Maryville University Nurs 621 - HEENT Exam 1
What are conditions that require immediate referral? - correct answer -severe or sudden vision
loss.
-sudden or intense eye pain.
-corneal ulceration.
-trauma.
-foreign body
-herpetic infection of the eye
What type of pain does conjunctivitis, stye and dry eyes have? - correct answer Irritation,
grittiness or scratchiness.
What type of pain will the patient experience if the cornea is the issue? - correct answer -
photophobia (can be severe)
-difficulty keeping eye open.
What 2 things can we ask the patient to help us distinguish between viral, allergic and
bacterial? (in terms of eye complaints) - correct answer -Ask about timing of the discharge.
-Ask about the characteristic of the eye discharge.
-Also ask about history of any URI symptoms
What are the basics in terms of physical exam for someone with an eye complaint? - correct
answer -making sure the globe is intact.
-red reflex
-pupils are reactive to light.
-EOM
-Visual acuity.
What is Blepharitis? - correct answer -Inflammation involving the structures of the lid margin.
-The most common ocular disease.
What is the presentation of Blepharitis? - correct answer -redness
,-scaling
-crusting of the lid margins and eye lashes.
-pt reports burning, itching, feeling like something is in the eye.
How do you manage Blepharitis? - correct answer -Warm compresses 5-10 mins BID.
-scrub lash with diluted baby shampoo BID.
-Treatment:
Bacitracin, erythromycin, azithromyacin drops.
What is a Hordeolum (stye)? - correct answer -an erythematous tender lump within the eye lid.
-involves infection or inflammation of a hair follicle of the eye lashes along the lid margin.
- caused by blocked meibomian glad or infection of sebaceous glands of the eyelash.
What is the onset for a Hordeolum? - correct answer Acute
Presentation of hordeolum? - correct answer -Sudden onset
-painful swelling
-pimple/abscess in either upper or lower lid.
-tender lump.
What is a Chalazion? - correct answer -A hordeolum that doesn't resolve and eventually forms
granulation tissue.
-A blocked Meibomian gland.
-Pea-sized nodule within the eyelid, typically top eyelid.
What are the symptoms of a Chalazion? - correct answer -slow developing.
-no pain.
-hard mass/nodule within the eye lid (upper eyelid usually)
Is a Chalazion an infection? - correct answer No
What do you do if the Chalazion is persistent? - correct answer Refer to ophthalmology for
further evaluation.
What is bacterial conjunctivitis?
Is it contagious? - correct answer Inflammation and infection of the conjunctiva which is caused
by bacteria.
, Yes, highly contagious - direct contact with secretions or contaminated surfaces.
What is the symptomatic presentation of bacterial conjunctivitis? - correct answer -redness
-purulent or mucopurulent discharge (thick and globular)
-unilateral at onset
-eyelids "glued" shut in the AM.
-eyelid edema.
What are major pathogens in acute bacterial conjunctivitis? - correct answer Gram Positive
Organisms
-Staphylococcus aureus (most common in adults)
-Streptococcus pneumoniae
Gram Negative Organisms
-Moraxella catarrhalis
-Haemophilius influenzae
-N. gonorrhoeae
What is the diagnostic clue of Chlamydial Conjuctivitis? - correct answer A CC that an eye
infection has persisted for >3 weeks despite treatment with topical antibiotics.
How is Chlamydia Conjunctivits trasmitted? - correct answer Autoinoculation from infected
genital secretions.
What are the S/S of chlamydial conjunctivitis? - correct answer -mucopurulent discharge.
-corneal infiltrates.
-palpable preauricular node is usually present.
Ear infection and rhinitis cold accompany it.
What is the treatment of chlamydial Conjunctivitis? - correct answer Doxycycline 100mg BID x7
days
OR
Azithromyacin 1 gram PO in combination with topicals.
What are conditions that require immediate referral? - correct answer -severe or sudden vision
loss.
-sudden or intense eye pain.
-corneal ulceration.
-trauma.
-foreign body
-herpetic infection of the eye
What type of pain does conjunctivitis, stye and dry eyes have? - correct answer Irritation,
grittiness or scratchiness.
What type of pain will the patient experience if the cornea is the issue? - correct answer -
photophobia (can be severe)
-difficulty keeping eye open.
What 2 things can we ask the patient to help us distinguish between viral, allergic and
bacterial? (in terms of eye complaints) - correct answer -Ask about timing of the discharge.
-Ask about the characteristic of the eye discharge.
-Also ask about history of any URI symptoms
What are the basics in terms of physical exam for someone with an eye complaint? - correct
answer -making sure the globe is intact.
-red reflex
-pupils are reactive to light.
-EOM
-Visual acuity.
What is Blepharitis? - correct answer -Inflammation involving the structures of the lid margin.
-The most common ocular disease.
What is the presentation of Blepharitis? - correct answer -redness
,-scaling
-crusting of the lid margins and eye lashes.
-pt reports burning, itching, feeling like something is in the eye.
How do you manage Blepharitis? - correct answer -Warm compresses 5-10 mins BID.
-scrub lash with diluted baby shampoo BID.
-Treatment:
Bacitracin, erythromycin, azithromyacin drops.
What is a Hordeolum (stye)? - correct answer -an erythematous tender lump within the eye lid.
-involves infection or inflammation of a hair follicle of the eye lashes along the lid margin.
- caused by blocked meibomian glad or infection of sebaceous glands of the eyelash.
What is the onset for a Hordeolum? - correct answer Acute
Presentation of hordeolum? - correct answer -Sudden onset
-painful swelling
-pimple/abscess in either upper or lower lid.
-tender lump.
What is a Chalazion? - correct answer -A hordeolum that doesn't resolve and eventually forms
granulation tissue.
-A blocked Meibomian gland.
-Pea-sized nodule within the eyelid, typically top eyelid.
What are the symptoms of a Chalazion? - correct answer -slow developing.
-no pain.
-hard mass/nodule within the eye lid (upper eyelid usually)
Is a Chalazion an infection? - correct answer No
What do you do if the Chalazion is persistent? - correct answer Refer to ophthalmology for
further evaluation.
What is bacterial conjunctivitis?
Is it contagious? - correct answer Inflammation and infection of the conjunctiva which is caused
by bacteria.
, Yes, highly contagious - direct contact with secretions or contaminated surfaces.
What is the symptomatic presentation of bacterial conjunctivitis? - correct answer -redness
-purulent or mucopurulent discharge (thick and globular)
-unilateral at onset
-eyelids "glued" shut in the AM.
-eyelid edema.
What are major pathogens in acute bacterial conjunctivitis? - correct answer Gram Positive
Organisms
-Staphylococcus aureus (most common in adults)
-Streptococcus pneumoniae
Gram Negative Organisms
-Moraxella catarrhalis
-Haemophilius influenzae
-N. gonorrhoeae
What is the diagnostic clue of Chlamydial Conjuctivitis? - correct answer A CC that an eye
infection has persisted for >3 weeks despite treatment with topical antibiotics.
How is Chlamydia Conjunctivits trasmitted? - correct answer Autoinoculation from infected
genital secretions.
What are the S/S of chlamydial conjunctivitis? - correct answer -mucopurulent discharge.
-corneal infiltrates.
-palpable preauricular node is usually present.
Ear infection and rhinitis cold accompany it.
What is the treatment of chlamydial Conjunctivitis? - correct answer Doxycycline 100mg BID x7
days
OR
Azithromyacin 1 gram PO in combination with topicals.
