RED EYES ~MASTERCARDS~

"Topical Antimicrobials can be used for prophylaxis when ___ and also for treatment of ___ and

___"

"Topical Antimicrobials can be used for prophylaxis when {{ epithelium is

compromised }} and also for treatment of {{bacterial conjunctivitis}} and

{{microbial keratitis}}"

What are the considerations for using topical antimicrobials?

"\- Loading dose,

\- Choice of antimicrobial,

\- Concentration, dosage,

\- Duration of treatment,

\- and Empirical treatment vs culture driven tx.

\- At risk populations such as children, elderly, immunocompromised, CL

wearers, OSD, nasolacrimal obstruction (punctal plugs) should also be

considered."

What is the purpose of a loading dose when using topical antimicrobials? ___

"What is the purpose of a loading dose when using topical antimicrobials? {{ To

achieve therapeutic levels of the drug more quickly }}"

"Gram +ve Staphylococcus aureus is the second most common cause of bacterial

conjunctivitis in ___"

"Gram +ve Staphylococcus aureus is the second most common cause of bacterial

conjunctivitis in {{ adults }}"

"What are the most frequently isolated microorganisms in bacterial

conjunctivitis and microbial keratitis?"

"\- For bacterial conjunctivitis, adults are mostly infected by Gram +ve

Staphylococcus epidermidis (33%), Staphylococcus aureus (23%), and

Streptococcal spp. (12%).

\- Children are mostly affected by Gram −ve H. influenzae (42%) and Gram +ve

S. pneumoniae (35%).

\- For microbial keratitis, the most frequent isolates are Gram +ve bacteria

(75%), mainly Staphylococcus aureus, coagulase negative Staphylococci, and

Streptococcus pneumonia/pyogenes/viridans.

\- Pseudomonas aeruginosa is the most common cause of contact lens related

bacterial keratitis

\- while Neisseria gonorrhoeae, Haemophilus influenzae, Corynebacterium

diphtheriae and Neisseria meningitides can invade an intact cornea."

What are the uses of fluoroquinolones and how do they work?

"Fluoroquinolones (e.g., Ofloxacin and Ciprofloxacin):

* Used to treat bacterial keratitis and severe bacterial conjunctivitis in the eyes.

* Employed as prophylaxis in high-risk surgical cases to prevent infections from wound leakage.

* Mechanism: Inhibit DNA gyrase, a key enzyme for bacterial replication.

* Broad-spectrum antibiotics effective against both Gram-positive and Gram-negative bacteria."

"Fluoroquinolones should be avoided in children under ___ due to

___"

"Fluoroquinolones should be avoided in children under {{12 months old}} due to

{{ the potential effects on cartilage of growth plates. }}"

What are the precautions for using fluoroquinolones in lactation?

"Fluoroquinolones are excreted in breast milk, so nursing should be temporarily

discontinued"

What are the adverse effects of fluoroquinolones in the elderly?

Tendonitis and tendon rupture

What are the precautions for using fluoroquinolones in pregnancy?

"No adequate well-controlled studies performed in pregnant women, but use of

oral fluoroquinolones associated with cartilage damage in weight bearing

joints in young animals"

"The use of ofloxacin may cause a temporary ___,

especially at the base of an epithelial defect, known as ___"

"The use of ofloxacin may cause a temporary {{white crystalline precipitate}},

especially at the base of an epithelial defect, known as {{ chalky white

deposits. }}"

What are the uses of Tobramycin eye drops mentioned in the text?

"\- Bacterial conjunctivitis,

\- Angular blepharoconjunctivitis,

\- Post surgery prophylaxis,

\- Bacterial keratitis"

What is the mode of action of aminoglycosides?

Bactericidal by inhibiting protein synthesis

Tobramycin and Gentamicin are effective against Gram ___

Tobramycin and Gentamicin are effective against Gram {{−ve bacteria}}

What are the major side effects of aminoglycosides?

Nephrotoxicity

Chloramphenicol is a bacteriostatic antibiotic that inhibits ___

"Chloramphenicol is a bacteriostatic antibiotic that inhibits {{inhibits

protein synthesis }}"

What are the uses of Chloramphenicol?

Bacterial conjunctivitis and blepharitis

What precautions should be taken when using Chloramphenicol?

Avoid in the weeks leading up to birth/during breastfeeding

Chloramphenicol can cause grey baby syndrome, characterized by ___

"Chloramphenicol can cause grey baby syndrome, characterized by {{ cyanosis,

hypotension, hypothermia }}"

"Chloramphenicol should be avoided in pregnancy and lactation due to its

potential to ___"

"Chloramphenicol should be avoided in pregnancy and lactation due to its

potential to {{enter foetal circulation}}"

"Sulfonamides are discontinued in Australia and should not be administered to

patients with ___"

"Sulfonamides are discontinued in Australia and should not be administered to

patients with {{a sulpha allergy }}"

Sulfacetamide sodium 10% (Bleph-10) is used to treat mild to moderate ___ infections

"Sulfacetamide sodium 10% (Bleph-10) is used to treat mild to moderate {{

conjunctivitis }} infections"

What are the contraindications of Sulfacetamide sodium 10% (Bleph-10)?

