AHN 577 PRACTICE EXAM 2025/2026 QUESTIONS AND
SOLUTIONS GRADED A+ TIP
✔✔Treatment of corneal abrasions - ✔✔Bacitracin-polymyxin eye ointment
Mydriatic
-Topical analgesics or oral NSAIDs,
- Don't pad eye unless its a laceration
- smoking affects healing time (slower)
✔✔Eye Lacerations - ✔✔If lower lid not involved can be sutured
Conjunctiva- sutures not necessary, topical abx to prevent infection
✔✔Corneal or scleral laceration - ✔✔emergent ophthalmology consult
cover with shield
advise pt not to squeeze eye shut and limit movement
✔✔Corneal Ulcer - ✔✔a pitting of the cornea caused by an infection or injury
Can be due to neurotrophic keratitis (loss of sensation), exposure keratitis (poor lid
closure), allergic eye disease, and inflammatory diseases
✔✔Conjunctival and corneal foreign bodies - ✔✔H&P:
If a patient complains of "something in my eye" and gives a consistent history, a foreign
body is usually present on the cornea or under the upper lid.
Lab/Diag:
Visual acuity should be tested before treatment is instituted. After local anesthetic the
eye is examined with a slit-lamp. Corneal foreign bodies may be made more apparent
by the instillation of sterile fluorescein.
CI:
They are then removed with a sterile wet cotton-tipped applicator or hypodermic
needle. Bacitracin-polymyxin ophthalmic ointment should be instilled.
✔✔iron containing foreign bodies - ✔✔Can leave a diffuse rust ring in the eye, requires
excision under local anesthesia
✔✔Intraocular foreign bodies - ✔✔Emergency! require treatment by ophthalmologist
✔✔Contusions= closed globe Injury - ✔✔Can cause black eye, subconjunctival
hemorrhage, corneal edema, hemorrhage of anterior chamber (hyphema). rupture root
of iris (irisdodialysis), dislocation of lens, vitreous hemorrhage, retinal hemorrhage
w/detachment, edema, rupture of choroid, orbital floor fracture
✔✔Hyphema - ✔✔risk of secondary hemorrhage leading to intractable glaucoma with
permanent visual loss (canthotomy to decompress)
, ✔✔Cataracts - ✔✔decrease in visual acuity, blurred vision, enhanced glare, loss of red
reflex, opacity on fundoscopic exam
Treatment: glasses, contacts, IOL implant is definitive treatment
✔✔treatment of closed globe injury - ✔✔Rest, frequent ophthalmologic exams
AVOID ASPIRN
sickle cell pts have worse outcomes
✔✔hordeolum (stye or sty) - ✔✔staphylococcal abscess on upper or lower eyelid.
Localized edema, acutely tender, painful to palpation
Tx: warm compress, bacitracin or erythromycin ointment, I&D in extreme cases
✔✔chalazion - ✔✔a nodule or cyst, usually on the upper eyelid, caused by obstruction
in a Meibomian gland.
- hard, non-tender cyst, red conjunctiva
- tx is I&D
✔✔blepharitis - ✔✔chronic inflammation of the lid margins. Can be caused by
staphylococcus, seborrhea, meibomian gland dysfunction, associated with acne
rosacea
s/s: irritation, itching, burning, erythema, crusting of lid margins, greasy/frothy tears,
crusting
tx: clean scalp and eyebrows, remove scales, abx ointment, expression of Meibomian
glands, systemic abx, steroids
✔✔Otitis Externa - ✔✔inflammation of external auditory canal. Pain, pruitis, purulent
discharge, pain with movement of the tragus and pinna
- Commonly known as swimmer's ear, q-tip trauma, painful erythema and edema of ear
canal.
- Caused by gram negative rods (pseudomonas, proteus) or fungi (aspergillus)
✔✔Treatment of otitis externa - ✔✔Remove exudate/debris so abx can reach source.
Protect from moisture, avoid further trauma. 50/50 mix of isopropyl alcohol and vinegar.
