FNP2 Quiz 1 Eyes

  1. Blood floating in eye, usually from blunt trauma
    hyphema
  2. s/s of hyphema
    • blurry vision
    • pain/pressure
    • pain sensitive to light
  3. Tx for hyphema.
    • Will heal on its own in about 2 weeks
    • (increased risk of rebleed during first week)
  4. How is viral conjunctivitis spread?
    • hand-to-eye contact
    • hand-to-object contact
  5. Most common cause of viral conjunctivitis.
    adenovirus
  6. How is bacterial conjunctivitis spread?
    • direct hand-to-eye contact from contaminated hands
    • large respiratory tract droplets
  7. S/S of Nasolacrimal Duct Obstruction (NLDO)
    • excessive tearing
    • overflow of tears onto eyelashes, lids, cheeks
    • eyelids red & swollen
  8. s/s of secondary infection from NLDO.
    tenderness & swelling over lacrimal duct
  9. tx for NLDO
    • spontaneously resolves usually by 1 yoa
    • if no improvement by 9 mos, refer to opthamologist
  10. Infection in one of the oil glands that surrounds an eyelash follicle.
    hordeolum (stye)
  11. Usual cause of hordeolum (stye).
    Staph aureus
  12. s/s of hordeolum (stye)
    • local or diffuse swelling of eyelid
    • tenderness
    • erythema spreading away from localized site of infection
    • occasional sensation of "grit" or foreign object in eye
  13. Tx for hordeolum (stye).
    • warm compresses,10-15 min qid (most resolve)
    • cleanse daily w/ neutral soap 1:1 w/ water
    • abx drops or erythromycin ointment bid x 7 days if persists
  14. Develops in meibomian glands on the conjunctival side of lid (chronic granuloma or result of chronic hordeolum/prior excision).
    Chalazion
  15. localized lesions, hard, nontender, minimal erythema.
    chalazion
  16. Where is a chalazion usually located?
    away from lid border
  17. tx for chalazion
    • if small & asymptomatic, no tx
    • if lg or secondary infection, tx as with hordeolum
  18. Inflammation of eyelid margins (usually chronic).
    blepharitis
  19. What causes blepharitis?
    • staph
    • seborrheic dermatitis, rosacea, or allergies
  20. S/S of blepharitis.
    • scaling of eyelid margins
    • itching, crusting, erythema
    • burning, discomfort, poss feeling of foreign body
  21. s/s of severe and chronic blepharitis
    • purulent discharge
    • permanent changes in eyelid structure can occur over time
  22. Pts with blepharitis usually have a h/o?
    recurrent chalazio or hordeola
  23. Tx for blepharitis
    • cellufresh or bio tears if dry
    • warm wet compress 2 min 2-4x daily to lids
    • then gently scrub eyelids qd baby shampoo 1:1 w/ water
    • flares: topical abx
  24. How is blepharitis associated with seborrhea often improved?
    dandruff shampoo on scalp & eyebrows
  25. _________ usually results from a sinus infection and is localized anterior to the orbital septum, outside the body orbit.
    periorbital (preseptal) cellulitis
  26. s/s of periorbital (preseptal) cellulitis.
    • eye pain
    • conjunctivitis
    • epiphora (blurry, erythema, edema)
  27. Chandlar stage I of periorbital (preseptal) cellulitis.
    periorbital cellulitis
  28. Chandlar stage II of periorbital (preseptal) cellulitis.
    inflammatory orbital edema
  29. Chandlar stage III of periorbital (preseptal) cellulitis.
    subperiosteal abscess
  30. Chandlar stage IV of periorbital (preseptal) cellulitis.
    orbital abscess
  31. Tx of periorbital (preseptal) cellulitis.
    • In older children & adults: abx that would tx URI
    • (amox/clavulanic acid or 1st gen cephalosporin; IM ceftriaxone)
    • younger: need hospital eval
  32. If no improvement in periorbital (preseptal) cellulitis in 48-72 hours, what is tx?
    consider IV abx
  33. An acute infection of the tissues immediately surrounding the eye, including eyelids, eyebrow, & cheek. Also involves infection of fat & muscle w/in bony orbit.
    Orbital Cellulitis
  34. What is the usual cause of Orbital Cellulitis?
    • bacteria from a sinus infection
    • also can be caused by styes, bug bites, eyelid injury
  35. Eye infection that is dangerous with potentially serious complications - get worse quickly and if left untreated can lead to blindness.
    Orbital Cellulitis
  36. S/S of Orbital Cellulitis.
    • painful swelling of upper & lower eyelid, can include cheek & eyebrow
    • bulging eyes
    • decreased vision
    • eye pain, esp w/ movement of eye
    • fever (usually 102 or higher)
    • shiny, red/purple eyelid
  37. Tx for Orbital Cellulitis.
    • IV abx
    • surgery may be necessary to drain abscesses
  38. Diffuse dilation of vessels with redness that tends to be maximal at periphery.
    Conjunctival injection (pink eye; conjunctivitis)
  39. Result of small BV rupture in conjunctival tissue.
    subconjunctival hemorrhage
  40. s/s of subconjunctival hemorrhage.
