1. Herpes Keratitis !! 2. Herpes Keratitisdx/tx 3. Contact lensKer-atitis 4. Contact lensKer-atitis tx 5. Acute Angle-Clo-sure Glaucoma !! !! Infection with herpes (simplex/v. zoster) that causes acute onset of severe eye pain, photophobia, tearing andblurred vision. Infection causes permanent damage and can cause corneal blindness. Fern-like lines in corneal surface revealed by fluroesceindye/black lamp. Eruption of crusty rash @trigeminal nerveforehead, eyelids, and tip of nose. Refer to ED. -visual acuity -flush eye w/saline Zovirax orValtrex BID Pain management, topical pain management Red eye, blurred vision, watery eyes, photophobia. Usual due toFB.FBsensationpersists evenafter removal. -visual acuity -flush with saline Top abx: ciprofloxacin, ofloxacin,TMP-polymyxin B.Treat TID x 5 days, treat pain. Suddenblockageof aqueous humor casingmarked ‘ofIOP , results inischemia and permanentdamage tooptic nerve(CNII) Family Nurse Practitioner Certification FNP Review HEENT Terms 2022 2 / 18 6. Acute Angle-Clo-sure Glaucoma dx 7. Acute Angle-Clo-sure Glaucoma tx 8. Older pt pre- sents with acuteonset of decreased /blurry vision with se- vere eye pain. Has HA that is causing N/V. 9. Primary Open-Angle Glaucoma 10. Primary Open-Angle Glaucoma dx 11. Primary Open-Angle Glaucoma tx 12. Multiple Sclero- sis Optic Neuritis Sudden severe eye pain, HA, N/V, halos, “vision Mid dilated oval pupil, cloudy cornea, cupping of opticnerve, pupils slow react, conjunctival injection/tearing Ophthalmological emergency...refer to ED Acute Angle-Closure Glaucoma Gradual onset of ‘IOP >22 due to blockage of aqueous humor drainage. Retina undergoes ischemic changes, and can become permanently damaged over time, mostcommon type of glaucoma>>blindness. Gradual changes in peripheral vision followed by cenralvision. Exam shows cupping, IOP (tonometer) is too high. Betimol 0.5% (timolol)-“ aqueous productionLatanoprost (Xalatan)-‘ aqueous outflow SE(same as PO):brochospasm, fatigue, depression, HG,bradycardia Dont use in HF, COPD, heart block 2/3, asthma, emph. Young adult female with new or intermittent loss of visionin one eye (optic neuritis), alone or with nystagmus/oth- er abnormal eye movements.May have other neuro sx Family Nurse Practitioner Certification FNP Review HEENT Terms 2022 3 / 18 (aphasia, paresthesia, abnormal gait). Heat exacerbates and worsens sx. Has recurrent episodes. :Refer Neurology 13. Orbital cellulits Caused by acute bacterial infection of orbital contents. Acute onset of erythematous swollen eyelid with proptosis (eyeball bulging), and eye pain. Cannot perform full ROM of eyes with pain on movement. Note hx of recent rhinos-inusitis or URI. :Refer to ED 14. Retinal Detach-ment Sudden onset of multiple floaters associated with "cur- tain-like" appearance. May have sudden flashes of light(photopsia). :Refer ED. 15. Cholesteatoma "Cauliflower-like" growth with foul-smelling ear drainageand hearing loss. Can't visualize TM due to destruction by tumor. May erode intobones offace and damage facial nerve (CNVII). Treat with abx and surgical debridement. :Refer Otolaryngology