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- Glaucoma
- Narrow angle glaucoma (closed angle glaucoma)
- Eye findings linked with medical diseases
Hyphema = traumablood can cause increased IOP, often have 2nd bleeding day 2-5 Treatment: dilate pupil to prevent adhesions of lens and iris / topical steroids? RTC with changes in vision / early: wash out blood / late: forms a dumbbell-shaped clot, must maintain outflow and wait for clot to dissolve Other Ocular Conditions Actinic keratosis [pic] Arcus junenilis [pic] Chalazion [pic][pic][pic] Dermoid [pic] Gerontoxon [pic] GlaucomaScreening PMH, FH, visual acuity, IOP exam [15-20 normal, 22 mm HG is worrisome] Few early symptoms of 1o open angle glaucoma (OAG) (only diagnosed by eye exam) Cup: small, pale / vertical cup-disc ratio changes Neural rim: wide, symmetrical, orange-red / color and width of neural rim changes / asymmetry between eyes Early: ⅓ disc surface / cup extends to rim (always abnormal) Narrow angle glaucoma (closed angle glaucoma)Findings: intense pain, mid-dilated pupil, blurred vision, light reflex broken up, eye may appear red, nausea, vomiting Treatment: pilocarpine 2% gtts q 15 mins (constrict pupil) / acetazolamide 500 mg PO or IV (reduces production) / oral glycerine or isosorbide 1 cc/kg (osmotic agents to reduce pressure) / surgical correction Congenital glaucoma (1 in 10,000) presents with tearing (more likely congenital obstruction of nasolacrimal duct, Rx with little probe) Chronic (open angle glaucoma) (OAG) incidence of 1.5 million (?most common type of glaucoma) Hordeolum (“stye”) [pic][pic] pain, swelling, discomfort / very common / acute inflammatory process usu. limited to 5-7 days, 50% resolve with medical management in < 6 wks Ddx: acute chalazion Treatment: initially, medical (warm compresses, eyelid hygiene, topical anti-inflammatories and possibly/probably concomitant topical antibiotic therapy; oral if severe), but if not improving or severe, consult ophthalmologist for possible surgical incision and curettage under topical anesthesia / may need to treat accompanying blepharitis or meibomianitis Hyperemia [pic] Presbycusis most common cause of sensorineural hearing loss in elderly / damage over time (> 2000 Hz) Ddx: Meniere’s, chronic otitis media (both unilateral) / rule out cerumen impaction Pterygium chronic irritation (like wind/dust) causes damage to cornea [pic][pic] Treatment: removal/radiation
Papilledema – HTN/increased ICP Ddx for red eye includes acute NAG vs. Adenovirus (with pre-auricular LAD with pink eye) Pain think cornea or bacteria > viral Steroids contraindicated in HSV, fungus, increased IOP (25% with 1-2 wks use), cataracts (long term use) Eye findings linked with medical diseases
Female [postmenopausal bleeding] [amenorrhea] [obstetrics] Infections BV, chlamydia, Trichomonas, PID Female Breast Breast Cancer (screening) Vulva, Vagina Cervix CIN, cervical Ca Endometrium functional disorders, endometriosis, neoplasia, mesenchymal tumors, gestational trophoblastic Fallopian tube Ovary follicular cysts, PCOS, ovarian tumors – epithelial/germ cell Other incontinence, women’s health maintenance, menopause, PMOF Disorders of Sexual Development Gonadal dysgenesis (Turner’s syndrome) 1 in 2500-10,000 live female births / 45,X / not familial, is not related to the mother’s age Ovaries fail to develop (bilateral streaks of connective tissue, no germ cells) Estrogen deficiency sexual infantilism (no 2o sexual characteristics) and ↑LH/FSH Somatic abnormalities Short stature (48 to 58 in), short, webbed neck, epicanthal folds, low-set ears, a shield- chest with widely spaced nipples, cubitus valgus (wide carrying angle), and renal and cardiac abnormalities (coarctation of aorta) Treatment: estrogen to promote secondary sexual characteristics (cyclic E/P can cause regular menstruation, but not fertility) / removal of streak ovaries: can have sex chromosome mosaicism (some cells have Y chromosome, can lead to gonadal tumors) Download 3.95 Mb. Share with your friends:
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