disclosure common eye conditions every primary care
play

Disclosure Common Eye Conditions Every Primary Care Clinician - PowerPoint PPT Presentation

Dec 15, 2023 •183 likes •323 views

UCSF Family Medicine Board Review Chiu Disclosure Common Eye Conditions Every Primary Care Clinician Should Know I have no financial interest in any of the products mentioned in this presentation Cynthia S. Chiu, MD, FACS Associate

  1. UCSF Family Medicine Board Review Chiu Disclosure Common Eye Conditions Every Primary Care Clinician Should Know I have no financial interest in any of the products mentioned in this presentation Cynthia S. Chiu, MD, FACS Associate Professor Director, Comprehensive Ophthalmology & Optometry UCSF Department of Ophthalmology UCSF Family Medicine Board Review March 18, 2015 http://www.timandjeni.com/images/cookiemonster.jpg The Eye Exam Pupils � Eye Vital Sign � Look for afferent pupillary defect � Near Vision Card � Swinging flashlight � Held at 14 inches test � Glasses as needed � +APD indicates optic nerve or large retinal lesion http://www.drbanker.com/images/Nearvision.gif http://img.tfd.com/ElMill/thumb/F0P-24-S2958.jpg 1

  2. UCSF Family Medicine Board Review Chiu Motility Confrontational Visual Fields � Six extraocular � Cover eyes on muscles same side � Test cardinal fields � Hold fingers of gaze midway between � Normal per eye: 60-60-60-90 http://www.opsweb.org/OpPhoto/Extern/Motility/muscle.jpg http://www.opsweb.org/OpPhoto/Extern/Motility/9gazedwg.jpg http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A3460&rendertype=figure&id=A3464 Penlight Exam Anterior Chamber Depth Lids Lashes Conjunctiva/Sclera Cornea � Deep chamber: illumination of nasal iris Iris/Pupil � Shallow chamber: shadow on nasal iris Puncta Lens � Dilation: Phenylephrine 2.5%, Tropicamide 1% http://iei.ico.edu/images/anatomy.jpg http://cache.heraldinteractive.com/blogs/sports/rap_sheet/wp-content/uploads/2009/11/bionic-eye.jpg http://www.ophthobook.com/wp-content/uploads/2007/12/video-glaucoma-shallowpenlight.jpg 2

  3. UCSF Family Medicine Board Review Chiu Fundoscopy Primary Care Ophthalmology � PanOptic or Direct Ophthalmoscope � Evaluate optic nerve, retinal vessels, macula http://www.welchallyn.com/images/corporate/0509_wa_bmurf/011810xx1PanOpticRedHe.jpg http://webvision.med.utah.edu/imageswv/retina.jpeg http://www.factzoo.com/sites/all/img/reptiles/chameleon-eyes.jpg The Red Eye Viral Conjunctivitis � URI � Clear or mucous discharge � Lymphadenopathy � Contagious! � Treat for comfort http://i.zdnet.com/blogs/lord-of-the-rings-ii-eye-of-sauron-4900244.jpg 3

  4. UCSF Family Medicine Board Review Chiu Bacterial Conjunctivitis Allergic Conjunctivitis � Purulent discharge � History of atopy � Culture � Conjunctival edema � Staph, Strep, Hflu � Itchy! – Polymixin/Trimethoprim – Fluoroquinolones � Topical antihistamines – NOT Tobra or Gent – Elestat � GC, chlamydia – Zaditor – Systemic Rx – Patanol � Visine tachyphylaxis Blepharitis Herpes Simplex � When to refer: V1, V2 red eye eye pain � Redness, itching, “grit”, dry eyes change in vision � Rosacea, Staph, Demadex � Warm compresses, baby shampoo, artificial tears � Acyclovir � Doxycycline, Azithromycin http://www.stop-rosacea.com/ 4

  5. UCSF Family Medicine Board Review Chiu Herpes Zoster Uveitis � Inflammation of vascular tissue � Auto-immune � Infectious � Toxic � Masquerade � Hutchinson’s sign: nasociliary nerve � May require � Treat Post-Herpetic Neuralgia: immunosuppression Lyrica, Neurontin, TCA’s Angle Closure Glaucoma Subconjunctival Hemorrhage � Headache � Loss of vision � Firm eye � IV Diamox, Mannitol � Glaucoma gtt’s � Valsalva, HTN, anticoagulants, eye rubbing, � Surgical treatment spontaneous � In the setting of trauma: refer 5

  6. UCSF Family Medicine Board Review Chiu Corneal Abrasion Corneal Foreign Body � Pain! � Loss of epithelium � Not infected � Iron is toxic � Surgical treatment � Erythromycin ung � Artificial Tears � Patching Hyphema Ruptured Globe � Peaked pupil � Severe eye trauma � Brown tissue outside the eye � Risk of rebleed � CT scan NOT MRI � Risk of glaucoma � Fox shield, NPO 6

