7. Conjunctivitis
Bacterial:
-pus drainage
-strep or staph
-pseudomonal (contact
lens, treat with
aminoglyc/quinolone)
Tx: topical abx
ghonorrhea: 1st 3 days of
life, ocular emergency,
pouring pus out of the
eye, systemic abx
(rocephin, topical
erythromycin, cover for
chlamydia)
Chlamydia: first 5-14
days of life, systemic and
topical abx
Contagious for 2 weeks
12. Foreign Body
Remove with
moistened cotton
swab, needle
Evert eyelids, stain
with flourescein
Rust ring: needs to
be removed, burr
device, refer ophtho
14. Herpes
Simplex
Keratitis causing foreign body
sensation
Dendritic corneal lesion
Tx: urgent ophtho consult, topical/po
antiviral, no topical steroids
Zoster
Ophthalmic branch of the trigeminal N.
(V1)
Hutchinson sign
Tx: systemic/topical antiviral, emergent
ophtho consult, +/- steroids, pain
control
15. Preseptalv. Orbital Cellulitis
Orbital
Sick, pain with eye
movement, proptosis
Tx: CBC, Bldcx, CT
obrits, IV abx
Preseptal/Periorbital
Pain, swollen lid
Complications:
meningitis, sepsis,
abscess, cavernous
sinus thrombosis (CN 3,
4, 6)vision loss from high
IOP
17. Chronic (Open angle
glaucoma)
Gradual peripheral vision loss
age >40,African American, family hx
Tx: topical/systemic meds to decrease
aqueous humor production and increase
flow
18. Acute angle glaucoma
Precipitated by dim light (dilated pupil)
“walking out of a movie theater”
Painful loss of vision, headache, nausea, halos
Eye injected, steamy cornea, elevated IOP 40-70
Tx: emergency ophtho referral, topical/systemic meds to
decrease aqueous humor production and increase
flow
IV carbonic anhydrase inhibitor, BB gtt, mannitol,
pilocarpinegtt
19. Iritis
Acute painful red eye,
blurry vision
Can be traumatic
Ciliary flush – reddening
of sclera at the limbus
Cells and flare
No relief with topical
anesthetic
Tx: topical cycloplegic
22. Optic Neuritis
Acute painful (central)
vision loss
Pain with eye movement
Inflammation of optic
nerve
“Marcus gun pupil” (APD)
Associated with MS
Can be caused by toxins,
meds, autoimmune dz
Tx: IV steroids
23. Retinal Detachment
Traumatic or atraumatic
Retinal tear allows vitreous
fluid to separate retina from
choroid
Risk factors:
old, degenerative
myopia, previous
detachment
Painless flashes of
light, floaters, curtain over
eye
28. Globe Rupture
Scleral rupture from high IOP
Teardrop pupil, seidel’s sign
NO TONOPEN
Tx: hard shield, analgesia, tetanus, IV abx, ophtho consult
29. Hyphema
Blood in the anterior chamber
Can lead to increased IOP,
eye staining
Trauma, anticoagulation,
spontaneous (sickle cell)
Secondary bleeding as clot
retracts
Increased risk of glaucoma,
adhesions, vision loss
Tx: bedrest, analgesics, no
anticoag, ophtho consult
30. Orbital Fracture
Orbital walls made of thin bones
Weakest = floor
-infraorbital nerve involvement, inhibited upward
gaze, numbness of cheek or upper lip, diplopia
Tx: if nml exam, urgent ophtho referral
32. Lid Lacerations
Ophtho repair:
involve lid margin
6-8mm from medial canthus
involving lacrimal duct
involving inner surface of the lid
associated ptosis
<1mm heal spontaneously