Chapter 60: Pingueculae and Pterygia Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What information will the provider provide the patient about this lesion?

a. Artificial tear drops are contraindicated.

b. Spontaneous bleeding is likely.

c. UVB eye protection is especially important.

d. Visine may be used for symptomatic relief.

ANS: C a. Consult with an ophthalmologist. b. Continue the medication for 7 more days.

This patient has a pinguecula which has become inflamed. Wide-brimmed hats and sunglasses with UVB protection should be advised since UVB light will make this worse. Artificial tear drops are recommended to reduce irritation. These types of lesions typically do not bleed spontaneously. Visine is contraindicated because chronic vasoconstriction may lead to rebound inflammation.

2. A patient experiencing an inflamed pterygia lesion has been prescribed loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action?

NURSINGTB.COM c. Prescribe a systemic corticosteroid. d. Refer the patient to the emergency department.

ANS: A

Topical steroid medications are used to treat pterygia but should not be used longer than 7 days without ophthalmic consultation. Systemic corticosteroids are not indicated, and an emergent referral is not necessary.