  7. UCSF Family Medicine Board Review Chiu Common Diseases of Aging Cataract � Painless progressive loss of vision with age � Also caused by DM, XRT, trauma, medications � Difficulty reading, driving, glare � Outpatient surgery http://www.jaredyellin.com/wp-content/uploads/2009/12/old-man-winking1.jpg Glaucoma Macular Degeneration � Chronic progressive optic neuropathy � Risk factors: age, UV, tobacco, Family Hx � Loss of visual field � Loss of central vision � Risk factors: age, tobacco, race, family hx � Dry form: AREDS vitamins, stop smoking � Medications may have systemic interactions � Wet form: anti-VEGF injections http://img.medscape.com/fullsize/migrated/569/545/569545.fig2.gif http://cdn.shopmedvet.com/images/uploads/2640_7780_thumb.jpg 7

  8. UCSF Family Medicine Board Review Chiu Disorders of the Chalazion Eyelid and Orbit � Blocked oil gland � Inflammation � Warm compresses � Incision/curettage http://greatpiercingshop.com/blog/wp-content/uploads/2009/12/eyelid-piercing-method-and-aftercare_49.jpg Cellulitis Thyroid Orbitopathy � Preseptal vs Orbital � Proptosis � Strabismus/Diplopia � Preseptal: full EOM, � Corneal exposure no proptosis, quiet eye � Optic nerve � Treat PO Abx compression � Orbital: proptosis, � 131-I may aggravate strabismus, inflamed eye � Surgical treatment � Treat IV ABx 8

  9. UCSF Family Medicine Board Review Chiu Disorders of the Retina Retinal Detachment � Flashes/Floaters � Loss of vision/field � Sudden, painless � Surgical treatment http://www.rameshshahmd.com/pictures/retinal%20detach.%201.jpg?nxg_versionuid=published http://webphysics.davidson.edu/faculty/dmb/EdibleOpticalMaterials/index_files/cyclops.jpg Diabetic Retinopathy Hypertensive Retinopathy � Microvascular disease � Bleeding � Macular edema � Mild: arteriolar narrowing � Neovascularization � Mod: cotton wool spots, hemorrhages � Severe: disc edema, � Glucose/BP control vessel leakage, infarcts � Laser ablation � Anti-VEGF 9

  10. UCSF Family Medicine Board Review Chiu HIV/CMV Retinopathy Retinal Artery Occlusion � Microvascular disease � Embolic: cardiac echo, carotid doppler � Annual exam if CD4>200 � Vasculitic (GCA) � CMV retinitis http://depts.washington.edu/hivaids/images/oit/oit_c7_d06.jpg Retinal Vein Occlusion Neuro-Ophthalmology � Hypertension � Glaucoma � Young patients: hypercoagulable http://www.capitalgainsmedia.com/images/Development%20News%20Photos/Dev-Ino-Issues%2002/Dev-Ino%20Issue%200244/DSC01869.jpg 10

  11. UCSF Family Medicine Board Review Chiu Stroke Pituitary Adenoma � Homonymous field defect � Compression of nasal � Location of fibers at optic chiasm lesion is � Bitemporal hemianopia contralateral + upside-down http://www.lfhk.cuni.cz/patfyz/intranet/Figures/58/18.13.jpg Temporal Arteritis Optic Neuritis � Acute vision loss � Loss of vision � Headache, jaw claudication, � Pain with EOM scalp tenderness, proximal � +/- disc edema myalgias, constitutional symptoms � Multiple Sclerosis � ESR and CRP � Steroids � Prednisone 100mg QD � Temporal artery biopsy http://www.djo.harvard.edu/files/2982_355.jpg 11

  12. UCSF Family Medicine Board Review Chiu Pseudotumor Cerebri Horner Syndrome � Headache, tinnitus � Papilledema � Vision loss � Anisocoria in the dark � Female, overweight � Mild ptosis � Medication-induced � Acute and painful: R/O carotid dissection � LP: opening pressure http://www.caleyes.com/images/papilledema-image.jpg http://www.mrcophth.com/oculoplasticgallery/traumatichorner/horner.jpg Third Nerve Palsy Thank You! � Aniscoria in the light � Severe Ptosis � EOM paresis � Microvascular � PCA/PCom aneurysm http://www.nature.com/eye/journal/v18/n3/images/6700625f1.jpg http://www.revophth.com/Images//2008/10/083_RPJ8_F6.gif http://blog.omy.sg/dingan/files/2009/05/bob.jpg 12

