Term
| What are congenital cataracts? What is the cause associated with it? Symptoms? Treatment? |
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Definition
Clouding of the lens at birth.
NO CAUSE ASSOCIATED but:
Chromosomal conditions and intrauterine infection (Rubella) have high incidences.
Surgery to remove them, artificial lens placement, patch, and treat UNDERLYING disorder. |
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Term
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Definition
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Term
|
Definition
| Underdeveloped small auricle |
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Term
|
Definition
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Term
| What gender is associated with congenital ear defects? |
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Definition
| Males. Associated with other conditions affecting the head. |
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Term
| How do congenital ear defects manifest themselves? |
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Definition
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Term
| What is congenital hearing loss associated with? |
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Definition
| Maternal rubella and syphilis. |
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Term
| When do age related eye changes begin? |
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Definition
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Term
| What are age related eye changes? |
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Definition
-Decreased tear production
-Cornea less sensitive (unable to detect injury)
-Pupils decrease 1/3 size @ age 60
-Pupils react more slowly to light
-Lens becomes yellowed, less flexible, cloudy
-Eye sinks back into the skull
-Eye muscles weaken - limiting visual field
-Presbyoipa - difficulty focusing |
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Term
| What is conjunctivitis? Symptoms? What are the 2 types and their differences? |
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Definition
Infection/inflammation of the conjunctiva (lining of eyelid)
Symptoms: blurry vision, photophobia
-Viral: watery, mucus exodate -> contagious
-Bacterial: yellow-green exudate -> contagious |
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Term
| What are causes of conjunctivitis and the risk factors for getting it? What are teachings? |
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Definition
Causes - virus, bacteria, allergens, chemicals, trauma
R.F. - Contact lenses, contaminated makeup, opthalmic medications.
Teachings: hand washing, limit contact, eye hygiene, d/c contaminated products |
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Term
| How do you treat conjunctivitis? |
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Definition
| May resolve on it's own. If not: opthalmic/oral antibiotics, antihistamines, corticosteriod agents, warm compress to sooth. |
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Term
| What is infant conjunctivitis? |
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Definition
| Infant gets it from Mom's STI. Treat it with opthalmic antibiotics shortly after birth. |
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Term
| What is keratitis? What causes it? |
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Definition
| Inflammation of the cornea triggered by infection or trauma. HSV-1 can be self-transmitted from the mouth to cause ulcerated keratitis. |
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Term
| What are the symptoms of keratitis? How is it treated? |
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Definition
| Severe pan, photophobia, visual disturbances. Opthalmic/Oral antibiotics and corticosteriods. |
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Term
| What are 2 topical anesthetics used in the eyes? What do you need to do afterwards? |
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Definition
Proparacaine HCL & Tertracaine HCL.
Wear a patch until affects are gone. |
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Term
| What are some antibacterial antiinfectives used in the eye? |
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Definition
-Chloramphenicol - For treatment of severe infections
-Ciproflaxin - Bacterial conjunctivitis
-Erythromycin - Most commonly used
-Gentamicin Sulfate - External eye infections. (Preg C)
-Levofloxacin - Conjunctivitis & coreal ulcers
-Norfloxacin - Conjunctivitis
-Silver Nitrate - Opthalmia neonatorum
-Sulfacetamide - Not effective w/ purulent drainage
-Tobramycin - External ocular infections
-Tetracycline HCL - ALternative to silver nitrate
-Triple antibiotic opthalmic ointment - Combo dosage |
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Term
| What is an ocular anti fungal? |
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Definition
| Natamycin - can cause stinging or burning |
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Term
| What are the 3 ocular antivirals? |
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Definition
Ioxuridine - To treat herpes simplex keratitis
Trifluridine - Herpectic opthalmic infections
Vidarabine monohydrate - Herpes simplex keratitis |
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Term
| What are some non steroidal ocular antiinflammatories? |
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Definition
Diclofenac sodium - postop inflammation/photophobia
Flurbiprofen sodium - Decrease corneal edema, miosis
Ketorolac tormethamine - Itching w/ allergies
Suprofen - Prevent intraoperative miosis |
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Term
| What are some steroidal ocular antiinflammatories? |
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Definition
-Dexmethasone - Inflammation of conjunctiva, cornea, lids.
-Medrysone - Allergic conditions
-Prednisone acetate - Uveitis, allergic cond., burns, inflamm.
