Ophthalmology Required Clinical Encounters

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Ophthalmology Required Clinical Encounters

Red Eye (1) Ophthalmology Allergic Conjunctivitis Bacterial Conjunctivitis Blepharitis Required Clinical Chemical Injury Corneal Abrasion Encounters Corneal Foreign Body Corneal Laceration (open globe) Minimum participation for diagnoses: Observed Dry Eye Acute Vision Loss (2) Hyphema Amaurosis Fugax Orbital Cellulitis Compressive Optic Neuropathy Preseptal Cellulitis Corneal Edema Scleritis Giant Cell Arteritis Subconjunctival Hemorrhage Hyphema Viral Conjunctivitis Non-arteritic Ischemic Optic Neuropathy Optic Neuritis Subspecialty Ophthalmology (1) Retinal Arterial Occlusion Amblyopia Retinal Detachment CN III, IV or VI Palsy Retinal Vein Occlusion Compressive Optic Neuropathy Vitreous Hemorrhage Congenital Cataract Congenital Glaucoma Chronic Vision Loss (2) Giant Cell Arteritis Cataract Horner Syndrome Glaucoma Idiopathic Intracranial Hypertension Macular Degeneration Internuclear Ophthalmoplegia Myasthenia Gravis Ocular Pharmacology (1) Non-arteritic Ischemic Optic Neuropathy Hydroxychloroquine Optic Disc Elevation Injected Corticosteroids Optic Neuritis Oral Corticosteroids Retinoblastoma Systemic Anticholinergics Strabismus Systemic Sympathomimetics Thyroid Eye Disease Topical Alpha-Agonists Visual Field Defect Topical Anticholinergics Topical Beta-Blockers Minimum participation for exam skills: Performed Topical Corticosteroids Exam: Alignment Assessment (3) o Hirschberg Ophthalmology Assessment of Systemic Disease (2) Exam: Confrontation Visual Fields (3) Cerebral Vascular Event Exam: Extraocular Motility (3) Diabetes Mellitus Exam: Instillation of Drops (3) Giant Cell Arteritis Exam: Penlight Assessment (3) HIV o Include: Lids, conjunctiva/sclera, Hypertension cornea, anterior chamber depth Increased Intracranial Pressure and clarity of media Malignancy Exam: Pupil Assessment (3) Pregnancy Exam: Visual Acuity (3) Rheumatoid Arthritis o With near card, including pinhole Sarcoidosis Exam: Funduscopy (3) Sickle Cell Disease o Direct ophthalmoscopy online Systemic Lupus Erythematosus module fulfills three skills Thyroid Eye Disease .

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Summary Benchmarks for Preferred Practice Pattern® Guidelines
SUMMARY BENCHMARKS FOR PREFERRED PRACTICE PATTERN® GUIDELINES TABLE OF CONTENTS Summary Benchmarks for Preferred Practice Pattern Guidelines Introduction . 1 Glaucoma Primary Open-Angle Glaucoma (Initial Evaluation) . 3 Primary Open-Angle Glaucoma (Follow-up Evaluation) . 5 Primary Open-Angle Glaucoma Suspect (Initial and Follow-up Evaluation) . 6 Primary Angle-Closure Disease (Initial Evaluation and Therapy) . 8 Retina Age-Related Macular Degeneration (Initial and Follow-up Evaluation) . 10 Age-Related Macular Degeneration (Management Recommendations) . 11 Diabetic Retinopathy (Initial and Follow-up Evaluation) . 12 Diabetic Retinopathy (Management Recommendations) . 13 Idiopathic Epiretinal Membrane and Vitreomacular Traction (Initial Evaluation and Therapy) . 14 Idiopathic Macular Hole (Initial Evaluation and Therapy) . 15 Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration (Initial and Follow-up Evaluation) . 17 Retinal and Ophthalmic Artery Occlusions (Initial Evaluation and Therapy) . 18 Retinal Vein Occlusions (Initial Evaluation and Therapy) . 19 Cataract/Anterior Segment Cataract (Initial and Follow-up Evaluation) . 20 Cornea/External Disease Bacterial Keratitis (Initial Evaluation) . 22 Bacterial Keratitis (Management Recommendations) . 23 Blepharitis (Initial and Follow-up Evaluation) . 24 Conjunctivitis (Initial Evaluation) . 25 Conjunctivitis (Management Recommendations) . 26 Corneal Ectasia (Initial Evaluation and Follow-up) . 27 Corneal Edema and Opacification (Initial Evaluation) . 28 Corneal Edema
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Repair of Open Globe Injury
Advances in Ophthalmology & Visual System Case Report Open Access Case report: repair of open globe injury Abstract Volume 3 Issue 1 - 2015 Globe rupture is a common sight-threatening ophthalmic emergency. We present a twelve-year-old girl with ocular trauma by sharp object resulting in corneal laceration, Nader Hussein Fouad Hassan Department of Ophthalmology, Benha University Hospital, hyphema, traumatic cataract and iris prolapse. This case illustrates the importance of early Egypt diagnosis, proper wound repair of ruptured globe as well as management of post-operative complications and value of early post-operative visual rehabilitation. Correspondence: Nader Hussein Fouad Hassan, Ophthalmology department, Benha University Hospital, Keywords: globe rupture, open globe injury, corneal laceration Kaliyobeya, Egypt, Tel +201224727982, Email Received: October 16, 2015 | Published: October 19, 2015 Abbreviations: FB, foreign body; VA, visual