lice infestations, trisomy 21, chemical or
environmental irritants, eye makeup, contact lenses
• blepharitis risk factors: dry eye, frequent hordeolum or chalazium, facial or
scalp seborrhea, immunocompromised state, acne, diabetes, and use of
retin-A
• Blepharitis Seborrheic s/s: chronic inflammation eyelid, erythema, greasy
scaling of anterior eyelid, loss of lashes, and sebborrheic dermatitis of
eybrows and scalp
• Blepharitis treatment: warm moist compresses and lid scrubs with baby
shampoo, ( if d/t meibomian glands) massage gland, no contacts
• Blepharitis pharm antibiotic ointments: (start with) bacitracin,
erythromycin, and quinolone
• Blepharitis pharm oral antibiotics: (First line) doxycycline 100mg PO BID or
Tetracycline 250 mg 4 times daily
• Hordeolum Definition & s/s: (sty) small glands that line the eyelid get
plugged & may fill with pus & erythema, tenderness and sometimes exudate.
pearl- inflammation of sebaceous glands at base of eyelash
• External hordeolum (stye) cause: inflammation and infection of the eyelid
margin; affects hair follicles and eyelashes.
• Internal Hordeolum (stye): inflammation and infection of the meibomian
glands.
• Chalazion (definition, differentiation, cause): -granulomatous infection of
meibomian gland & -painless swelling of the eyelid & -initially may be
tender, then nontender lump & -can be caused from recurrent styes and or
blepharitis pearl- hard, non-tender nodule, inflammation meibomian gland
• chalazion vs hordeolum: hordeola: is painful, pus & chalazion: no pain, no
exudate, firm nodule -pear: differentiation
• Chalazion management: moist compresses, lid massaging scrubs, injected
with steroids, referral if surgical removal needed
• Conjunctivitis: -inflammation of the conjunctiva (front part of the eye) & -
s/s: red, sometimes itchy, sometimes exudates (r/t bacterial) Pearl:
differentiation bacterial vs viral
• Bacterial conjunctivitis causes: -(common): staph, strep, h flu, and m
catarrhalis & -Pseudomonas & -gonorrhea
, • Viral conjunctivitis causes: adenoviruses, coxsackie virus, varicella,
herpes, and herpes zoster
• Herpes in the eye: -viral conjunctivitis & -can cause blindness & -
fluorescein stain w/ positive dendrites & -referred immediately to an
ophthalmologist
• Conjunctivitis s/s: erythema, burning, exudate, itching, sensation of foreign
body
• Patient presents with eye problems, first action is: visual acuity test:
Snellin test & -if there's any visual acuity changes at all, these patients
need to be referred out to an ophthalmologist.
• Conjunctivitis: Red flags: diminished visual acuity, photophobia, foreign
body sensation, corneal opacity, fixed pupil, severe headache -pear (all
above, referral)
• Allergic Conjunctivitis pharm and management: -decongestant antihistamine
drops: Naphcon -A, Vasocon-A & -mast cell stabilizers: Palatal or
Optivar & -(first line) prevention, avoid allergen triggering
conjunctivitis
• Bacterial Conjunctivitis pharm and management: -antibiotic drops:
Sulfacetamide 10%, Tobramycin, Ciprofloxacin, Ofloxacin, Moxifloxacin,
Gatifloxacin
• Viral Conjunctivitis pharm and management (Chlamydial and gonococcal): -
systemically and topically & -Systemic: penicillin and doxycycline & -
Ocular: managed by ophtomologist (Gentamicin, Ofloxacin, Norofloxacin,
tetracycline) & -hand hygiene, clean washcloth every time, change the
pillowcases, warm compresses alt w/ cool compresses, discard old contacts
and eye makeup (discard q30 days)
• Cellulitis of the eye cause: -orbital or periorbital & -staph, group A strep,
strep pneumonia, H influenza, and fungus & -referred out immediately
• Cellulitis pharm and management: -Broad spectrum antibiotics:
Cephalosporin or Ampicillin- Clavulanic acid (Outpatient) & -follow up 12-
24hr & -with no improvement= referral (may need hospitalization w/ iv
antibiotics)
• Pingueculum and pterygium (definition, cause, prevention): -lesions on the
conjunctiva & -result from hyperplasia & -chronic sun exposure and
environmental irritants (ex. works outside w/ wind blowing dirt) & -
prevention: eye protection, avoid irritants and sun
• Pingueculum definition: yellowish growth on the nasal aspect of the
conjunctiva
• Pterygium definition: vascular rise lesion that extends from the
conjunctiva to the nasal cornea.
