NR 602 Week 4 Midterm Study Guide
Questions and Answers (2026) | 100%
Verified Solutions | A+ Study Pack
• Strabismus -✓✓crossed eyes; a defect in In ocular alignment, or the position of the
eyes in relation to each other; It is commonly called lazy eye. And strabismus, the visual
axes are not parallel because the muscles of the eyes are not coordinated; When one
eye is directed straight ahead, the other deviates
• Retinoblastoma -✓✓tumor arising from a developing retinal cell; intraocular tumor that
develops in the retina. Although it is rare, this malignant retinal tumor is the most
common tumor in childhood (some 4% of cancers in children younger than 15 years of
age)
• Retinoblastoma clinical findings -✓✓strabismus is the most common finding
there is a decreased visual acuity uni- or bilateral white pupil (leukocoria), described
often as an intermittent "glow, glint, gleam, or glare" by parents, is usually seen in low
light settings or noted in photographs taken with a flash i.e. (cat's eye reflex); other
symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital Cellulitis and
photophobia, hyphema, hypopyon (plus an anterior Chamber of eye); Signs of global
rupture or also possible
• leukocoria -✓✓condition of white pupil
• Bulbar or palpebral conjunctival infection -✓✓a common presentation, which can be
unilateral or bilateral
• conjunctival infection differential diagnosis -✓✓allergy, conjunctivitis, infection, foreign
body, chemical exposure, or systemic inflammatory disease, irritation of the conjunctiva
or cornea, and congenital glaucoma.
• conjunctival infection drainage -✓✓watery discharge; purulent/mucoid discharge
• watery discharge -✓✓can occur with allergies, nasolacrimal obstruction, foreign
bodies, viral infection, and iritis.
• Purulent or mucoid discharge -✓✓noted with chronic dacrocystitis or nasolacrimal
obstruction.
• Dacrocystitis -✓✓inflammation of the tear sac
• Advanced allergic conjunctivitis -✓✓have some mucoid production.
,To differentiate, microscopic investigation of discharge may lead to other clues
• photophobia -✓✓sensitivity to light; symptom common of trauma and in infants with
glaucoma or retinal disease. Other non-eye related causes of this include migraines and
meningitis.
• leukocoria -✓✓serious finding and demands immediate referral to the pediatric
ophthalmologist. white pupil
• causes of leukocoria -✓✓retinal detachment, cataract, retinal dysplasia, retinopathy of
prematurity, and in newborns retinoblastoma All newborns should have a fundoscopic
examination within 24 hours of birth and yearly on physical examinations.
• ophthalmia neonatorum -✓✓conjunctivitis of the newborn. Etiology: chlamydia,
staphylococcus aureus, gonorrhea, HSV (silver nitrate reaction occurs on 10% of
neontes). Clinical findings: erythema, chemosis, purulent exudate with gonorrhea. Clear
to mucoid exudate with chlamydia. Diagnosis through gram stain to rule out gonorrhea
and chlamydia.
• ophthalmia neonatorum management -✓✓saline irrigation to the eyes until exudate is
gone; follow with erythromycin ointment. N. gonorrohea: ceftriaxone IM or IV.
Chlamydia:
• ceftriaxone IM or IV. Chlamydia: -✓✓ophthalmia neonatorum management x/t N.
gonorrohea:
• Erythromycin or possibly azithromycin PO -✓✓ophthalmia neonatorum management
d/t Chlamydia:
• Antivirals IV or PO -✓✓Ophthalmia neonatorum management d/t HSV
• Bacterial conjunctivitis -✓✓pinkeye; very contagious
• Bacterial conjunctivitis -✓✓in neonates 5-14 days, preschoolers, sexually active
teens: Haemphilus influenza (Most common organism), streptococcus pneumoniae, S.
Aureus, N. gonorrohea. Erythema, chemosis, itching, burning, mucopurulent exudate,
matter in the eyelashes - worse in the morning, causing eyelashes to be shut; worse in
winter; Dx through cultures (required in neonates), r/o pharyngitis, AOM, URI, seborrhea
• chemosis -✓✓edema of the conjunctiva
• Bacterial conjunctivitis neonate treatment -✓✓Erythromycin 0.5% ophthalmic ointment
,• Bacterial conjunctivitis >1 year treatment -✓✓fourth generation fluoroquinolone. If
concurrent AOM: treat accordingly for AOM. Warm soaks to eyes TID; don't share
towels or pillows; no school or work until treatment begins
• Chronic Bacterial Conjunctivitis -✓✓Lasts more than 3 weeks and unresponsive to
treatment
Most common org is Staphylococcus Aureus. Gram negative orgs include:
-moraxella lacunata, serratia marcescens, ecoli, klebsiella pneumoniae, proteus.
