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Conjunctivitis
Inflammation of the conjunctiva, with or without infection.
Bacterial conjunctivitis
-characterized by purulent discharge that results in eyelids being matted shut in the
mornings
-If sudden and severe discharge is present, consider gonococcal or chlamydial infection of
the eye
Viral conjunctivitis
characterized by watery discharge. Enlarged preauricular nodes also noted
Allergic conjunctivitis
characteristic by watery discharge with white, stringy mucus along with itching and
swelling. Take note of hx of allergies
Corneal Ulcer
Can result from corneal abrasions due to bacterial infiltration.
Diffuse erythema with pupillary constriction, eye discharge pain, and photophobia.
Vision loss may be present depending on the location of ulceration
Corneal Abrasion
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,Caused by eye trauma, retained foreign bodies, chemical splash, or improper contact lens
use.
Abrasions can cause inflammatory response.
Corneal abrasions are superficial epithelial defects.
Pt presents with eye pain, watering, photophobia, and foreign body sensation.
You can detect corneal abrasions by using fluorescein dye and a UV light
Ectorpion
lower eyelid turns outward
Entropion
lower eyelid turns inward
Exopthalmous
Marked protrusion of the eyes.
Bilateral exophthalmos suggests Graves' disease (hyperthyroidism).
If present unilaterally, rule out tumor or inflammation
Glaucoma
Increases intraocular pressure, producing ischemic damage to nerve fibers at the optic
disc. You will see progressive increase in cup-to-disk ration.
Open-angle glaucoma
most common, occurs in older persons who may see colored halos around lights and
experience insidious, painless blindness
Narrow angle glaucoma
Less common, Medical emergency
caused by an obstruction to aqueous drainage from the anterior chamber. Acute
symptoms are extreme eye pain with nausea and vomiting and loss of vision
Diabetic retinopathy
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,Often leads to blindness from damage to the macular region.
Visible areas of blot hemorrhages and microaneurysms are some of the telltale markers
Malignant Melanoma
-Rare aggressive cancer of the eye that can spread rapidly.
-Need to refer to ophthalmologist, or emergency room in some cases.
-Goal is to preserve vision, and sometimes even life
Weber test
for lateralization
Rinne test
compares air conduction to bone conduction
AC>BC
Whisper test, finger rub test
test gross hearing
Acute Otitis Media (AOM)
-caused by infection and inflammation of middle ear
-bulging of tympanic membrane (appearance of donut or bagel) and boney landmarks
cannot be distinguished
-tympanic membrane discolored (red, yellow, or white)
Serous Otitis Media
-Usually caused by viral URIs or sudden change in atmospheric pressure preventing
Eustachian tube from equalizing pressure in middle ear with outside ear (Air from middle
ear is absorbed into the systemic circulation, causing build-up of serous fluid)
Otitis Externa (Swimmer's Ear)
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, -infection of external auditory canal and pinna, Usually bacterial
-symptoms include pain, purulent drainage, hearing difficulty
-differentiate from OM b/c pain increases with movement of pinna, erythema, swelling of
ear canal, and skin debris in ear canal
Tinnitus in inner ear
sign of Meniere's disease
Peripheral Vertigo (dizziness)
sudden onset and variable duration
seconds (benign paroxysmal positional)
minutes (Meniere's disease)
hours (vestibular neuritis)
Central Vertigo
-symptoms are unremitting and disabling
-vertigo that occurs because of a CNS issue. often sudden, no LOH or tinnitus. usually
occurs with other brainstem deficits like ataxia, crossed motor and sensory deficits;
includes acoustic neuroma as a subset
Tympanosclerosis
Chalky white plaques (hyaline material) and may follow severe otitis media. Usually does
not impair hearing
cerumen impaction
excessive buildup of wax in the ear that often reduces hearing acuity, especially in elderly
persons
c/o fullness in ear, declining hearing, and discomfort (otalgia)
perforated tympanic membrane
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