Sulpha allergy and contact lens wear

"Stevens-Johnson syndrome (SJS) is a ___caused by certain

medications and infections with a mortality rate of ___."

"Stevens-Johnson syndrome (SJS) is a {{severe skin reaction }}caused by certain

medications and infections with a mortality rate of {{ 30-40% }}."

Severe Cutaneous Reactions (SCAR) is a spectrum of disorders that includes ___ and ___

"Severe Cutaneous Reactions (SCAR) is a spectrum of disorders that includes {{

Erythema multiforme,}} and {{ Toxic epidermal necrolysis (TEN) }}"

"Neosporin Ophthalmic Eye Ointment is used for superficial infections of the

external eye, including ___"

"Neosporin Ophthalmic Eye Ointment is used for superficial infections of the

external eye, including {{ conjunctivitis, blepharitis, blepharoconjunctivitis

}}"

"Propamidine (Brolene) eye drops are used for ___

and ___. They are also part of combination therapy for

___ infections of the external eye"

"Propamidine (Brolene) eye drops are used for {{mild bacterial conjunctivitis}}

and {{bacterial blepharitis}}. They are also part of combination therapy for

{{ Acanthamoeba keratitis, MRSA }} infections of the external eye"

What are the uses of topical Azithromycin?

Treatment of bacterial conjunctivitis

"Erythromycin is used as an alternative to ___ for Chlamydia,

___for lid margin disease, and ___for preseptal

cellulitis in oral form."

"Erythromycin is used as an alternative to {{azithromycin}} for Chlamydia,

{{doxycycline }}for lid margin disease, and {{penicillin }}}for preseptal

cellulitis in oral form."

"Erythromycin is category ___ for use in pregnancy and lactation, and it is

___for use in children > 2 months old."

"Erythromycin is category {{ A }} for use in pregnancy and lactation, and it is

{{approved }}for use in children > 2 months old."

What are the uses of oral tetracyclines like Doxycycline in ophthalmology?

"Treating inclusion conjunctivitis, prophylaxis and treatment of trachoma,

anti-inflammatory for ocular surface disease"

"Doxycycline can cause increased ___ in

some cases when exposed to UV light."

"Doxycycline can cause increased {{ Photosensitivity or photodermatitis }} in

some cases when exposed to UV light."

Oral Tetracyclines - Doxycycline cannot be prescribed by an optometrist for ______.

"Oral Tetracyclines - Doxycycline cannot be prescribed by an optometrist for {{

Children under 12 years old }}{{ Children under 12 years old }}."

What are the approved uses of 5% Povidone Iodine in ophthalmology?

Topical peri-operative prophylaxis on lids, lashes, and ocular surface

Only commercially antifungal available, available only through SAS is ___ 5% Ophthalmic Suspension.

"Only commercially antifungal available, available only through SAS is {{

Natamycin }} 5% Ophthalmic Suspension."

Aciclovir 3% eye ointment is used for ___ viruses

"Aciclovir 3% eye ointment is used for {{ Herpes Simplex Virus - HSV,

Varicella Zoster Virus - VZV }} viruses"

Some drugs used for allergic and inflammatory eye conditions include ______ and ______.

"Some drugs used for allergic and inflammatory eye conditions include {{

Diclofenac and Ketorolac }}{{ Diclofenac and Ketorolac }} and {{ Diclofenac

and Ketorolac }}{{ Diclofenac and Ketorolac }}."

List three types of drugs used for allergic and inflammatory eye conditions.

Vasoconstrictors

One type of drug used for allergic and inflammatory eye conditions is ___ immunosuppressant.

"One type of drug used for allergic and inflammatory eye conditions is {{

Ciclosporin }} immunosuppressant."

Naphazoline eye drops are used for short-term relief of ___

"Naphazoline eye drops are used for short-term relief of {{ mild superficial

ocular inflammation }}"

"Topical Vasoconstrictors (Decongestants) can cause ___,

mild ___"

"Topical Vasoconstrictors (Decongestants) can cause {{rebound hyperaemia}},

mild {{ mydriasis }}"

Topical Antihistamines + Decongestants can cause ___, ___, and decreased ___as adverse effects

"Topical Antihistamines + Decongestants can cause {{punctate keratitis}}, {{lid

oedema}}, and decreased {{lacrimation }}as adverse effects"

What are the side effects of topical antihistamines + decongestants?