Teens: Chlamydia
Erythema, chemosis, itching, burning, mucopurulwnt exudate, matter in the eyelashes;
foreign body; Dx by gram stain culture to r/o dacryostenosis, blepharitis, corneal ulcers,
trachoma
• Chronic Bacterial Conjunctivitis treatment -✓✓depends on prior treatment, lab results,
and differential diagnosis. Review compliance of previous drug choices; consult
ophthalmologist
• Inclusion conjunctivitis -✓✓occurs in neonates 5-14 days old and sexually active
teenagers: caused by : Chlamydia trachomatis; Erythema, chemosis, itching, burning,
mucopurulnt exudate or clear drainage, palpebral follicles. Cultures: ELISA, PCR r/o
sexual activity
• Inclusion conjunctivitis treatment -✓✓Neonates: erythromycin or azithromycin PO;
Adolescents: doxycycline, azithromycin, EES, erythromycin base, levofloxacin PO
• Viral conjunctivitis -✓✓adenovirus MC; HSV-1 (dendritic ulcers); Erythema, chemosis,
bilateral tearing; HSV and herpes zoster: unilateral with photophobia, fever; Zoster:
nose lesion. Cultures to r/o corneal infiltration
• Viral conjunctivitis treatment -✓✓• Lubricant drops
• Cool compresses TID-QID
• Antihistamines
refer to ophthalmologist if HSV or photophobia is present
• Allergic or Vernal (springtime) conjunctivitis -✓✓causes tearing, itching, redness, &
swelling.
treated with topical mast cell stabilizer/antihistamine drops. atopy sufferers; seasonal;
stringy, mucoid exudate, swollen eyelids and conjunctivae, itching, tearing, palpebral
follicles, headache, rhinitis; Eosinophils in conjunctival scrapings
• Allergic or Vernal (springtime) conjunctivitis treatment -✓✓naphazoline/pheniramine,
naphazoline/antazoline ophthalmic solution. Mast cell stabilizer. Refer to allergist
• chalazion -✓✓a nodule or cyst, usually on the upper eyelid, caused by obstruction in a
sebaceous gland. Most commonly found above the eyelashes on the upper lid; a
, blocked oil gland (meibomian or zeiss); firm painless lump; PAINLESS, NOT
INVOLVING LASHES
Lid edema, or palpable mass
Red or grey mass on the inner aspect of lid margin; prevention: good hygiene.
treatment: warm compresses, surgery. antibiotic eyedrops if secondary infection
(sulfacetamide or erythromycin); follow up in 2-4 weeks, if still present after 6 weeks
follow up with ophthalmologist
• Chalazion -✓✓Benign, chronic lipogranulomatous inflammation of the eyelid
• Risk of Chalazion -✓✓hordeolum or any condition which may impede flow through the
meibomian gland. Also mite species that reside in lash follicles
• hordeolum (stye) -✓✓staph infection of a sebaceous gland in the eyelid. Most
commonly found at or near an eyelash follicle. Caused by bacterial infection either at
the root of the eyelash follicle or in the oil glands of the eyelid. Symptoms are
tenderness and swelling; treatment: spontaneous drainage and warm compresses
• blepharitis -✓✓inflammation of the eyelid; Inflammation/infection of the lid margins
(chronic problem); can have flaking skin, excessive tearing, redness, irritation, eyelash
loss and/or crusty debris along the lash line
• Seborrheic Blepharitis -✓✓Mybomian gland dysfxn; posterior lid margin; greasy
dandruff- no skin ulcer; (non ulcerative) : irritants (smoke, make up, chemicals)
s&s - chronic inflammation of the eyelid, erythema, greasy scaling of anterior eyelid,
loss of eyelashes, seborrhea dermatitis of eyebrows and scalp
• ulcerative blepharitis -✓✓1) due to staph infection of follicles at the lid margin 2)
accompanied by loss of lashes, deformity of lashes (trichiasis); infection with
staphylococcus or streptococcus
s&s - itching, tearing, recurrent styes, chalazia, photophobia, small ulceration at eyelid
margin, broken or absent eyelashes
the most frequent complaint is ongoing eye irritation and conjunctiva redness
• Blepharitis treatment -✓✓Treatment-focused on lid hygiene - Careful daily cleansing
of eyelids to remove oils. This can be done with a Q-tip and baby shampoo. Couple
times a day will be very beneficial . Lid massage
Warm, moist compresses
Antibiotic : For infected eyelids - antistaphyloccocal antibiotics BACITRACIN,
ERYTHROMYCIN 0.05% for 1 week AND QUIONOLONE OINTMENTS; For infection
resistant to topical - TETRACYCLINE 250 MG PO X4 DOXYCYCLINE 100 MG PO X2
Avoid the use of contact lenses and use good hand hygeine
Questions and Answers (2026) | 100%
Verified Solutions | A+ Study Pack