• Pingueculum and pterygium pharm & management: -topical ophthalmic
lubricants & -topical steroid therapy: Rimexolone, Loteprednol & -anti-
inflammatory: voltaren, ketorolac & -surgical removal only if absolutely
necessary (may cause visual problems long term)
• Glaucoma management -prevention (first): IOP measured in yearly eye
exams, avoid OTC vasoconstrictive ocular agents and anticholinergic agents
• Blephatitis definition: inflammation of the eyelid
• Blepharitis Ulcerative form s/s: pustules base of hair follicles that crust
and bleed, lashes can become thick and break easily, itching, tearing,
chalazia, recurrent styes, photophobia, small ulcerations at the eyelid
margin
• Blepharitis Non-ulcerative form associated with: psoriasis seborrhea,
eczema, allergies, lice infestations, trisomy 21, chemical or
environmental irritants, eye makeup, contact lenses
• blepharitis risk factors: dry eye, frequent hordeolum or chalazium, facial or
scalp seborrhea, immunocompromised state, acne, diabetes, and use of
retin-A
• Blepharitis Seborrheic s/s: chronic inflammation eyelid, erythema, greasy
scaling of anterior eyelid, loss of lashes, and sebborrheic dermatitis of
eybrows and scalp
• Blepharitis treatment: warm moist compresses and lid scrubs with baby
shampoo, ( if d/t meibomian glands) massage gland, no contacts
• Blepharitis pharm antibiotic ointments: (start with) bacitracin,
erythromycin, and quinolone
• Blepharitis pharm oral antibiotics: (First line) doxycycline 100mg PO BID or
Tetracycline 250 mg 4 times daily
• Hordeolum Definition & s/s: (sty) small glands that line the eyelid get
plugged & may fill with pus & erythema, tenderness and sometimes exudate.
pearl- inflammation of sebaceous glands at base of eyelash
• External hordeolum (stye) cause: inflammation and infection of the eyelid
margin; affects hair follicles and eyelashes.
• Internal Hordeolum (stye): inflammation and infection of the meibomian
glands.
• Chalazion (definition, differentiation, cause): -granulomatous infection of
meibomian gland & -painless swelling of the eyelid & -initially may be
tender, then nontender lump & -can be caused from recurrent styes and or
blepharitis pearl- hard, non-tender nodule, inflammation meibomian gland
• chalazion vs hordeolum: hordeola: is painful, pus & chalazion: no pain, no
exudate, firm nodule -pear: differentiation
• Chalazion management: moist compresses, lid massaging scrubs, injected
with steroids, referral if surgical removal needed
• Conjunctivitis: -inflammation of the conjunctiva (front part of the eye) & -
s/s: red, sometimes itchy, sometimes exudates (r/t bacterial) Pearl:
differentiation bacterial vs viral
• Bacterial conjunctivitis causes: -(common): staph, strep, h flu, and m
catarrhalis & -Pseudomonas & -gonorrhea
, • Viral conjunctivitis causes: adenoviruses, coxsackie virus, varicella,
herpes, and herpes zoster
• Herpes in the eye: -viral conjunctivitis & -can cause blindness & -
fluorescein stain w/ positive dendrites & -referred immediately to an
ophthalmologist
• Conjunctivitis s/s: erythema, burning, exudate, itching, sensation of foreign
body
• Patient presents with eye problems, first action is: visual acuity test:
Snellin test & -if there's any visual acuity changes at all, these patients
need to be referred out to an ophthalmologist.
• Conjunctivitis: Red flags: diminished visual acuity, photophobia, foreign
body sensation, corneal opacity, fixed pupil, severe headache -pear (all
above, referral)
• Allergic Conjunctivitis pharm and management: -decongestant antihistamine
drops: Naphcon -A, Vasocon-A & -mast cell stabilizers: Palatal or
Optivar & -(first line) prevention, avoid allergen triggering
conjunctivitis
• Bacterial Conjunctivitis pharm and management: -antibiotic drops:
Sulfacetamide 10%, Tobramycin, Ciprofloxacin, Ofloxacin, Moxifloxacin,
Gatifloxacin
• Viral Conjunctivitis pharm and management (Chlamydial and gonococcal): -
systemically and topically & -Systemic: penicillin and doxycycline & -
Ocular: managed by ophtomologist (Gentamicin, Ofloxacin, Norofloxacin,
tetracycline) & -hand hygiene, clean washcloth every time, change the
pillowcases, warm compresses alt w/ cool compresses, discard old contacts
and eye makeup (discard q30 days)
• Cellulitis of the eye cause: -orbital or periorbital & -staph, group A strep,
strep pneumonia, H influenza, and fungus & -referred out immediately
• Cellulitis pharm and management: -Broad spectrum antibiotics:
Cephalosporin or Ampicillin- Clavulanic acid (Outpatient) & -follow up 12-
24hr & -with no improvement= referral (may need hospitalization w/ iv
antibiotics)
• Pingueculum and pterygium (definition, cause, prevention): -lesions on the
conjunctiva & -result from hyperplasia & -chronic sun exposure and
environmental irritants (ex. works outside w/ wind blowing dirt) & -
prevention: eye protection, avoid irritants and sun
• Pingueculum definition: yellowish growth on the nasal aspect of the
conjunctiva
• Pterygium definition: vascular rise lesion that extends from the
conjunctiva to the nasal cornea.
• Pingueculum and pterygium pharm & management: -topical ophthalmic
lubricants & -topical steroid therapy: Rimexolone, Loteprednol & -anti-
inflammatory: voltaren, ketorolac & -surgical removal only if absolutely
necessary (may cause visual problems long term)
