Catch the red eye
What are the 2 cardinal symptoms of conjunctivitis?
Otitis externa is most commonly caused by what?
Bacterial Infection (P. aeruginosa, S. aureus, polymicrobial)
What is the diagnosis:
Patient presents with a unilateral, painless lesion on the left upper eyelid. There is no erythema and it has slowly grown in size over the past week.
Chalazion
#1 risk factor for primary open angle glaucoma
Elevated IOP
Other risk factors include: Older Age, Race/Ethnicity: non-white (particularly black), Family history of glaucoma, Moderate to high myopia, Low diastolic blood pressure
What types (3) of discharge are not commonly associated with bacterial conjunctivitis?
Serous, mucoid, mucoserous
How should the ear be manipulated when instilling ear drops in an adult patient like Jim?
Gently pull the top of the ear up and back
What is the role of ophthalmic corticosteroids with respect to treatment of dry eye disease?
Short term only - either pulse therapy to reduce DED symptoms & ocular inflammation or overlap with immunomodulator imitation
DAILY DOUBLE - In a patient with ACAG - why would they be given mannitol?
dehydrate the vitreous body to reduce IOP
A current URTI is most commonly associated with which type of conjunctivitis and which pathogen?
Viral Conjunctivitis + Adenovirus
Otitis Externa may be distinguished from Otitis Media by what signs when manipulating the ear?
Tenderness of the tragus when pushed and of the pinna when pulled
What are the 3 key risks of prolonged ophthalmic corticosteroid use?
Elevated IOP, infection, cataracts
Name the clinical outcome and the surrogate marker that it is correlated to that are monitored in patients with POAG
Clinically meaningful outcome: Vision loss
Surrogate marker: IOP
DAILY DOUBLE - Prolonged or Overuse use of medications such as naphazoline are associated with these 2 adverse drug reactions
What is a key piece of education to tell patients to do after they have instilled the correct number of ear drops?
Stay in the same position for 3–5 minutes to allow the drops to run down into the ear canal
A patient presents post cataract surgery with a prescription for:
Besivance (besifloxacin) eye drops
What is the purpose of this eye drop?
prevent endophthalmitis
When deciding on a target IOP, state 2 patient factors that would result in a lower target IOP.
Advanced Disease
Long life expectancy
Lower baseline IOP
Fast Rate of progression
Additional risk factors such as secondary glaucoma
State 4 red flag symptoms that would prompt an URGENT referral when assessing a patient for an eye complaint
- Trauma to the eye: Chemical Exposure or Mechanical Injury (Recent surgery, fingernail, mascara wand, branch, etc.)
- Visual Disturbance: Anything that impacts the ability to see clearly (Double vision, halos & glare, blurred or wavy vision, blindness, flashes, etc.)
- Photophobia
- Pain (As a prominent symptom, Moderate - Severe)
- Prior History of ocular disease such as: keratitis, uveitis/iritis, corneal ulcer, ACAG, orbital cellulitis, endophthalmitis, scleritis
- Severe Systemic Symptoms such as Nausea, headache
Visually assess for:
•Irregular Pupils, Visible Corneal Opacity/Haze, Focal Redness, Rash ± Vesicles on eyelid or around eye, Ciliary Flush, Hyper-purulent Discharge
Which of the following agents is SAFE to use with a non-intact tympanic membrane and why?
- Polymyxin B/Gramicidin eye/ear drops
- Ciprofloxacin/Dexamethasone ear drops
- Tobramycin eye drops
Ciprofloxacin/dexamethasone ear drops are safe
Not ototoxic like tobramycin and Polymyxin B/Gramicidin
Explain why VEGF inhibitors would be effective for neovascular (wet) AMD but would not be effective for nonexudative (dry) AMD
How they work: ↓ VEGF levels = inhibit growth + regress new blood vessels in choroidal neovascular (CNV) membranes
wet AMD: abnormal blood vessels grow under retina - this is not so in dry AMD
dry AMD: macular thins with age + drusen grow
What is the mechanism for why antihistamines (and other anticholinergic medications) lead to elevated IOP in closed-angle glaucoma?
May lead to pupillary block, caused by dilating the pupil