acuity; CT scan, patient then was given tetanus immunization, antiemetics, analgesics computerized tomography; RD, retinal detachment; INR, international and intravenous broad spectrum antibiotics and prepared for globe normalized ratio; GA, general anesthesia; D, diopter rupture repair under GA. Laboratory tests included a full blood count, liver function tests, INR, prothrombin time, partial thromboplastin Introduction time, kidney function tests, all were within normal. Ruptured Globe is a common ophthalmic emergency. It is a leading cause of blindness. Early examination with high level of suspicion is recommended in any patient with ocular trauma. Many signs may obscure detection of globe rupture, so the ophthalmologist should examine the patient thoroughly and treat the patient as early as impossible including early visual rehabilitation for young patients to prevent amblyopia. Globe rupture may be associated with traumatic hyphema, traumatic cataract, lens dislocation, vitreous hemorrhage, retinal detachment, uveal prolapse, scleral wound, orbital wall fractures, or optic nerve damage.
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URGENT/EMERGENT When to Refer Financial Disclosure
URGENT/EMERGENT When to Refer Financial Disclosure Speaker, Amy Eston, M.D. has a financial interest/agreement or affiliation with Lansing Ophthalmology, where she is employed as a ophthalmologist. 58 yr old WF with 6 month history of decreased vision left eye. Ache behind the left eye for 2-3 months. Using husband’s contact lens solution made it feel better. Seen by two eye care professionals. Given glasses & told eye exam was normal. No past ocular history Medical history of depression Takes only aspirin and vitamins 20/20 OD 20/30 OS Eye Pressure 15 OD 16 OS – normal Dilated fundus exam & slit lamp were normal Pupillary exam was normal Extraocular movements were full Confrontation visual fields were full No red desaturation Color vision was slightly decreased but the same in both eyes Amsler grid testing was normal OCT disc – OD normal OS slight decreased RNFL OCT of the macula was normal Most common diagnoses: Dry Eye Optic Neuritis Treatment - copious amount of artificial tears. Return to recheck refraction Visual field testing Visual Field testing - Small defect in the right eye Large nasal defect in the left eye Visual Field - Right Hemianopsia. MRI which showed a subacute parietal and occipital lobe infarct. ANISOCORIA Size of the Pupil Constrictor muscles innervated by the Parasympathetic system & Dilating muscles innervated by the Sympathetic system The Sympathetic System Begins in the hypothalamus, travels through the brainstem. Then through the upper chest, up through the neck and to the eye. The Sympathetic System innervates Mueller’s muscle which helps to elevate the upper eyelid.
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Differentiate Red Eye Disorders
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A Case of Uveitis-Hyphema-Glaucoma Syndrome Due to Express Miniature Implantation
Henry Ford Health System Henry Ford Health System Scholarly Commons Case Reports Medical Education Research Forum 2020 5-2020 A Case of Uveitis-Hyphema-Glaucoma Syndrome due to ExPRESS Miniature Implantation Andrew Hou Henry Ford Health System, [email protected] Madeline Hasbrook Henry Ford Health System David A. Crandall Henry Ford Health System, [email protected] Follow this and additional works at: https://scholarlycommons.henryford.com/merf2020caserpt Recommended Citation Hou, Andrew; Hasbrook, Madeline; and Crandall, David A., "A Case of Uveitis-Hyphema-Glaucoma Syndrome due to ExPRESS Miniature Implantation" (2020). Case Reports. 135. https://scholarlycommons.henryford.com/merf2020caserpt/135 This Poster is brought to you for free and open access by the Medical Education Research Forum 2020 at Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Case Reports by an authorized administrator of Henry Ford Health System Scholarly Commons. A Case of Uveitis-Hyphema-Glaucoma Syndrome due to ExPRESS Miniature Implantation Andrew Hou MD, Madeline Hasbrook MD, David Crandall MD Department of Ophthalmology, Henry Ford Health System, Detroit, Michigan Purpose Results Discussion To report a case of a 69-year-old patient We believe etiology for the UGH who developed uveitis-glaucoma- syndrome the significant iridodonesis seen hyphema (UGH) syndrome after an on gonioscopy. In the interim between uneventful ExPRESS (Alcon, Fort Worth, surgery and presentation, the patient had TX) mini shunt surgery for advanced been prescribed tamsulosin for his benign primary open-angle glaucoma. To our prostatic hyperplasia. knowledge, this is the first case report Tamsulosin has been well established as describing glaucoma device induced UGH the cause of intraoperative floppy iris syndrome and its successful treatment syndrome secondary to iris dilator atrophy.