Recommend

Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS

Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS

Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Professor UCSF Department of Ophthalmology UCSF Family Medicine Board Review March 7, 2017 http://www.timandjeni.com/images/cookiemonster.jpg

579 views • 54 slides
PRIMARY EYE CARE AND CHILDHOOD BLINDNESS PRIMARY EYE CARE TRAINING Training will be provided

PRIMARY EYE CARE AND CHILDHOOD BLINDNESS PRIMARY EYE CARE TRAINING Training will be provided

ACTIVITIES PLANNED FOR PRIMARY EYE CARE AND CHILDHOOD BLINDNESS PRIMARY EYE CARE TRAINING Training will be provided to primary health care teams (DMOs/MOHs/PN/PHI/PHMW) Training will concentrate on screening and identification of common

267 views • 26 slides
Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Upper

Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Upper

4/5/18 UCSF CME PRIMARY CARE MEDICINE: Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Upper Extremity Conditions You Will See in Office Practice Cindy J. Chang M.D. UCSF Primary Care Sports

540 views • 16 slides
Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Knee

Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Knee

4/3/18 UCSF CME PRIMARY CARE MEDICINE: Disclosures Update 2018 April 1-6, 2018 No relevant financial relationship exists Common Knee and Ankle Conditions You Will See in Office Practice Cindy J. Chang M.D. Primary Care Sports Medicine

192 views • 18 slides
Disclosure No relevant financial relationship exists UCSF CME PRIMARY CARE MEDICINE: Update 2018

Disclosure No relevant financial relationship exists UCSF CME PRIMARY CARE MEDICINE: Update 2018

4/6/18 Disclosure No relevant financial relationship exists UCSF CME PRIMARY CARE MEDICINE: Update 2018 April 1-6, 2018 Management of Concussions in Your Active Patient Cindy J. Chang, MD Primary Care Sports Medicine Clinical Professor of

301 views • 15 slides
Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Associate Professor UCSF

Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Associate Professor UCSF

Common Eye Conditions Every Primary Care Clinician Should Know Cynthia S. Chiu, MD, FACS Associate Professor UCSF Department of Ophthalmology UCSF Family Medicine Board Review March 9, 2016 http://www.timandjeni.com/images/cookiemonster.jpg

773 views • 50 slides
AKI in Primary Care AKI: Context and focus for primary care Definition, staging and

AKI in Primary Care AKI: Context and focus for primary care Definition, staging and

Acute Kidney Injury (AKI) In Primary Care Supporting early detection and consistent management Responding to AKI Warning Stage Test Results for Adults in Primary Care: Best Practice Guidance AKI in Primary Care AKI: Context and focus for

783 views • 35 slides
11/19/16 Disclosures Dermatology in Primary Care: Recognition and treatment of common

11/19/16 Disclosures Dermatology in Primary Care: Recognition and treatment of common

11/19/16 Disclosures Dermatology in Primary Care: Recognition and treatment of common disorders I have no conflicts of interest to disclose. of the skin I may discuss off-label use of treatments for cutaneous disease.

676 views • 23 slides
Medical Cannabis 101 The Practical Application of Cannabinoids in Primary Care Speaker Disclosure

Medical Cannabis 101 The Practical Application of Cannabinoids in Primary Care Speaker Disclosure

Medical Cannabis 101 The Practical Application of Cannabinoids in Primary Care Speaker Disclosure Dr. McKenzie has disclosed that he has no actual or potential conflict of interest in relation to this topic. Learning Objectives By the end

929 views • 68 slides
The Future of Primary Care Lessons Learned from COVID-19 Disclosure Dr. Fields has disclosed

The Future of Primary Care Lessons Learned from COVID-19 Disclosure Dr. Fields has disclosed

The Future of Primary Care Lessons Learned from COVID-19 Disclosure Dr. Fields has disclosed that neither he nor members of his immediate family have any actual or potential conflict of interest. All information in this deck is confidential

563 views • 22 slides
Commissioning and Enabling Primary Care in Doncaster Laura Sherburn 30 June 2016 Primary Care

Commissioning and Enabling Primary Care in Doncaster Laura Sherburn 30 June 2016 Primary Care

Commissioning and Enabling Primary Care in Doncaster Laura Sherburn 30 June 2016 Primary Care Strategic Model Proactive Responsive Primary Keeping people Coordinated Extended Primary Care well Primary Care Care Bringing care closer

466 views • 9 slides
Using the PAM to improve quality of care for patients with chronic conditions Professor Mark

Using the PAM to improve quality of care for patients with chronic conditions Professor Mark

Faculty of Medicine - Centre for Primary Health Care and Equity Using the PAM to improve quality of care for patients with chronic conditions Professor Mark Harris Executive Director, Centre for Primary Health Care and Equity, UNSW Sydney Using