"Stinging/burning on instillation, decongestant side effects, punctate

keratitis, lid oedema, decreased lacrimation, headaches"

What are the side effects of topical antihistamines + mast cell stabilizers?

Headaches

What are the contraindications for the use of NSAIDs?

"Aspirin or NSAID-induced reactions (e.g. asthma, urticaria, rhinitis,

anaphylaxis (rare))"

"Prednefrin Forte eye drops combine prednisolone acetate 1% with phenylephrine

0.12% and can be used to treat ___

conditions."

"Prednefrin Forte eye drops combine prednisolone acetate 1% with phenylephrine

0.12% and can be used to treat {{ allergic and toxic blepharoconjunctivitis }}

conditions."

How does Loteprednol differ from other corticosteroids?

"Loteprednol is a soft steroid (ester-based steroid) that rapidly undergoes

hydrolysis in the anterior chamber to become inactive. It is less likely to

cause unwanted side effects such as raised intraocular pressure."

What are the uses of Loteprednol as a corticosteroid?

GPC, and post-op inflammation following cataract surgery

Loteprednol is ___ likely to cause raised IOP compared to Pred Forte

Loteprednol is {{less}} likely to cause raised IOP compared to Pred Forte

"Topical steroids, like dexamethasone, prednisolone, fluorometholone, and

Loteprednol, have a higher propensity to cause IOP response compared to ___"

"Topical steroids, like dexamethasone, prednisolone, fluorometholone, and

Loteprednol, have a higher propensity to cause IOP response compared to {{

hydrocortisone }}"

"Steroid IOP response is more likely to occur in ___,

___, POAG patients, secondary glaucoma patients, and those with a

first order relative with glaucoma, as well as in ___ and those ___"

"Steroid IOP response is more likely to occur in {{high myopes}},

{{diabetics}}, POAG patients, secondary glaucoma patients, and those with a

first order relative with glaucoma, as well as in {{children}} and those {{

over 40 years old }}"

"Hydrocortisone ointment is used for ___, and

the dosing frequency is ___"

"Hydrocortisone ointment is used for {{lid or periocular inflammation}}, and

the dosing frequency is {{ bid or nocte }}"

"Xiidra is indicated for the treatment of ___ in adults

who have not had sufficient relief from ___. It is dosed ___"

"Xiidra is indicated for the treatment of {{moderate to severe DED}} in adults

who have not had sufficient relief from {{artificial tears}}. It is dosed {{

bid }}"

What are the uses of cycloplegics?

Reduce AC activity

"Cyclopentolate and tropicamide are considered ___ to use in breastfeeding

mothers. The greatest risk to the fetus occurs during the ___

trimester of pregnancy."

"Cyclopentolate and tropicamide are considered {{safe}} to use in breastfeeding

mothers. The greatest risk to the fetus occurs during the {{ first }}

trimester of pregnancy."

Cyclopentolate can cause ___

Cyclopentolate can cause {{ Hallucinations, CNS effects }}

What are the uses of phenylephrine?

Mydriasis

What are the adverse effects of phenylephrine?

Hypertension

"Children and the elderly should not use the ___ concentration of

phenylephrine due to increased risk of systemic effects."

"Children and the elderly should not use the {{ 10% }} concentration of

phenylephrine due to increased risk of systemic effects."

"Prostaglandin analogues increase aqueous outflow and are the most effective

class for treating glaucoma. They may cause ___ and

___ changes."

"Prostaglandin analogues increase aqueous outflow and are the most effective

class for treating glaucoma. They may cause {{ iris hyperpigmentation }} and

{{ eyelash }} changes."

What are the first-line drugs for glaucoma?

Latanoprost, Bimatoprost, Travoprost, Tafluprost

What are the second-line drugs for glaucoma?

Apraclonidine, Brimonidine

"List three drugs that are considered unsafe, but may be prescribed if other

drugs are ineffective in treating a life-threatening disease."

Gentamicin

"List three drugs that are considered safe for pregnant women or women of

child-bearing age without evidence of harm to the human fetus."

Chloramphenicol

"What is the category of drugs that are presumed safe based on limited studies

and have only been taken by a limited number of pregnant women or women of

child-bearing age without an increase in fetal malformation or harmful effects

to the fetus?"

Category B

The safest antibiotic to use during pregnancy and breastfeeding is___

"The safest antibiotic to use during pregnancy and breastfeeding is{{

Erythromycin }}"

"Antivirals have ___ adverse effects reported with use in

pregnancy at clinically recommended dose."

"Antivirals have {{ No adverse effects }} adverse effects reported with use in

pregnancy at clinically recommended dose."

"Topical Anaesthetics, Fluorescein, and Rose Bengal are ___ during

pregnancy."

"Topical Anaesthetics, Fluorescein, and Rose Bengal are {{ safe }} during

pregnancy."