-Predisolone sodium - Prevent/decrease tissue response to inflammatory process
-Tobramycin - Fungal/mycobacterial/viral infections |
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Term
| What are clinical manifestations of direct physical trauma or chemical burns? |
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Definition
| Pain, edema, blurred vision, diplopia, dry eyes, photophobia, floaters, pupil dilation, pupils unresponsive to light |
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Term
| How do you treat direct physical trauma or chemical burns to the eyes? |
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Definition
| saline flush, avoid rubbing, leave embedded object, sterile dressing, eye patch, surgically repair |
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Term
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Definition
SECOND LEADING CAUSE OF BLINDNESS
Increased IOP that leads to damage to the optic nerve by decreased blood flow to the optic nerve by:
-blocked outflow of aqueous humor
-increased production of aqueous humor |
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Term
| What is open angle glaucoma? |
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Definition
MOST COMMON!
IOP increases gradually over time.
Usually painless, insidious, bilateral changes in vision such as tunnel vision, blurred vision, halos, decreased color discrimination. |
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Term
| How do beta blockers treat open angle glaucoma? |
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Definition
| Reduce aqueous humor production (BB) |
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Term
| How do alpha agonists treat OA glaucoma? |
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Definition
| Reduction in production and an increase in drainage of a. humor |
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Term
| How do carbonic anhydrase inhibitors treat OA glaucoma? |
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Definition
| Reduces aqueous humor production (CAI) |
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Term
| How do prostaglandin-like compounds treat OA glaucoma? |
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Definition
| Increase a. humor outflow (P) |
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Term
| How do miotics/cholinergic agents treat OA glaucoma? |
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Definition
| Increase a. humor outflow. (M/C) |
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Term
| How do epinephrine compounds treat OA glaucoma? |
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Definition
| Increase a. humor outflow (E) |
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Term
| How do alpha-2 adrenergic agonists treat OA glaucoma? |
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Definition
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Term
| Are oral carbonic anhydrase drugs used to treat OA glaucoma used alone or in combo. with other drugs? |
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Definition
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Term
| How do n-methyl-d-aspartate receptors treat OA gluacoma? |
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Definition
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Term
| What non pharmacological treatments are used for OAG? |
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Definition
-Laser surgery to open a. humor flow
-Filtering surgery (remove small part of trabecular meshwork)
-Drainage implants |
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Term
| What is the drug action of cholinergic/anticholinesterace miotics? |
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Definition
| Direct acting, Lower IOP, increase blood flow to retina and decrease retinal damage. |
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Term
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Definition
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Term
| Who should NOT use pilocarpine? |
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Definition
| Patients w/ retinal detachment, adhesions between eyes/lens, acute ocular inflammation, must avoid systemic absorption with coronary artery disease, epilepsy, asthma. |
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Term
|
Definition
| 7 day dose of pilocarpine |
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Term
| What are the side effects of pilocarpine? |
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Definition
| Blurred vision, eye pain, headache, eye irritation, brow ache, stinging/burning, nausea, vomiting, diarrhea, increased salivation/perspiration, muscle tremors, contact allergy, conjunctival irritation w/ occusert. |
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Term
| What are the adverse rxn of pilocarpine? |
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Definition
| Dyspnea, TACHYCARDIA, HYPERTENSION, RETINAL DETACHMENT, BRONCHOSPASM. |
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Term
| What are the first line treatment of OA glaucoma? |
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Definition
| Beta-Adrenergic Blockers. |
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Term
| What are the side effects with beta-adrenergic blockers? |
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Definition
| Bradycardia, hypotension, bronchospasm |
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Term
| Who shouldn't use beta-adrenergic blockers? |
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Definition
| Asthmatic patients, those already taking oral beta blockers for their heart. |
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Term
| What is the benefit of prostaglandin analogues? |
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Definition
| Work the same as beta blockers but without the side effects. |
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Term
| What are osmotics used to treat? |
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Definition
| ACUTE closed angle glaucoma. Decreases A. humor volume rapidly which also reduces IOP. |
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Term
| What are the side effects of osmotics? What should you check? |
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Definition
| Headache, nausea, vomiting, diarrhea, electrolyte imbalances. Intake and output levels, electrolyte levels, daily weight. |
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Term
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Definition
| Osmotic drug. Pulmonary edema/congestion, anuria (no pee), and dehydration. |
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Term
| What is closed angle glaucoma? |
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Definition
MEDICAL EMERGENCY!
There is a sudden block of aqueous humor outflow.
Caused by trauma, sudden pupil dilation, prolonged pupil dilation, emotional stress.
