Summary
Summary Ophthalmology Key Points for PEBC Exam
Key points on ophthalmology material required to be successful on the PEBC MCQ Exam.
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OPHTH SHORT LESSON- Instill 1 drop at a time and close eye wo squeezing for at least 30s-1min
- Wait 5-10min bw each drop
i. Same med: 3-5min
ii. >1med: 5-10min
- Discard after 28d of opening
- Remove contact lens prior to instilling and wait 15min after to reinsert
Cataract Surgery Post-Op
Patho Sx: blurred vision, glare, dbl vision, impaired night vision
Refer: intense pain, inflamm and/or infx, trauma, change in vision, itching, swelling, photophobia
Glaucoma
Patho Optic neuropathy secondary to ↑ IOP >22 periph vision loss
- 2nd leading cause of blindness
Sx:
- AOAG: eye pain, blurred vision, halos, HA, N/V
Drug CS (dex, prednisolone), antichols (antihistamines, decongestants, AD, antismasmodics), TOP (ACG),
topical mydriatics/cycloplegics (outflow), OCs (>3-5y POAG), vasodilators
Mydriasis: muscle relaxants, BZDs, SSRIs/MAOIs, salicylates, OC
Nonpharm Aerobic exercise
Laser/surgical when drug therapy unsuccessful
PGs First line OD
MOA: ↑uveroscleral outflow (bimatoprost + ↑ trabecular outflow)
ADR: foreign body sensation, burning, stinging, itching, ↑ iris pig, lash length,
HA, flu like sx, conjunctival hyperemia
- BAK: bimatoprost, latanoprost (fridge)
CI: hx recurrent intraocular inflamm, macular/corneal edema
- AVOID in preg
BB MOA: inh aq humor formation
ADR: local effects, bronchospasms, CHF exacerbation, SOB, brady,
hypotension, syncope, depression, impotence, hypoglycemia response, ↓
HDLs
- No preservatives: timolol available
CI: asthmatics, obstructive lung disease (can use betaxolol)
CAI MOA: inh aq humor production
OAG ADR (better in brinzolamide): taste, stinging, local rxn
Pharm - Preservative free: dorzolamide
AA (alpha MOA: suppressing aq humor formation + ↑ uveroscleral outflow
2 agonist) (brimonidine)
- Tachyphylaxis
ADR: local rxn (apraclonidine), dry mouth, tachy, hypotension, HA, tremor
- BAK: apraclonidine, brimonidine
- Purite: brimonidine
CI: MAOIs
- Caution: severe CVD, HTN, cerebrovasc, CKD, depression
Pilocarpine MOA: contract ciliary muscle and ↑ trabecular outflow
(cholinergic ADR: ↓ vision, brow ache, miosis, myopia, GI upset, retinal tear/detachment,
Ag) closed angle glaucoma, sweating, tremor, salivation, diarrhea, low BP/HR
- BAK
CI: uncontrolled asthma, CV
ACG Avoid drugs that dilate pupils
Laser iridotomy
Monitoring ↓IOP: 2w
Preg: consider AAA
Refer: eye pain, vision loss, abnormal photophobia, eye irritation/redness, asthma/COPD, hypotension
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