• Strabismus -✓✓crossed eyes; a defect in In ocular alignment, or the position of the
eyes in relation to each other; It is commonly called lazy eye. And strabismus, the visual
axes are not parallel because the muscles of the eyes are not coordinated; When one
eye is directed straight ahead, the other deviates
• Retinoblastoma -✓✓tumor arising from a developing retinal cell; intraocular tumor that
develops in the retina. Although it is rare, this malignant retinal tumor is the most
common tumor in childhood (some 4% of cancers in children younger than 15 years of
age)
• Retinoblastoma clinical findings -✓✓strabismus is the most common finding
there is a decreased visual acuity uni- or bilateral white pupil (leukocoria), described
often as an intermittent "glow, glint, gleam, or glare" by parents, is usually seen in low
light settings or noted in photographs taken with a flash i.e. (cat's eye reflex); other
symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital Cellulitis and
photophobia, hyphema, hypopyon (plus an anterior Chamber of eye); Signs of global
rupture or also possible
• leukocoria -✓✓condition of white pupil
• Bulbar or palpebral conjunctival infection -✓✓a common presentation, which can be
unilateral or bilateral
• conjunctival infection differential diagnosis -✓✓allergy, conjunctivitis, infection, foreign
body, chemical exposure, or systemic inflammatory disease, irritation of the conjunctiva
or cornea, and congenital glaucoma.
• conjunctival infection drainage -✓✓watery discharge; purulent/mucoid discharge
• watery discharge -✓✓can occur with allergies, nasolacrimal obstruction, foreign
bodies, viral infection, and iritis.
• Purulent or mucoid discharge -✓✓noted with chronic dacrocystitis or nasolacrimal
obstruction.
• Dacrocystitis -✓✓inflammation of the tear sac
• Advanced allergic conjunctivitis -✓✓have some mucoid production.
,To differentiate, microscopic investigation of discharge may lead to other clues
• photophobia -✓✓sensitivity to light; symptom common of trauma and in infants with
glaucoma or retinal disease. Other non-eye related causes of this include migraines and
meningitis.
• leukocoria -✓✓serious finding and demands immediate referral to the pediatric
ophthalmologist. white pupil
• causes of leukocoria -✓✓retinal detachment, cataract, retinal dysplasia, retinopathy of
prematurity, and in newborns retinoblastoma All newborns should have a fundoscopic
examination within 24 hours of birth and yearly on physical examinations.
• ophthalmia neonatorum -✓✓conjunctivitis of the newborn. Etiology: chlamydia,
staphylococcus aureus, gonorrhea, HSV (silver nitrate reaction occurs on 10% of
neontes). Clinical findings: erythema, chemosis, purulent exudate with gonorrhea. Clear
to mucoid exudate with chlamydia. Diagnosis through gram stain to rule out gonorrhea
and chlamydia.
• ophthalmia neonatorum management -✓✓saline irrigation to the eyes until exudate is
gone; follow with erythromycin ointment. N. gonorrohea: ceftriaxone IM or IV.
Chlamydia:
• ceftriaxone IM or IV. Chlamydia: -✓✓ophthalmia neonatorum management x/t N.
gonorrohea:
• Erythromycin or possibly azithromycin PO -✓✓ophthalmia neonatorum management
d/t Chlamydia:
• Antivirals IV or PO -✓✓Ophthalmia neonatorum management d/t HSV
• Bacterial conjunctivitis -✓✓pinkeye; very contagious
• Bacterial conjunctivitis -✓✓in neonates 5-14 days, preschoolers, sexually active
teens: Haemphilus influenza (Most common organism), streptococcus pneumoniae, S.
Aureus, N. gonorrohea. Erythema, chemosis, itching, burning, mucopurulent exudate,
matter in the eyelashes - worse in the morning, causing eyelashes to be shut; worse in
winter; Dx through cultures (required in neonates), r/o pharyngitis, AOM, URI, seborrhea
• chemosis -✓✓edema of the conjunctiva
• Bacterial conjunctivitis neonate treatment -✓✓Erythromycin 0.5% ophthalmic ointment
,• Bacterial conjunctivitis >1 year treatment -✓✓fourth generation fluoroquinolone. If
concurrent AOM: treat accordingly for AOM. Warm soaks to eyes TID; don't share
towels or pillows; no school or work until treatment begins
• Chronic Bacterial Conjunctivitis -✓✓Lasts more than 3 weeks and unresponsive to
treatment
Most common org is Staphylococcus Aureus. Gram negative orgs include:
-moraxella lacunata, serratia marcescens, ecoli, klebsiella pneumoniae, proteus.
