Eye Notes From Lecture.docx

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Terminology o Oculus dexter  RE o Oculus sinister  LE o OU (both eyes) Visual acuity, pupillary exam, IOP (always check!) Anterior segment exam uses the fluorescein stain (uses slit lamp to examine the anterior segment) (stains devitalized cell)  distuinguishes between herpes simplex and VSV (herpes simplex has terminal bulbs) (pseudodendrite  herpes zoster virus) o When herpes comes back it can infect the deeper portions of the eye o DO NOT TREAT WITH CORTICOSTEROIDS (keratitis) THE RED EYE o 2 day history of pink eye  adnexal disease (supporting structures around the eye)  When herpes attacks the cornea  keratitis o Acute angle closure glaucoma  Opthalmologic emergency  The normal flow through trabecular meshwork and Schlemm’s canal gets blocked from the pushing of the lens and blocks the normal flow  Treatment is to get the pressure down (dimox, mannitol)  Anterior chamber is the problem here o Collections of WBC in the eye  Iritis/iridocyclitis  Also look for flair (protein in the light beam can be seen) o Infectious conjunctivitis  Usually viral form adenovirus following an URI or cold, very contagious  1. Enlarged follicles in lower aspect of eyelid (lymphoid hyperplasia)  2. Preauricular lymphadenopathy  Bacterial  purulent/mucopurulent  Chlamydia is very high  Erthyromycin  Neisseria also present  Possible visual sequelae is corneal scarring o Subconjunctival hemorrhage  “tiny bruise” on eye  usually very benign o Corneal abrasion  5 layers on the cornea  epithelium can be disrupted o Hyphema  Blood in the anterior chamber (traumatic injury)  Treat similar to iritis (topical corticosteroids, cyclopegic)  Should have sickle cell on your differential with this condition

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Reason is that dimox can put them into a sickle cell crisis and metabolic acidosis

o Alkali burn  Treatment starts immediately with irrigation  very poor prognosis compared to acid burn  Flush with lactated ringer’s  Alkali can penetrate very deep  When you start to see white around instead of red blood vessels it’s a very poor prognosis 80 yo male with white eye o Cataracts  Patients become more nearsighted as they loose elasticity of the lens  Kids remove right away to remove amblyopia  One eye is deprived at a young age, the nerves can atrophy (reversible but only if treated quickly) (competition b/w eyes) o Baby  white pupil  retinoblastoma