USUALLY HAPPENS UNILATERALLY. |
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Term
| What are the clinical manifestations of CAG? |
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Definition
Sudden onset:
-Sever eye pain
-HA,
-Nausea
-Vomiting
-Nonreactive pupil
-Haziness of cornea, visual changes (halos) |
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Term
|
Definition
Iridotomy - surgical laser procedure to open a new channel in the iris.
Meds -> Anticholinergic mydriatics + cycloplegics |
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Term
| Why do they use anticholinergic mydriatics/cycloplegics before C.A.G. surgery? |
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Definition
| Dilate pupils and paralyze eye muscles |
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Term
| What is congenital glaucoma? |
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Definition
| Present @ birth. Abnormal development of outflow channels of the eye. Follows X-linked, recessive hereditary pattern. |
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Term
| What are the clinical manifestations of congenital glaucoma? |
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Definition
| Excessive lacrimation, photophobia, corneal edema, grey-white appearance of cornea, enlarged eye globe, vision deficit. |
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Term
| How is congenital glaucoma treated? |
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Definition
| surgery to open the AH outflow. Laser, filtering, drainage implants. |
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Term
| What is secondary glaucoma? |
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Definition
| IT's the result of corticosteroid use, eye diseases, arteriosclerosis and diabetes mellitus. |
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Term
| How is secondary glaucoma treated? |
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Definition
| Chronic disease management, eliminated underlying causes, glaucoma meds and surgical treatments |
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Term
| What are diagnostic tests used to diagnose glaucoma? |
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Definition
-H&P
-Complete opthalmic exam
-Tonometry (measure of IOP)
-Visual acuity testing
-Visual field measurement
-At risk persons should be screened annually |
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Term
|
Definition
Clouding of the lens uni or bilaterally.
Cloudy/fuzzy/foggy/filmy vision
Color intensity loss
Diplopia
Impaired night vision/halos/photosensitivity
Frquent changes in eye glasses or contact rx |
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Term
| What are the risk factors for cataracts? |
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Definition
-Family history
-advances age
-smoking
-uv light exposure
-diabetes mellitus
-corticosteriods
-eye injury |
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Term
| What is macular degeneration? |
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Definition
| Deterioration of the macular area of the retina caused by impaired blood supply to the macula. |
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Term
| What are the risk factors for mac. degeneration? |
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Definition
| advanced age, family, tendency, females, caucasian, smoking, high fat diet, obesity. |
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Term
| Clinical manifestations of macular degeneration? |
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Definition
| Affects the ability to read, drive, watch television, and do routine daily tasks (ADL’s) |
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Term
| What is dry macular degernation? |
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Definition
| Blood vessels under the macula become thin and brittle. Causes blurred vision and dim spots in the central vision. Progesses gradually. Most common. NO TREATMENT |
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Term
| What is wet macular degeneration? |
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Definition
Brittle vessels break down and new fragile vessels grow under the macula and they leak. Less common. Sudden onset with rapid loss of vision. Distortion of straight lines, dark sports in central vision, sudden loss of central vision.
NO CURE. Laser surgery, photodynamic therapy, antiangiogenesis (slows formation of new blood vessels) |
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Term
| What medications treat wet macular degenerations? |
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Definition
Pegaptanib - injectible eye agent used to stabilize vision loss slightly
Ranibizumab - injectible eye agent used to stop vision loss or improve vision in the early stages of wet age-related macular degeneration 65+ |
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Term
| What is retinal detachment? |
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Definition
MEDICAL EMERGENCY
Acute condition in which the retina separates from supporting structures, vitreous humor leaks through a retinal tear and accumulates under retina which causes it to peel away from the choroid. Expands overtime and leads to ischemic retina and vision loss. |
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Term
| What are the clinical manifestations of retinal detachment? |
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Definition
Flashes of light in the peripheral vision, blurred vision, floaters, darkening vision (curtain)
REQUIRES EMERGENCY SURGERY |
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Term
| What are age related changes in the ear |
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Definition
Structures thicken
Presbycusis - hearing loss
Impacted cerumen
Sensioneural loss - damage to inner ear, auditory nerve, brain
Conductive hearing loss - transmission problem from outer to inner ear
Tinnitus |
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Term
|
Definition
