Question 1

FDA Cosmetics Safety Guidelines

Accepted Answer

Keep eye cosmetics clean
Don't swap
Keep containers clean
Wash hands before applying
Ingredients must be declared
Discard mascara after 3 months of purchase
False eyelashes and adhesives are cosmetics and must be labeled appropriately.

Question 2

Blepharitis

Accepted Answer

Inflammation of lash follicles at eyelid margin. Can be caused by bacteria, meibomian gland dysfunction or seborrhea. Blinking may cause granular sensation. Loss or inversion of eyelid may occur.

Question 3

Treatment of blepharitis

Accepted Answer

Warm compress; eyelid hygiene; antibiotics (top or sys); top anti-inflammatory agent. Don't use contacts during acute phase. NP only treat bacterial.

Question 4

Antibiotic Ointments Blepharitis

Accepted Answer

Erythromycin 0.5% opthalmic ointment
Bacitracin 500 units/gram ointment
Opthalmic fluorquinolone ($$$): gatifloxacin, levofloxacin, moxifloxacin

Question 5

Patient education Blepharitis

Accepted Answer

Good eyelid hygiene
Warm massages
Tends to be chronic in nature

Question 6

Conjunctivitis

Accepted Answer

Injected blood vessels in the periphery of the eye-along the conjunctival sac especially inner/outer canthus; areas of inflammation upper and lower lid.

Question 7

Phlytenular conjunctivitis

Accepted Answer

Gray/yellow nodules on cornea or conjunctiva; persist several days-1 week. Associated allergic reaction to staph or systemic TB. Ulcerate but heal w/out scar. Recommended tx: corticosteroid or ABX. Refer to opthamologist

Question 8

Chlamydial Conjunctivits (Trachoma)

Accepted Answer

Requires systemic therapy f/b monthly tx of abx oinmt. Eyelid edema*, photophobia*, and lacrimation. *uncommon-send to opth. Follic. phase (small foll appear in upper conj over 10d); invasion of cornea w/ neovascularization (month-year); corneal scarring.

Question 9

Treatment Chlamydial Conjunctivitis

Accepted Answer

Doxy 100 mg BID x 10d
Azithromycin 1gm x 1 dose
Pregnant women, nursing mother, infants:substitute erythromycin
Developing countries w/ endemic trachoma: topical tetracycline or erythromycin top should be applied first 5d of month x 6 mo.

Question 10

Corticosteroids for Conjunctivitis

Accepted Answer

DO NOT PRESCRIBE corticosteroids AS AN NP. They suppress the immune system. Could lead to corneal scarring and blindness.

Question 11

Treatment Allergic Conjunctivitis

Accepted Answer

Topical anhistamines
Topical non-steroidal (anti-inflammatory)
Topical Mast-cell stabilizers
Take care w/ topical decongestants. Patients can become dependent in order to clear redness in the eye. Can lead to chronic state where eyes are addicted.

Question 12

Treatment adenoviral conjunctivitis

Accepted Answer

Use supportive therapy: clean lids; cold compresses; lubricant to eyes; separate towels and washcloth; clean basins frequently.

Question 13

Instructions for contacts

Accepted Answer

Take out contacts before administering eye drops and leave out for 10 minutes after; don't use ointments (eye drops day ointments at night).

Question 14

Dry Eye

Accepted Answer

Artificial tears in day and lubricating ointment at night. Etiology often autoimmune in nature or r/t Bells Palsy. Cornea can be more easily abraded w/ dryness.

Question 15

OPTHAMOLOGIST AND DRY EYE

Accepted Answer

Pilocarpine increases tearing. Topical cyclosporine, immunosuppresive, decreases cytokine production that causes dry eye; topical corticosteroid.

Eye Disorders

Pharmacology

Question	Answer
FDA Cosmetics Safety Guidelines	Keep eye cosmetics clean Don't swap Keep containers clean Wash hands before applying Ingredients must be declared Discard mascara after 3 months of purchase False eyelashes and adhesives are cosmetics and must be labeled appropriately.
Blepharitis	Inflammation of lash follicles at eyelid margin. Can be caused by bacteria, meibomian gland dysfunction or seborrhea. Blinking may cause granular sensation. Loss or inversion of eyelid may occur.
Treatment of blepharitis	Warm compress; eyelid hygiene; antibiotics (top or sys); top anti-inflammatory agent. Don't use contacts during acute phase. NP only treat bacterial.
Antibiotic Ointments Blepharitis	Erythromycin 0.5% opthalmic ointment Bacitracin 500 units/gram ointment Opthalmic fluorquinolone ($$$): gatifloxacin, levofloxacin, moxifloxacin
Patient education Blepharitis	Good eyelid hygiene Warm massages Tends to be chronic in nature
Conjunctivitis	Injected blood vessels in the periphery of the eye-along the conjunctival sac especially inner/outer canthus; areas of inflammation upper and lower lid.
Phlytenular conjunctivitis	Gray/yellow nodules on cornea or conjunctiva; persist several days-1 week. Associated allergic reaction to staph or systemic TB. Ulcerate but heal w/out scar. Recommended tx: corticosteroid or ABX. Refer to opthamologist
Chlamydial Conjunctivits (Trachoma)	Requires systemic therapy f/b monthly tx of abx oinmt. Eyelid edema, photophobia, and lacrimation. *uncommon-send to opth. Follic. phase (small foll appear in upper conj over 10d); invasion of cornea w/ neovascularization (month-year); corneal scarring.
Treatment Chlamydial Conjunctivitis	Doxy 100 mg BID x 10d Azithromycin 1gm x 1 dose Pregnant women, nursing mother, infants:substitute erythromycin Developing countries w/ endemic trachoma: topical tetracycline or erythromycin top should be applied first 5d of month x 6 mo.
Corticosteroids for Conjunctivitis	DO NOT PRESCRIBE corticosteroids AS AN NP. They suppress the immune system. Could lead to corneal scarring and blindness.
Treatment Allergic Conjunctivitis	Topical anhistamines Topical non-steroidal (anti-inflammatory) Topical Mast-cell stabilizers Take care w/ topical decongestants. Patients can become dependent in order to clear redness in the eye. Can lead to chronic state where eyes are addicted.
Treatment adenoviral conjunctivitis	Use supportive therapy: clean lids; cold compresses; lubricant to eyes; separate towels and washcloth; clean basins frequently.
Instructions for contacts	Take out contacts before administering eye drops and leave out for 10 minutes after; don't use ointments (eye drops day ointments at night).
Dry Eye	Artificial tears in day and lubricating ointment at night. Etiology often autoimmune in nature or r/t Bells Palsy. Cornea can be more easily abraded w/ dryness.
OPTHAMOLOGIST AND DRY EYE	Pilocarpine increases tearing. Topical cyclosporine, immunosuppresive, decreases cytokine production that causes dry eye; topical corticosteroid.

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