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A Case of Anterior Ischemic Optic Neuropathy Associated with Uveitis
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Two Cases of Endogenous Endophthalmitis That Progressed To
rine to more distal vessels may have led to vasoconstric- References tion and subsequent vasospasm. In conclusion, epinephrine can lead to OAO following 1. Niemi G. Advantages and disadvantages of adrenaline in accidental intra-arterial injection of subcutaneously ad- regional anaesthesia. Best Pract Res Clin Anaesthesiol ministered local anesthetics. Hence, physicians should 2005;19:229-45. carefully administer local anesthesia while considering the 2. Park KH, Kim YK, Woo SJ, et al. Iatrogenic occlusion of possibility that such a complication may occur. the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Retina Society. JAMA Byung Gil Moon Ophthalmol 2014;132:714-23. Retina Center, Department of Ophthalmology, HanGil Eye 3. Lazzeri D, Agostini T, Figus M, et al. Blindness following Hospital, Incheon, Korea cosmetic injections of the face. Plast Reconstr Surg 2012;129:995-1012. June-Gone Kim 4. Savino PJ, Burde RM, Mills RP. Visual loss following intra- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea nasal anesthetic injection. J Clin Neuroophthalmol E-mail: [email protected] 1990;10:140-4. 5. Webber B, Orlansky H, Lipton C, Stevens M. Complica- tions of an intra-arterial injection from an inferior alveolar Conflict of Interest nerve block. J Am Dent Assoc 2001;132:1702- 4. No potential conflict of interest relevant to this article was reported. Korean J Ophthalmol 2017;31(3):279-281 litus presented with blurred vision of the right eye for 10 https://doi.org/10.3341/kjo.2017.0002 days. Abdominal and chest computed tomography showed an emphysematous prostatic abscess with multiple pulmo- nary lesions.
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Transient Monocular Visual Loss
Transient Monocular Visual Loss VALÉRIE BIOUSSE, MD AND JONATHAN D. TROBE, MD ● PURPOSE: To provide a practical update on the diagno- when most episodes of TMVL do not cause total loss of sis and management of transient monocular visual loss vision.2 (TMVL). The most important step in evaluating a patient with ● DESIGN: Perspective. visual loss is to establish whether the visual loss is ● METHODS: Review of the literature. monocular or binocular.2,5 Monocular visual loss always ● RESULTS: TMVL is an important clinical symptom. It results from lesions anterior to the chiasm (the eye or the has numerous causes but most often results from tran- optic nerve), whereas binocular visual loss results from sient retinal ischemia. It may herald permanent visual lesions of both eyes or optic nerves, or, more likely, of the loss or a devastating stroke, and patients with TMVL chiasm or retrochiasmal visual pathway. should be evaluated urgently. A practical approach to the Deciding whether an episode of abrupt visual loss evaluation of the patient with TMVL must be based on occurred in one eye or both is not always easy. Very few the patient’s age and the suspected underlying etiology. patients realize that binocular hemifield (homonymous) In the older patient, tests should be performed to inves- visual field loss affects the fields of both eyes. They will tigate giant cell arteritis, atherosclerotic large vessel usually localize it to the eye that lost its temporal field. The disease, and cardiac abnormalities. In the younger pa- best clues to the fact that visual loss was actually binocular tient, TMVL is usually benign and the evaluation should are reading impairment (monocular visual loss does not be tailored to the particular clinical setting.