What adverse effect can Fluoroquinolones have on growing children?

damage to epiphyseal growth plates

What adverse effect can Aminoglycosides have on the foetus?

nephrotoxicity and ototoxicity

What adverse effect can Tetracyclines have on infants?

discolouration of infants' teeth

What adverse effect can Prostaglandin Analogues have on pregnancy?

effect uterine muscle contractility

What adverse effect can Beta-blockers have on the foetus?

"low birth weight, bradycardia, cardiac arrhythmia, apnoea, respiratory

compromise"

What adverse effect can Miotics have on premature infants?

neonatal hypothermia, restlessness, seizures

What adverse effect can Chloramphenicol have on neonates?

suppression of bone marrow

What adverse effect can Alpha-2 adrenergic agonists have on neonates/infants?

CNS depression, drowsiness, apnoea

Why should NSAIDs be avoided in later stages of pregnancy?

may cause foetal cardiovascular and kidney damage, and delay labour and birth

What adverse effects can Mydriatics and Atropine have on infants?

anti-cholinergic effects, toxic in premature infants

What adverse effect can Phenylephrine have on foetus and pre-term infants?

hypertensive effect, hypertension, intraventricular bleeding

"What adverse effect can Carbonic Anhydrase Inhibitors have if used during

pregnancy?"

low birth weight

What are the different pediatric subpopulations based on age?

Neonate

What are the symptoms of bacterial conjunctivitis?

"Meaty" red, gritty, burning eyes

What are the signs of bacterial conjunctivitis?

Conjunctival and episcleral injection, mild chemosis

"Bacterial Conjunctivitis is characterized by ___ red, gritty,

burning eyes."

"Bacterial Conjunctivitis is characterized by {{ "Meaty" }} red, gritty,

burning eyes."

What are the signs and symptoms of hyperacute bacterial conjunctivitis?

Rapid onset of membranes/pseudomembranes (within 24-48 hrs)

"The appropriate management for Bacterial Conjunctivitis includes ___ to remove discharge and topical antibiotics to ___ and minimizes side

effects."

"The appropriate management for Bacterial Conjunctivitis includes {{saline

bathing of the eyes}} to remove discharge and topical antibiotics to {{ speed

resolution and reduce spread to fellow eye and others }} and minimizes side

effects."

"Ophthalmia Neonatorum is managed by immediate ___ to treat ___

infection."

"Ophthalmia Neonatorum is managed by immediate {{referral to paediatrician, GP

or ER for swabs and IV antibiotics or antivirals}} to treat {{ gonococcal }}

infection."

"___ or ___ ointment is used for prophylaxis

in Ophthalmia Neonatorum to prevent ___ infections."

"{{Erythromycin 0.5%}} or {{Tetracycline 1%}} ointment is used for prophylaxis

in Ophthalmia Neonatorum to prevent {{ Chlamydia, gonorrhoea }} infections."

"___can be used as an alternative option for prophylaxis

in Ophthalmia Neonatorum to prevent ___ infection."

"{{Povidone iodine 2.5% }}can be used as an alternative option for prophylaxis

in Ophthalmia Neonatorum to prevent {{ gonococcal }} infection."

What are the prophylactic measures for Ophthalmia Neonatorum?

Silver nitrate 1-2%

"What is the most common bacterial STI that causes adult inclusion

conjunctivitis?"

Chlamydia trachomatis

What are the specific features of trachoma scarring?

Herbet's pits and Arlt's line

"Trachomatous Scarring (TS) is identified by ___ of

___scarring."

"Trachomatous Scarring (TS) is identified by {{white fibrous bands}} of

{{superior tarsal }}scarring."

What are the diagnostic criteria for Trachomatous Inflammation - Intense (TI)?

"Marked inflammation of superior tarsus (obscures >50% of normal deep tarsal

vessels), superior pannus, central or peripheral corneal infiltrates"

What is the treatment for Cat Scratch Disease?

Oral antibiotics Doxycycline 100 mg bid for 1 month

What is the recommended management for adenoviral conjunctivitis?

Advice on hygiene

What should be done before and after Povidone Iodine lavage treatment?

Drop of topical steroid or NSAID

"Vernal Keratoconjunctivitis predominantly affects males aged 5-20 years, with

a peak between ___ years."

"Vernal Keratoconjunctivitis predominantly affects males aged 5-20 years, with

a peak between {{ 11-13 }} years."

"Vernal Keratoconjunctivitis primarily affects the ___

conjunctiva."

"Vernal Keratoconjunctivitis primarily affects the {{ superior tarsal }}

conjunctiva."

"The main aim of treatment for Shield Ulcer in Vernal Keratoconjunctivitis is

to prevent ___"

"The main aim of treatment for Shield Ulcer in Vernal Keratoconjunctivitis is

to prevent {{ corneal scarring }}"