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Glaucoma: What happens to the IOP and the optic nerve? What causes a change in the anterior chamber pressure?
The IOP is increased and the optic nerve is damaged. Any impediment to the flow of aqueous humor through the trabecular meshwork and canal of Schlemm will increase pressure in the anterior chamber.
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Typical open-angle glaucoma patient
Older than 40 years, more common in AA and pts with family history of glaucoma.
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Which type of glaucoma is an ophthalmologic emergency?
Angle-closure glaucoma
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What are some clinical features of acute-closure glaucoma? What would the PE reveal?
- Painful eye, loss of vision, nausea, vomiting, diaphoresis.
- Circumlimbal injection, steamy cornea, fixed mid-dilated pupil, decreased visual acuity, anterior chamber is narrowed, IOP acutely elevated
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Orbital cellulitis is more common in children or adults?
Children
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What are some possible causes of orbital cellulitis?
Sinusitis, dental infections, facial infections, infection of the globe or eyelids, and infections of the lacrimal system. Less often, it results from trauma.
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In children younger than 4 years, what causes orbital cellulitis?
Haemophilus influenzae and Streptococcus pneumoniae.
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In older children and adults, what causes orbital cellulitis?
Usually secondary to acute or chronic sinusitis, many possible causative agents
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What is the presentation of orbital cellulitis?
Ptosis, eyelid edema, exophthalmos, purulent discharge, conjunctivitis. On PE, fever, decreased ROM in EOM, and sluggish papillary response
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