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Acute Keratoconus-Like Corneal Hydrops Secondary to Ocular
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Ocular Dysmetria in a Patient with Charcot-Marie- Tooth Disease Michelle Lee, OD A patient with the inherited neuropathy, Charcot-Marie-Tooth disease (CMT), presents with ocular dysmetria. Although abnormal ocular motility has not been reported in CMT patients, the absence of other etiologies indicates a possible ocular manifestation. CASE HISTORY • Patient demographics: 74 year old Caucasian male • Chief complaint: no visual or ocular complaints • Ocular History o Mild cataracts OU o Dry eye syndrome OU o Refractive error OU • Medical history o Charcot-Marie-Tooth disease o Asthma o Hypercholesterolemia o Herpes zoster o Chronic lower bacK pain o Dermatitis o Obstructive sleep apnea • Medications o Albuterol o Gabapentin o Meloxicam o Mometasone furoate o Oxybutynin chloride o Simvastatin o Tamusolisn HCL o Aspirin o Vitamin D • Ocular medications: artificial tears prn OU • Family history: father and grandfather also with CMT PERTINENT FINDINGS • Clinical o Mixed hypometric and hypermetric saccades with intermittent disconjugate movement o Trace restriction of lateral gaze and inferior temporal OS o Ptosis OD o Borderline reduced contrast sensitivity OD, mildly reduced contrast sensitivity OS o Pertinent negatives: no evidence of light-near-dissociation, no signs of optic neuropathy 1 of 4 • Physical o Abnormal gait • Lab studies o EMG consistent with positive family history of CMT • Radiology studies o MRI (04/13): no intracranial mass or acute infarcts seen, no evidence of cerebellar abnormality noted DIFFERENTIAL DIAGNOSIS • Primary/leading
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Eleventh Edition
SUPPLEMENT TO April 15, 2009 A JOBSON PUBLICATION www.revoptom.com Eleventh Edition Joseph W. Sowka, O.D., FAAO, Dipl. Andrew S. Gurwood, O.D., FAAO, Dipl. Alan G. Kabat, O.D., FAAO Supported by an unrestricted grant from Alcon, Inc. 001_ro0409_handbook 4/2/09 9:42 AM Page 4 TABLE OF CONTENTS Eyelids & Adnexa Conjunctiva & Sclera Cornea Uvea & Glaucoma Viitreous & Retiina Neuro-Ophthalmic Disease Oculosystemic Disease EYELIDS & ADNEXA VITREOUS & RETINA Blow-Out Fracture................................................ 6 Asteroid Hyalosis ................................................33 Acquired Ptosis ................................................... 7 Retinal Arterial Macroaneurysm............................34 Acquired Entropion ............................................. 9 Retinal Emboli.....................................................36 Verruca & Papilloma............................................11 Hypertensive Retinopathy.....................................37 Idiopathic Juxtafoveal Retinal Telangiectasia...........39 CONJUNCTIVA & SCLERA Ocular Ischemic Syndrome...................................40 Scleral Melt ........................................................13 Retinal Artery Occlusion ......................................42 Giant Papillary Conjunctivitis................................14 Conjunctival Lymphoma .......................................15 NEURO-OPHTHALMIC DISEASE Blue Sclera .........................................................17 Dorsal Midbrain Syndrome ..................................45
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Ocular Side Effects of Systemic Drugs.Cdr
ERA’S JOURNAL OF MEDICAL RESEARCH VOL.6 NO.1 Review Article OCULAR SIDE EFFECTS OF SYSTEMIC DRUGS Pragati Garg, Swati Yadav Department of Ophthalmology Era's Lucknow Medical College & Hospital, Sarfarazganj Lucknow, U.P., India-226003 Received on : 06-03-2019 Accepted on : 28-06-2019 ABSTRACT Systemic drugs are frequently administered in persons of all age group Address for correspondence ranging from children to the elderly for various disorders. There has been Dr. Pragati Garg increased reporting of ocular side effects of various systemic drugs in the Department of Ophthalmology past two decades. Some offenders well known are α -2-adrenergic agonists, Era’s Lucknow Medical College & quinine derivatives, β- adrenergic antagonists and antituberculosis drugs. Hospital, Lucknow-226003 Newer systemic drugs causing ocular side effects are being reported in Email: [email protected] available literature. Knowledge regarding these is expected to aid Contact no: +91-9415396506 clinicians in identifying these side effects and the offending drug, thereby, prescribing the appropriate treatment for the condition the patient maybe suffering from without any ocular disturbances. KEYWORDS: Ocular side effects, Systemic drugs. Introduction This article will briefly cover how systemic drugs can Many common systemic medications can affect ocular affect the various ocular structures. tissues and visual function to varying degrees. When a Factors Affecting The Production Of Ocular Side systemic medication is taken to treat another part of the Effects By A Drug body, the eyes frequently are affected. Systemic A) Drug related factors medications can have adverse effects on the eyes that range from dry eye syndrome, keratitis and cataract to (1) The nature of the drug: Absorption of drug in blinding complications of toxic retinopathy and optic body and its pharmacological effects on the body's neuropathy (1).
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