    no s/s  - usually someone else notices or noticed in mirror
  41. Causes of subconjunctival hemorrhage.
    • coughing, vomiting, straining
    • HTN; blood thinners
    • in infants during vag births
  42. tx for subconjunctival hemorrhage
    • blood will gradually reabsorb in about a week. No tx
    • (color of blood will change)
  43. Often benign inflammation of covering of sclera.
    Episcleritis
  44. s/s of Episcleritis
    • bilateral mild stinging
    • tearing, photophobia
    • peripheral injection
    • *no visual acuity impairment or discharge*
  45. tx for Episcleritis
    usually improves w/o tx
  46. How is scleritis different than episcletiritis?
    • scleritis can result in destructive disease, is unilateral, & visual acuity can be affected
    • episcleritis is benign inflammation, bilateral, & visual acuity is not affected
  47. s/s of scleritis
    • unilateral pain & ciliary injection
    • tearing
    • visual acuity can be affected
  48. Inflammation of the iris & ciliary body.
    Anterior uveitis or iritis
  49. s/s of Anterior uveitis or iritis
    • moderate & aching eye pain
    • decreased visual acuity
    • minimal eye discharge
    • pupil smaller
    • *central redness of eye w/ ciliary flush
  50. Involves choroid, a layer of BV, and CT.
    posterior uveitis or choroiditis
  51. Which can develop with systemic infection or autoimmune disease - posterior uveitis (choroiditis) or anterior uveitis (iritis)?
    posterior uveitis (choroiditis)
  52. Which one can be idiopathic or in response to coexistent infection or trauma - posterior uveitis (choroiditis) or anterior uveitis (iritis)?
    anterior uveitis (iritis)
  53. Tx for posterior uveitis (choroiditis) or anterior uveitis (iritis).
    • sun protection
    • poss steroid eye drops or pupil dilation drops
    • if pain continues, refer.
  54. infection/irritation of the cornea.
    keratitis
  55. s/s of keratitis.
    • moderate to severe eye pain
    • some discharge, tearing
    • decreased visual acuity; photophobia
    • cloudy corneadiffuse peripheral injection
    • ciliary flush
  56. Tx for keratitis.
    • depends on cause
    • if noninfectious - eye patch 24 hrs + eye lube
  57. s/s of corneal abrasion
    • eye pain, feeling of foreign object in eye
    • redness
    • tearing
  58. tx of corneal abrasion.
    • minor - heal w/in 72 hrs
    • remove foreign body if present
    • abx ointment/drop
    • no eye make-up or contacts til healed
  59. s/s of primary angle-closure glaucoma
    • unilateral h/a
    • visual blurring
    • nausea
    • photophobia
  60. Physical exam findings for primary angle-closure glaucoma.
    • non-reactive, semi-dilated pupils
    • scleral injection
  61. A common non-cancerous growth of the conjunctiva in one or both eyes and extends into cornea, usually from nasal aspect.
    pterygium
  62. A small, yellowish nodule on the conjunctiva near cornea; usually on nasal side.
    pinguecula
  63. Tx for pinguecula.
    usually none needed
  64. Pinguecula can be a precursor for __________.
    pterygium
  65. _______ is confined to the bulbar conjunctiva.
    pinguecula
  66. RF for pterygium.
    • exposure to sunny, dusty, sandy, or windblown areas
    • farmers, fishermen
    • living near equator
    • rare in kids
  67. Tx for pterygium.
    none needed
  68. Nearsightedness.
    Myopia
  69. Farsightedness.
    Hyperopia
  70. Eye does not focus light on retina evenly & objects appear blurry & stretched out.
    Astigmatism
  71. Difficulty focusing on near objects b/c eye no longer able to change shape as easily.
    presbyopia (age-related)
  72. S/S of cataracts.
    • decreased vision
    • glare (oftenwhen driving at night)
    • straight edges appear wavy; double vision
    • altered color perception
  73. RF for cataracts.
    • DM
    • steroid therapy
    • tobacco & ETOH
  74. What will be noted on a mature cataract?
    leukokoria (white pupil)
  75. An abnormality in the trabecular angle tissue causing resistance to fluid flow; onset is slow and insidious; chronic condition.
    Primary Open Angle Glaucoma
  76. With Primary Open Angle Glaucoma, there is a gradual loss of ___________.
    peripheral vision
  77. Primary symptom of Primary Open Angle Glaucoma.
    loss of peripheral vision
  78. __________ is affected late in Primary Open Angle Glaucoma.
    central visual acuity
  79. What is photopsia?
    flashes in the eye
  80. What is entopsia?
    floaters in the eye
  81. s/s of retinal detachment.
    • sudden increase in floaters
    • light flashes
    • peripheral vision loss
  82. Can feel like a "curtain going down on eye."
    retinal detachment
  83. Leading cause of blindness in US
    age-related macular degeneration
  84. Macular degeneration may be asymptomatic or associated with gradual loss of ________.
    central vision
  85. Rapid vision loss d/t development of abnormal BV under retina that leak fluid; straight lines often appear wavy.
    Exudative/wet AMD (age-related macular degen)
  86. Light-sensitive cells of the macula slowly break down; there is gradual loss of central vision; three stages.
    Nonexudative/dry AMD (age-related macular degen)
  87. Physical exam for macular degeneration.
    • visual acuity test
    • dilated eye exam
    • tonometry
  88. Tx for exudative/wet AMD (age-related macular degen)
    • laser sx
    • photodynamic therapy
    • injections of meds to stop growth of BV
  89. Tx of nonexudative/dry AMD (age-related macular degen).
    • if has reached advanced stage, NO tx
    • if found early, zinc/antioxidant supplements
Author
MeganM
ID
320034
Card Set
FNP2 Quiz 1 Eyes
Description
Mod 1
Updated