| Infection in the middle ear that is common to young children with narrow, straight, and short eustachian tubes. Fluid does not drain properly, sets stage for bacteria. Also adenoid enlargement causes fluid to compress tube |
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Term
| How does otitis media begin? |
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Definition
| Begins with URT infection, may lead to ruptured tympanic membrane, scar tissue, conductive hearing loss |
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Term
| What are the risk factors for otitis media? |
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Definition
Daycares
Supine feedings for infants
Smoke exposure
History of allergic rhinitis |
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Term
| What are the clinical manifestations of otitis media? |
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Definition
Ear pain, crying, irritability
Rubbing, pulling at the ear
Mild hearing deficits
Sleep disturbances
Red bulging tympanic membrane
Fever, malaise, and chills
Purulent or clear exudate (ruptured tympanic)
N/V/HA |
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Term
| How is otitis media treated? |
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Definition
Eradicate infection-oral and otologic antibiotics
Decrease fluid- oral decongestant & antihistamine
Manage pain- anagesics
Control fever-antipyretic
Drainage tubes/removal of adenoids |
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Term
| What is usually used to treat OM? What if there is an allergy? |
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Definition
Amoxicillin 40-45mg/kg PO twice daily, 5-10days
PCN allergy then:
Azithromycin or clarithromycin
Cephalosporins if not severe allergy to PCN
Cefaclor (Ceclor)
SE-overgrowth or non-susceptible organism, hypersensitivity
CI- hypersensitivity |
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Term
| What is otitis externa? Who is at risk? |
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Definition
| Swimmer's ear. Infection/inflammation to the outer ear. usually bacterial in origin but may be fungal. Those who swim in contaminated water, scratchers of ears, foreign objects in ears. |
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Term
| What are the clinical manifestations of OE? Treatments? |
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Definition
Clinical manifestations
Ear pain worsens with auricle movement
Purulent exudate
Itiching
Fullness in the ear
Hearing deficits
Diagnostics: H&P, otologic exam, exudate C&S
Treatment: local otologic antibiotic, antifungal, corticosteroids, analgesics, saline lavage
Prevention strategies: drying ears after swimming, avoid foreign bodies, treat pools properly |
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Term
| What drugs are used to treat OE? |
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Definition
Swimmers ear- Ear-Dry, Debrox gtts up to 4 days
See Table 49.9
Fluoroquinolones
Oral Cipro (adults) or Keflex (children) if extended to pinna
Antihistamine-decongestants
Reduces nasal and ear congestion
Reduces edema and promotes drainage of middle ear
SE-drowsiness, dry mucosa membranes |
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Term
|
Definition
Loosens and removes cerumen from the ear canal
Irrigate with ½ hydrogen peroxide sol. And ½ water or Debrox
1-2 gtts of olive oil or mineral oil softens wax |
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Term
| What are traumatic disorders of the ear? |
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Definition
Direct physical trauma
Excessively loud noises
Can result in hearing loss
Clinical manifestations: bloody or clear exudate, tinnitus, dizziness, ear pain, deficits, N/V/Edema
Treatment: remove object, surgery, limit loud sounds to allow healing |
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Term
|
Definition
Abnormal bone growth in the middle ear
Prevents ear structures from vibrating
Unknown cause, hereditary, pregnancy may trigger
Progressive hearing loss
Nerve loss can occur in conjunction with conductive loss
Most common in women and Caucasians |
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Term
| How is otosclerosis treated? |
|
Definition
Hearing aids
Surgery to remove the stapes and replace with prosthetic
Laser Surgery to create an opening in the stapes, prosthetic device may be placed |
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Term
| What is meniere's disease? |
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Definition
Disorder of the inner ear from endolymph swelling
Swelling interferes with hair receptors in the cochlea and vestibule
Cause is unknown
Associated with head injuries, otitis media, syphilis
Risk factors: allergic rhinitis, alcohol, stress, fatigue, medications (ASA), respiratory infection |
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Term
| What are the clinical manifestations of meineire's disease? |
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Definition
Clinical manifestation:
Waves of acute episodes lasting months with brief periods of relief
Triggered by barometric pressure or risk factors
Intermittent vertigo
Tinnitus,
Unilateral hearing loss, sensation of fullness
Repeated episodes lead to hearing loss |
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Term
| What are the treatments for meniere's disease? |
|
Definition
Treatment: no cure, Relieve pressure and symptoms
Antihistamine agents
Benzodiazepines
Anticholinergic agents
Diuretics
Antiemetics
Avoid triggers
Gentamicin, corticosteriods (reduce swelling) injections
Surgical removal of endo lymph or inner ear, vestibular nerve resection
Hearing aids, PT to improve balance |
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Term
| Notes on Meniere's Diseases: |
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Definition
| Disruption of the endolymph (fluid in inner ear assist with hearing) due to jerky movements (like spinning around or driving over bumps while riding in a car) can cause motion sickness.[2] A condition where the volume of the endolymph is greatly enlarged is called endolymphatic hydrops and has been linked to Ménière's disease |
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