NR569 Differential Diagnosis In Acute Care Final
Study Guide – Accurate Answers To All Questions
Save Groups
Terms in this set (109)
Allergic Conjunctivitis - Inflammation of the conjunctiva due to allergies is
common, occurring in up to 40% of the population.
Itching is the most consistent sign of allergic
conjunctivitis; it is also characterized by red eyes and
other allergic disease symptoms such as sneezing.
- Symptoms: severe itching (MOST PROMINENT) ,
generalized hyperemia of the conjunctiva, & mild-
moderate tearing. Rubbing of eyelids can lead to
eyelid edema and temporary hyperpigmentation
(allergic shiners/raccoon eyes). Allergic conjunctivitis
often accompanied by s/s of allergic rhinitis,
including the presence of a crease on the nose from
frequent manipulation (toddler salute).
- Treatment: Mild-moderate symptoms ma be
managed with artificial tears and cool/cold
compresses. Severe s/s may require an
ophthalmology consultation, and immune modulation
with topical antihistamine, mast cell stabilizer, or mild
steroid.
,Bacterial Conjunctivitis Bacterial conjunctivitis is the second most common
cause of infectious conjunctivitis, Red, itchy eyes are
associated with this condition, as is purulent or
mucopurulent discharge in one or both eyes.
- Symptoms: copious mucopurulent discharge
(MOST PROMINENT), often unilateral (helps
distinguish from allergic/viral etiology) but may
spread to both eyes via hands when rubbing eyes,
and pain/irritation with severe hyperemia. **There
should be NO frank vision loss.**
- Treatment: Usually with topical antibiotic ointments
or drops.
**Otherwise immunocompetent patients with
unilateral disease may be treated empirically with
topical fluoroquinolones such as moxifloxacin or
gatifloxixin. If no improvement within 48 hours,
cultures should be repeated and ophthalmology
should be consulted.
Toxic Conjunctivitis - Inflammation of the conjunctiva due to medications,
chemicals, or toxins can cause red, itchy eyes.
,Viral Conjunctivitis - Viral conjunctivitis is the most common cause of
infectious conjunctivitis. Red, itchy eyes are
associated with this condition, as is a watery
discharge.
**65-90 % of viral conjunctivitis are caused by
adenoviruses, which are highly contagious and
spread through direct contact. Communicability is
estimated to be 10-14 days. Topical ophthalmic
antihistamines (preferably OTC) may be
recommended to reduce itching and soothe the
eyes.
- Symptoms: Usually presents bilaterally, but
symptoms often start in 1 eye 1-2 days prior. Pain and
burning are the MOST PROMINENT symptoms, and
eyes are very red with copious tearing. Preauricular
lymph node may be palpated, which is relatively
specific to viral etiology. **Symptoms tend to
worsen for the first few days, and generally resolve
within 1-2 weeks.**
**Hand washing and contact precautions are
imperative to prevent the spread of infection.** If
hospital staff become infected, they will have to be
off for 7 days after symptoms start in SECOND eye.
, Blepharitis - Blepharitis, or inflammation of the eyelids, is
characterized by redness at the margins of the
eyelids. Symptoms of blepharitis include: dry, red,
itchy eyelids that may be crusted.
- TREAT - Treatment involves supportive care and
antibiotics. Supportive care: Use warm compresses
to loosen the eyelid crusting. Gently scrub the
eyelids with diluted baby shampoo at least twice
daily. Use artificial tears to lubricate eyes as needed.
Discontinue eye make-up until condition resolves
and then re-start with new products. Topical
antibiotics: Agents with gram positive coverage -
erythromycin or ciprofloxacin ophthalmic ointment.
Study Guide – Accurate Answers To All Questions
Save Groups
Terms in this set (109)
Allergic Conjunctivitis - Inflammation of the conjunctiva due to allergies is
common, occurring in up to 40% of the population.
Itching is the most consistent sign of allergic
conjunctivitis; it is also characterized by red eyes and
other allergic disease symptoms such as sneezing.
- Symptoms: severe itching (MOST PROMINENT) ,
generalized hyperemia of the conjunctiva, & mild-
moderate tearing. Rubbing of eyelids can lead to
eyelid edema and temporary hyperpigmentation
(allergic shiners/raccoon eyes). Allergic conjunctivitis
often accompanied by s/s of allergic rhinitis,
including the presence of a crease on the nose from
frequent manipulation (toddler salute).
- Treatment: Mild-moderate symptoms ma be
managed with artificial tears and cool/cold
compresses. Severe s/s may require an
ophthalmology consultation, and immune modulation
with topical antihistamine, mast cell stabilizer, or mild
steroid.
,Bacterial Conjunctivitis Bacterial conjunctivitis is the second most common
cause of infectious conjunctivitis, Red, itchy eyes are
associated with this condition, as is purulent or
mucopurulent discharge in one or both eyes.
- Symptoms: copious mucopurulent discharge
(MOST PROMINENT), often unilateral (helps
distinguish from allergic/viral etiology) but may
spread to both eyes via hands when rubbing eyes,
and pain/irritation with severe hyperemia. **There
should be NO frank vision loss.**
- Treatment: Usually with topical antibiotic ointments
or drops.
**Otherwise immunocompetent patients with
unilateral disease may be treated empirically with
topical fluoroquinolones such as moxifloxacin or
gatifloxixin. If no improvement within 48 hours,
cultures should be repeated and ophthalmology
should be consulted.
Toxic Conjunctivitis - Inflammation of the conjunctiva due to medications,
chemicals, or toxins can cause red, itchy eyes.
,Viral Conjunctivitis - Viral conjunctivitis is the most common cause of
infectious conjunctivitis. Red, itchy eyes are
associated with this condition, as is a watery
discharge.
**65-90 % of viral conjunctivitis are caused by
adenoviruses, which are highly contagious and
spread through direct contact. Communicability is
estimated to be 10-14 days. Topical ophthalmic
antihistamines (preferably OTC) may be
recommended to reduce itching and soothe the
eyes.
- Symptoms: Usually presents bilaterally, but
symptoms often start in 1 eye 1-2 days prior. Pain and
burning are the MOST PROMINENT symptoms, and
eyes are very red with copious tearing. Preauricular
lymph node may be palpated, which is relatively
specific to viral etiology. **Symptoms tend to
worsen for the first few days, and generally resolve
within 1-2 weeks.**
**Hand washing and contact precautions are
imperative to prevent the spread of infection.** If
hospital staff become infected, they will have to be
off for 7 days after symptoms start in SECOND eye.
, Blepharitis - Blepharitis, or inflammation of the eyelids, is
characterized by redness at the margins of the
eyelids. Symptoms of blepharitis include: dry, red,
itchy eyelids that may be crusted.
- TREAT - Treatment involves supportive care and
antibiotics. Supportive care: Use warm compresses
to loosen the eyelid crusting. Gently scrub the
eyelids with diluted baby shampoo at least twice
daily. Use artificial tears to lubricate eyes as needed.
Discontinue eye make-up until condition resolves
and then re-start with new products. Topical
antibiotics: Agents with gram positive coverage -
erythromycin or ciprofloxacin ophthalmic ointment.
