OSCE conditions management

What is Atopic Keratoconjucntivitis and its management

• severe sight threatening allergic eye disease - chronic inflammation of surface

• symptom begin in late teens early twenties

• history of asthma + eczema

Mx:

• cool compress, elimination of pets

• ocular lubricants , drops during day and ointment at night

• systemic antihistamines → cetirizine

• for milder cases routine referral

• refer urgently if corneal involvement

what is Blepharitis and what is management of it

• inflammation of lids

• 2 types anterior + posterior

• Anterior → bacterial , infection

• Posterior → MGD

• itching, burning, blurred vision

Mx → let px know its chronic

• lid hygiene , massages

• warm compress

Cellulitis, preseptal + orbital

• infection of tissues

• trauma

• emergency same day referral

Chalazion Management

• caused by blockage of MGD

• may follow hordeolum

• PAINLESS lid lump

• tarsal plate

Mx:

• tend to resolve on own

• warm compress - 10 MINS massage + clean lids

• if it hasn’t resolved and persistent can be surgically removed - routine referral

Concretions Mx

• small yellow lesions of palpebral conjunctiva

• over age of 50

• usually asymptomatic

• treatment rarely required

Conjunctival pigmented lesions

• Naevous most common in white populations

• advise px if increase in size, colour elevation- take photos

• melanoma refer urgently

Allergic conjunctivitis management

• common allergic response to allergens grass pollen, animal hair

• swelling, itching

• watering

• cool compress for sx

• nothing to worry about , common , advise against lid rubbing

• antihistamines

bacterial conjunctivitis mx

• caused by bacteria

• redness, sticky discharge, crusting of lids

• CL wear

• self-limiting 5-7 days

• highly contagious - don’t share towels, wash hands regularly

• cease CL wear - throw away contaminated CL

Dermatoconjucntivitis mx

• chemical irritation - cosmetic , makeup

• cool compress for symptomatic relief

• culprits - benzalkonium chloride

• avoid irritant , preservative-free eye drops

Conjuncitval chlamydial

• young adulthood → 15-35yrs

• gritty, sticky discharge, droopy lid

• Advise against CL wear

• ocular lubricants - drops during day, ointment at night

• may need to refer to genintourinary clinic urgent referral one-week

Dacryosistcits mx

• inflammation of lacrimal sac

• usually secondary to duct obstruction

• for chronic → not painful, fluid-filled

• chronic conjunctivitis

• TX WARM compress, refer routinely if symptoms persist or recur

ACUTE:

• common in post-menopausal women

• sudden onset → painful red swelling

• EMERGENCY or urgent referral antibiotics

Dry Eye mx

• tear quality