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ComPbms.HEENT

Eye

QuestionAnswer
Corneal Abrasion: What The loss of surface epithelial tissue of the cornea due to trauma. Most heal within 48 hours and do not require referral or follow up.
Corneal Abrasion: Referral Corneal ulceration is a deeper injury to the ocular surface and is a medical emergency and should be referred immediately.
Corneal Abrasion: Clinical Presentation Haziness of the cornea. Redness and possible infection of the cornea. Disruption of corneal surface (may be seen with the naked eye but usually needs staining to be visible). FOB sensation and pain. Light sensitivity, tearing. Gritty feeling.
Corneal Abrasion: Work Up Fluorescein staining and slit lamp. Always get a visual acuity before any tx including analgesia. Intraocular pressure. Rule out any other disease or pathology.
Corneal Abrasion: Work Up It is important to complete an eye exam with fluorescence stain when a foreign body or abrasion may be present.
Corneal Abrasion: Treatment Patching has fallen out of favor but may offer comfort. Warm compresses are soothing and will aid in healing. Topical antibiotics without steroids current favored RX: Ciprofloxacin opth. Tobramycin opth. Vigamox (moxifloxacin).
Conjunctivitis: What The dreaded “pink eye” is inflammation of the conjunctiva resulting from viral, bacterial, allergies and chlamydia. Allergic conjunctivitis is the most common ocular allergy. Bacterial or viral is often seasonal and contagious!
Conjunctivitis:Physical Presentation Infection and chemosis of the conjunctivea with discharge. Cornea is generally clear but can be involved. Vision is usually normal but can be blurry.
Conjunctivitis: Treatment Warm compresses if infective and cool if allergy origins. Remove contacts and completely resolved. Antibiotic drops for bacterial in origin. Oral antihistamines for allergy symptoms.
Conjunctivitis: Treatment Mast cell stabilizers are useful if the eyes are the only system experiencing symptoms, these may be used for extended periods of time. Dry eyes should use artificial tears.
MACULAR DEGENERATION: What Is defined as a group of disease that result in the loss of central vision. Degenerative changes occur in the pigment, neural and vascular layers of the macula.
MACULAR DEGENERATION: What Two Types: Dry macular degeneration- ischemic in etiology. Wet or age related – is associated with blood vessel leakage.
MACULAR DEGENERATION: Epidemiology Leading cause of blindness in > 50year olds. Age 75-80 yrs is peak incidence. Approximately 50% of people > 50 have signs of macular degeneration. Both sexes are equally affected.
MACULAR DEGENERATION: Risk Factors Advancing age. Genetic factors. History of smoking within past 20 yrs. Dietary factors (low in antioxidants zinc and high fat). Obesity. White race more common.
MACULAR DEGENERATION: Referral & NP ROle These patients need close following by an Opthmologist, the role of the NP should be to encourage good health habits and appropriate follow up screening schedules.
CATARACTS What The clouding and opacification of the normally clear crystalline lens of the eye. Most common treatable cause of blindness. Physical findings is the actual visual of the cloudiness of the eye when examining the patient.
CATARACTS: W/U, Tx Work up for younger patients is to rule out DM, collagen vascular disease, or other metabolic diseases. There is no treatment to slow or reverse the cataract and surgery is postponed until visual compromise is present.
CATARACTS: NP ROle NP Role:monitor all health conditions, safety factors and referral when appropriate.
GLAUCOMA: Chronic open angle Chronic open angle glaucoma is damage to the retinal nerve associated with increased intraocular pressure. It is chronic slow progressive disease and now considered a primary disease of the eye. Must be closely monitored by the Opthmologist.
GLAUCOMA: Primary Closed Angle Is an elevated intraocular pressure associated with closure of the filtration or obstruction in the circulating pathway of aqueous humor. The patient will present with unilateral visual loss, red inflamed eye and PAIN.
GLAUCOMA: Primary Closed Angle Referral This is a sight threatening emergency, the sooner treatment to lower eye pressure is instituted the better the outcome. Referral to Ophthalmologist or Emergency department is imperative.
EYE EMERGENCIES Any sight loss, diminished sight or sudden significant change in eyesight is an emergency. Recognized early in many cases can result in vision restoration. Specific emergent conditions.
EYE EMERGENCIES Giant cell arteritis- HA, visual loss in one eye, fever, polymyalgia, tenderness of temporal artery. Retinal detachment- painless visual loss or describes a curtain over visual fields.
Created by: DianaB
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