Meds: Cortisporin, aminoglycosides (-ycins) anti-inflammatories, cipro drops w/w/o
steroids
✔✔Complications of otitis externa - ✔✔osteomyelitis of skull base, palsy of CN VI, VII,
and IX
Will need surgical debridement of bone with long term antibiotics
SOLUTIONS GRADED A+ TIP
✔✔Treatment of corneal abrasions - ✔✔Bacitracin-polymyxin eye ointment
Mydriatic
-Topical analgesics or oral NSAIDs,
- Don't pad eye unless its a laceration
- smoking affects healing time (slower)
✔✔Eye Lacerations - ✔✔If lower lid not involved can be sutured
Conjunctiva- sutures not necessary, topical abx to prevent infection
✔✔Corneal or scleral laceration - ✔✔emergent ophthalmology consult
cover with shield
advise pt not to squeeze eye shut and limit movement
✔✔Corneal Ulcer - ✔✔a pitting of the cornea caused by an infection or injury
Can be due to neurotrophic keratitis (loss of sensation), exposure keratitis (poor lid
closure), allergic eye disease, and inflammatory diseases
✔✔Conjunctival and corneal foreign bodies - ✔✔H&P:
If a patient complains of "something in my eye" and gives a consistent history, a foreign
body is usually present on the cornea or under the upper lid.
Lab/Diag:
Visual acuity should be tested before treatment is instituted. After local anesthetic the
eye is examined with a slit-lamp. Corneal foreign bodies may be made more apparent
by the instillation of sterile fluorescein.
CI:
They are then removed with a sterile wet cotton-tipped applicator or hypodermic
needle. Bacitracin-polymyxin ophthalmic ointment should be instilled.
✔✔iron containing foreign bodies - ✔✔Can leave a diffuse rust ring in the eye, requires
excision under local anesthesia
✔✔Intraocular foreign bodies - ✔✔Emergency! require treatment by ophthalmologist
✔✔Contusions= closed globe Injury - ✔✔Can cause black eye, subconjunctival
hemorrhage, corneal edema, hemorrhage of anterior chamber (hyphema). rupture root
of iris (irisdodialysis), dislocation of lens, vitreous hemorrhage, retinal hemorrhage
w/detachment, edema, rupture of choroid, orbital floor fracture
✔✔Hyphema - ✔✔risk of secondary hemorrhage leading to intractable glaucoma with
permanent visual loss (canthotomy to decompress)
, ✔✔Cataracts - ✔✔decrease in visual acuity, blurred vision, enhanced glare, loss of red
reflex, opacity on fundoscopic exam
Treatment: glasses, contacts, IOL implant is definitive treatment
✔✔treatment of closed globe injury - ✔✔Rest, frequent ophthalmologic exams
AVOID ASPIRN
sickle cell pts have worse outcomes
✔✔hordeolum (stye or sty) - ✔✔staphylococcal abscess on upper or lower eyelid.
Localized edema, acutely tender, painful to palpation
Tx: warm compress, bacitracin or erythromycin ointment, I&D in extreme cases
✔✔chalazion - ✔✔a nodule or cyst, usually on the upper eyelid, caused by obstruction
in a Meibomian gland.
- hard, non-tender cyst, red conjunctiva
- tx is I&D
✔✔blepharitis - ✔✔chronic inflammation of the lid margins. Can be caused by
staphylococcus, seborrhea, meibomian gland dysfunction, associated with acne
rosacea
s/s: irritation, itching, burning, erythema, crusting of lid margins, greasy/frothy tears,
crusting
tx: clean scalp and eyebrows, remove scales, abx ointment, expression of Meibomian
glands, systemic abx, steroids
✔✔Otitis Externa - ✔✔inflammation of external auditory canal. Pain, pruitis, purulent
discharge, pain with movement of the tragus and pinna
- Commonly known as swimmer's ear, q-tip trauma, painful erythema and edema of ear
canal.
- Caused by gram negative rods (pseudomonas, proteus) or fungi (aspergillus)
✔✔Treatment of otitis externa - ✔✔Remove exudate/debris so abx can reach source.
Protect from moisture, avoid further trauma. 50/50 mix of isopropyl alcohol and vinegar.
Meds: Cortisporin, aminoglycosides (-ycins) anti-inflammatories, cipro drops w/w/o
steroids
✔✔Complications of otitis externa - ✔✔osteomyelitis of skull base, palsy of CN VI, VII,
and IX
Will need surgical debridement of bone with long term antibiotics
