Acute closure-angle glaucoma vs Optic neuritis vs Orbital cellulitis - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 01-17-2011
Haisook's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 752
Threads: 124
Thanked 610 Times in 264 Posts
Reputation: 630
Eye Acute closure-angle glaucoma vs Optic neuritis vs Orbital cellulitis

I tend to mix up between those 3, especially when not enough information is given in the question. Are there any defining features (symptoms, local exam, fundus exam) that would tell them apart, so that one can be completely sure of the right choice?
Reply With Quote Quick reply to this message



  #2  
Old 01-17-2011
pakbrain's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 52
Threads: 3
Thanked 48 Times in 24 Posts
Reputation: 58
Default

patient with acute angle closure galucoma tends to present with nausea , vomiting and sudden painful loss of vision , pupil is oval , fixed and semi dilated , and anterior chamber is shallow and on gonioscopy there ll be angle closure

patient with optic neuritis will also present with sudden painful loss of vision but mostly central vision is affected due to central scotoma as compared to papilloedema where eventually complete blindness sets in , there ll be hyperemia and blurring of optic disc margin , vessels will be dilated and tortous , cotton wool spots or exudates might be evident ,

patient with orbital cellulitis will have marked swelling of both lids , there ll be vision loss but not as much as compared to above 2 , there ll be diplopia and i hope this info ll be helpful to u
Reply With Quote Quick reply to this message
The above post was thanked by:
Al-Saoudi (10-05-2011), Haisook (01-17-2011), Mondoshawan (01-19-2011), tkourkou (01-18-2011)
  #3  
Old 01-17-2011
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 590
Threads: 31
Thanked 1,227 Times in 410 Posts
Reputation: 1251
Default

One thing sort of unique to optic neuritis is loss of color vision, I think...
Reply With Quote Quick reply to this message
  #4  
Old 01-18-2011
tkourkou's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 220
Threads: 35
Thanked 283 Times in 99 Posts
Reputation: 293
Default

A unique feature of acute angle closure glaucoma is that the eye is "rock-hard", with fixed, dilated pupil, with conjuctival hyperemia and the patient sees hues around the objects.
__________________
No one has ever been killed from work
Reply With Quote Quick reply to this message
  #5  
Old 01-19-2011
Haisook's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 752
Threads: 124
Thanked 610 Times in 264 Posts
Reputation: 630
Default

Thanks for your input. Here I'll try to list the most specific "keywords" to each disease (as UW really tries to confuse you about these, and I'm assuming the real exam will too).
  • Acute closure-angle glaucoma: "rock hard eye".
  • Optic neuritis: color vision affection/blindness, blurring of the optic disc margins.
  • Orbital cellulitis: proptosis, diplopia (?)
I'm going to update it if we come up with other specific criteria.
Reply With Quote Quick reply to this message
The above post was thanked by:
1TA2B (03-14-2011), ag2011n (10-05-2011), Krazy (11-30-2013), lepidoptera (03-14-2011), Mondoshawan (01-19-2011)
  #6  
Old 03-14-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

that's useful!

3 confusing differential diagnoses-particularly first 2 can be difficult to differentiate-painful loss of vision is common feature
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #7  
Old 10-04-2011
Salvia's Avatar
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 3
Threads: 0
Thanked 2 Times in 1 Post
Reputation: 12
Default

more for orbital cellulitis: decreased motility, chemosis

and a nice case report: http://webeye.ophth.uiowa.edu/eyefor...Cellulitis.htm
Reply With Quote Quick reply to this message
  #8  
Old 10-05-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 505 Times in 231 Posts
Reputation: 515
Default

This is really good topic, let me just add little & put every thing together.
  • Acute closure-angle glaucoma: Sudden, painful red eye, "rock hard", fixed mid-dilated pupil not reactive to light. Seeing halos around the lights. Sudden decrease vision.
  • Optic neuritis & papillitis: inflammation of the optic nerve: suddenpainful loss of vision (may be unilateral or bilateral) color vision affection/blindness, blurring of the optic disc margins. Always remember multiple sclerosis here.
  • Orbital cellulitis: infection of the soft tissues of the orbit posterior to the orbital septum. Pain. Proptosis, ophthalmoplegia, diplopia and edema,erythema of the eyelids & decreased eye motility.
Reply With Quote Quick reply to this message



Reply

Tags
Internal-Medicine-, Ophthalmology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Acute Cholecystitis Vs Acute Ascending Cholangitis Hohepa USMLE Step 2 CK Forum 2 01-28-2015 05:28 AM
acute megakaryocytic leukemia or acute lymphoblastic leukemia in Down syndrome patients??? doctorF USMLE Step 1 Forum 6 10-05-2011 10:35 AM
Question about Cellulitis (Erysipales) Dr_Kal_El USMLE Step 1 Forum 0 09-16-2010 01:00 PM
Optic Atrophy Father? ecgram USMLE Step 1 Forum 6 07-15-2010 05:21 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)