AHN 577 Exam 1 Guide With
Complete Solution
Inflammation of mucous membrane that lines the surface of the eyeball and
inner eyelid - ANSWER conjunctivitis
bilateral eye disease with copious, watery discharge and follicular
conjunctivitis - ANSWER viral conjunctivitis
Common bugs of viral conjunctivitis - ANSWER Adenovirus (associated with
fever, pharyngitis, malaise), HSV (typically unilateral), enterococcus or
coxacki virus can cause hemorrhagic conjunctivitis
purulent discharge, eyelid matting, blurred vision, mild discomfort - ANSWER
bacterial conjunctivitis
Treatment of viral conjunctivitis - ANSWER symptomatic treatment, artificial
tears, typically self limiting to 10 days. Ganciclovir gel and/or oral
valacyclovir/acyclovir for HSV conjunctivitis
Common bugs of bacterial conjunctivitis - ANSWER Strep, MRSA,
pseudomonas, H. flu, moraxella. Gonorrhea can be an emergency
Treatment of bacterial conjunctivitis - ANSWER Usually self-limiting, 10-14
days. Sulfacetamide drops, gentamycin drops
treatment of gonorrhea conjunctivitis - ANSWER Rocpehin 500mg IM x1, if
over 150kg give 1g IM x1, can rapidly lead to perforation if untreated
Chlamydia conjunctivitis treatment - ANSWER leading cause of blindness
,worldwide. Give 1g azithromycin PO x1, can lead to recurrent episodes in
children
"Inclusion Conjunctivitis" doxycycline 100mg bid x 7 days '
May need surgical treatment to correct lid deformities and corneal
transplants
Usually chronic, asymptomatic initially, will see cupping of disc, loss of
peripheral visual fields, central vision preserved. IOP >21, usually
30-50mmhg - ANSWER open angle glaucoma
Treatment of open angle glaucoma - ANSWER beta blockers, carbonic
anhydrase inhibitors, prostaglandin analogs, cholinergic agonists. Laser or
trabeculectomy
Sudden onset of symptoms, eye pain, blurred vision, halos around lights,
fixed and dilated non-reactive pupil, nausea, abdominal pain, red eye, steamy
cornea - ANSWER closed angle glaucoma. IOP 40-90, EMERGENCY
Treatment of closed angle glaucoma - ANSWER Acetazolamide, osmotic
diuretics, laser iridectomy once pressures stabilize
Normal IOP - ANSWER 10-21 mmHg; however IOP outside of the range is not
pathogenic for glaucoma; it is only simply a risk factor associated with the
development or progression of glaucoma
Normal "cup to disc" ratio - ANSWER 0.1-0.5, if elevated causes "cupping"
which suggests glaucoma
Corneal Abrasions - ANSWER s/s: severe pain, photophobia
Can be caused by organic matter or dirt, with or without tissue necrosis will
, need tetanus booster within 5 yrs
Can be caused by metallic foreign bodies or associated with minimal tissue
destruction- tetanus booster in 10 yrs
Treatment of corneal abrasions - ANSWER 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 - ANSWER If lower lid not involved can be sutured
Conjunctiva- sutures not necessary, topical abx to prevent infection
Corneal or scleral laceration - ANSWER emergent ophthalmology consult
cover with shield
advise pt not to squeeze eye shut and limit movement
Corneal Ulcer - ANSWER 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 - ANSWER 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
Complete Solution
Inflammation of mucous membrane that lines the surface of the eyeball and
inner eyelid - ANSWER conjunctivitis
bilateral eye disease with copious, watery discharge and follicular
conjunctivitis - ANSWER viral conjunctivitis
Common bugs of viral conjunctivitis - ANSWER Adenovirus (associated with
fever, pharyngitis, malaise), HSV (typically unilateral), enterococcus or
coxacki virus can cause hemorrhagic conjunctivitis
purulent discharge, eyelid matting, blurred vision, mild discomfort - ANSWER
bacterial conjunctivitis
Treatment of viral conjunctivitis - ANSWER symptomatic treatment, artificial
tears, typically self limiting to 10 days. Ganciclovir gel and/or oral
valacyclovir/acyclovir for HSV conjunctivitis
Common bugs of bacterial conjunctivitis - ANSWER Strep, MRSA,
pseudomonas, H. flu, moraxella. Gonorrhea can be an emergency
Treatment of bacterial conjunctivitis - ANSWER Usually self-limiting, 10-14
days. Sulfacetamide drops, gentamycin drops
treatment of gonorrhea conjunctivitis - ANSWER Rocpehin 500mg IM x1, if
over 150kg give 1g IM x1, can rapidly lead to perforation if untreated
Chlamydia conjunctivitis treatment - ANSWER leading cause of blindness
,worldwide. Give 1g azithromycin PO x1, can lead to recurrent episodes in
children
"Inclusion Conjunctivitis" doxycycline 100mg bid x 7 days '
May need surgical treatment to correct lid deformities and corneal
transplants
Usually chronic, asymptomatic initially, will see cupping of disc, loss of
peripheral visual fields, central vision preserved. IOP >21, usually
30-50mmhg - ANSWER open angle glaucoma
Treatment of open angle glaucoma - ANSWER beta blockers, carbonic
anhydrase inhibitors, prostaglandin analogs, cholinergic agonists. Laser or
trabeculectomy
Sudden onset of symptoms, eye pain, blurred vision, halos around lights,
fixed and dilated non-reactive pupil, nausea, abdominal pain, red eye, steamy
cornea - ANSWER closed angle glaucoma. IOP 40-90, EMERGENCY
Treatment of closed angle glaucoma - ANSWER Acetazolamide, osmotic
diuretics, laser iridectomy once pressures stabilize
Normal IOP - ANSWER 10-21 mmHg; however IOP outside of the range is not
pathogenic for glaucoma; it is only simply a risk factor associated with the
development or progression of glaucoma
Normal "cup to disc" ratio - ANSWER 0.1-0.5, if elevated causes "cupping"
which suggests glaucoma
Corneal Abrasions - ANSWER s/s: severe pain, photophobia
Can be caused by organic matter or dirt, with or without tissue necrosis will
, need tetanus booster within 5 yrs
Can be caused by metallic foreign bodies or associated with minimal tissue
destruction- tetanus booster in 10 yrs
Treatment of corneal abrasions - ANSWER 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 - ANSWER If lower lid not involved can be sutured
Conjunctiva- sutures not necessary, topical abx to prevent infection
Corneal or scleral laceration - ANSWER emergent ophthalmology consult
cover with shield
advise pt not to squeeze eye shut and limit movement
Corneal Ulcer - ANSWER 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 - ANSWER 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