521 views • 17 slides
Primary Care Health Home Eligibility Two chronic conditions One chronic condition and the

Primary Care Health Home Eligibility Two chronic conditions One chronic condition and the

Primary Care Health Home Eligibility Two chronic conditions One chronic condition and the risk of developing another Asthma Diabetes Heart Disease BMI Over 25 Developmental Disability Designated providers Federally

450 views • 13 slides
APPROACH TO BLOATING Epidemiology Very common symptom in primary care (10- 30% in population

APPROACH TO BLOATING Epidemiology Very common symptom in primary care (10- 30% in population

Dr Juanda Leo Hartono Associate Consultant Div Gastroenterology and Hepatology National University Hospital, Singapore APPROACH TO BLOATING Epidemiology Very common symptom in primary care (10- 30% in population based studies) Most

716 views • 25 slides
Introduction to Primary Care First and Direct Contracting Models Introduction to Primary Care

Introduction to Primary Care First and Direct Contracting Models Introduction to Primary Care

Introduction to Primary Care First and Direct Contracting Models Introduction to Primary Care First (PCF) Primary Care First Goals Primary Care First Overview 5-year alternative payment model To reduce Medicare spending by 1 preventing

550 views • 19 slides
When? How? NOW! Mike Hogan, Ph.D. Behavioral Health in Primary Care: WHY? Clinical reasons:

When? How? NOW! Mike Hogan, Ph.D. Behavioral Health in Primary Care: WHY? Clinical reasons:

Behavioral Health Within Primary Care: When? How? NOW! Mike Hogan, Ph.D. Behavioral Health in Primary Care: WHY? Clinical reasons: Primary care is where people with MH/SUD conditions present Cost reasons: Dis - integrated Care is

275 views • 16 slides
Financial disclosure: none Primary angle closure (PAC) Pathogenesis: Pupillary block and

Financial disclosure: none Primary angle closure (PAC) Pathogenesis: Pupillary block and

Ying Han, MD, PhD Associate Professor of Ophthalmology Glaucoma Service UCSF Financial disclosure: none Primary angle closure (PAC) Pathogenesis: Pupillary block and anterior lens movement Most common cause Normal pressure gradient

412 views • 14 slides
Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care

Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care

Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care Information for Payers 1 Comprehensive Primary Care Plus Center for Medicare & Medicaid Innovation Three Main Goals Underlie CPC+ 1 A dvance care

515 views • 22 slides
Primary Care Network Development in Havering Jordanna Hamberger Primary Care Delivery Manager

Primary Care Network Development in Havering Jordanna Hamberger Primary Care Delivery Manager

Primary Care Network Development in Havering Jordanna Hamberger Primary Care Delivery Manager Emily Plane Head of Primary Care 24 July 2019 Why Primary Care Networks? - PCNs are the key building block of the NHS Long Term Plan. - At

1.1k views • 14 slides
Pain Management in Primary Care Pain was primary reason for 40% of doctor visits in a Finnish

Pain Management in Primary Care Pain was primary reason for 40% of doctor visits in a Finnish

Pain in Primary Care Pain Management in Primary Care Pain was primary reason for 40% of doctor visits in a Finnish study from 2001 Most common reason for visiting doctor Robert M. Taylor, MD Not enough pain specialists to treat all

426 views • 13 slides
Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care Through

Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care Through

Comprehensive Primary Care Plus Advancing the Delivery of and Payment for Primary Care Through Multi-Payer Partnership LAN Summit April 26, 2016 Laura Sessums, JD, MD 1 Comprehensive Primary Care Plus Center for Medicare & Medicaid

568 views • 20 slides
Steve McInnes Primary Care Relationship Manager NHS Portsmouth CCG Primary Care engagement

Steve McInnes Primary Care Relationship Manager NHS Portsmouth CCG Primary Care engagement

Steve McInnes Primary Care Relationship Manager NHS Portsmouth CCG Primary Care engagement Clinical and Practice engagement Facilitating quality improvements in primary care Commissioning of local primary care services Patient

421 views • 13 slides
Legally Speaking Understanding and managing common legal issues in the primary care setting

Legally Speaking Understanding and managing common legal issues in the primary care setting

Legally Speaking Understanding and managing common legal issues in the primary care setting Presenter Caroline M. Dellenbusch, J.D. Attorney Counselor Mediator Goals and Objectives Learn and understand legal terms that often occur in

706 views • 44 slides
Objectives Review most common diseases in dermatology What the primary needs to know

Objectives Review most common diseases in dermatology What the primary needs to know

8/5/2019 Objectives Review most common diseases in dermatology What the primary needs to know Strengthen the partnership between the PCP in the world of increased access and derm to provide the best care to the pt? Toby Maurer,MD Acne

897 views • 18 slides

More recommend