Teens: Chlamydia
Erythema, chemosis, itching, burning, mucopurulwnt exudate, matter in the eyelashes;
foreign body; Dx by gram stain culture to r/o dacryostenosis, blepharitis, corneal ulcers,
trachoma
• Chronic Bacterial Conjunctivitis treatment -✓✓depends on prior treatment, lab results,
and differential diagnosis. Review compliance of previous drug choices; consult
ophthalmologist
• Inclusion conjunctivitis -✓✓occurs in neonates 5-14 days old and sexually active
teenagers: caused by : Chlamydia trachomatis; Erythema, chemosis, itching, burning,
mucopurulnt exudate or clear drainage, palpebral follicles. Cultures: ELISA, PCR r/o
sexual activity
• Inclusion conjunctivitis treatment -✓✓Neonates: erythromycin or azithromycin PO;
Adolescents: doxycycline, azithromycin, EES, erythromycin base, levofloxacin PO
• Viral conjunctivitis -✓✓adenovirus MC; HSV-1 (dendritic ulcers); Erythema, chemosis,
bilateral tearing; HSV and herpes zoster: unilateral with photophobia, fever; Zoster:
nose lesion. Cultures to r/o corneal infiltration
• Viral conjunctivitis treatment -✓✓• Lubricant drops
• Cool compresses TID-QID
• Antihistamines
refer to ophthalmologist if HSV or photophobia is present
• Allergic or Vernal (springtime) conjunctivitis -✓✓causes tearing, itching, redness, &
swelling.
treated with topical mast cell stabilizer/antihistamine drops. atopy sufferers; seasonal;
stringy, mucoid exudate, swollen eyelids and conjunctivae, itching, tearing, palpebral
follicles, headache, rhinitis; Eosinophils in conjunctival scrapings
• Allergic or Vernal (springtime) conjunctivitis treatment -✓✓naphazoline/pheniramine,
naphazoline/antazoline ophthalmic solution. Mast cell stabilizer. Refer to allergist
• chalazion -✓✓a nodule or cyst, usually on the upper eyelid, caused by obstruction in a
sebaceous gland. Most commonly found above the eyelashes on the upper lid; a
, blocked oil gland (meibomian or zeiss); firm painless lump; PAINLESS, NOT
INVOLVING LASHES
Lid edema, or palpable mass
Red or grey mass on the inner aspect of lid margin; prevention: good hygiene.
treatment: warm compresses, surgery. antibiotic eyedrops if secondary infection
(sulfacetamide or erythromycin); follow up in 2-4 weeks, if still present after 6 weeks
follow up with ophthalmologist
• Chalazion -✓✓Benign, chronic lipogranulomatous inflammation of the eyelid
• Risk of Chalazion -✓✓hordeolum or any condition which may impede flow through the
meibomian gland. Also mite species that reside in lash follicles
• hordeolum (stye) -✓✓staph infection of a sebaceous gland in the eyelid. Most
commonly found at or near an eyelash follicle. Caused by bacterial infection either at
the root of the eyelash follicle or in the oil glands of the eyelid. Symptoms are
tenderness and swelling; treatment: spontaneous drainage and warm compresses
• blepharitis -✓✓inflammation of the eyelid; Inflammation/infection of the lid margins
(chronic problem); can have flaking skin, excessive tearing, redness, irritation, eyelash
loss and/or crusty debris along the lash line
• Seborrheic Blepharitis -✓✓Mybomian gland dysfxn; posterior lid margin; greasy
dandruff- no skin ulcer; (non ulcerative) : irritants (smoke, make up, chemicals)
s&s - chronic inflammation of the eyelid, erythema, greasy scaling of anterior eyelid,
loss of eyelashes, seborrhea dermatitis of eyebrows and scalp
• ulcerative blepharitis -✓✓1) due to staph infection of follicles at the lid margin 2)
accompanied by loss of lashes, deformity of lashes (trichiasis); infection with
staphylococcus or streptococcus
s&s - itching, tearing, recurrent styes, chalazia, photophobia, small ulceration at eyelid
margin, broken or absent eyelashes
the most frequent complaint is ongoing eye irritation and conjunctiva redness
• Blepharitis treatment -✓✓Treatment-focused on lid hygiene - Careful daily cleansing
of eyelids to remove oils. This can be done with a Q-tip and baby shampoo. Couple
times a day will be very beneficial . Lid massage
Warm, moist compresses
Antibiotic : For infected eyelids - antistaphyloccocal antibiotics BACITRACIN,
ERYTHROMYCIN 0.05% for 1 week AND QUIONOLONE OINTMENTS; For infection
resistant to topical - TETRACYCLINE 250 MG PO X4 DOXYCYCLINE 100 MG PO X2
Avoid the use of contact lenses and use good hand hygeine
