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Conjunctiva Flashcards

1
Q

Goblet cells most dense where

A

inferonasally and in the fornices

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2
Q

Krause and Wolfring - where

A

stroma

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3
Q

Subacute or chronic chemosis

A

thyroid, allergic, meningitis, vasculitis, superior vena cava syndrome, right-sided heart failure, nephrotic syndrome

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4
Q

True membranes

A

adenoviral, gonococcal, Streptococcus, Corynebacterium, ligneous, Stevens-Johnson

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5
Q

Follicles

A

vessels around, lymphoid germinal centre. viral, chlamydial, Parinaud oculoglandular syndrome, hypersensitivity to topical medications

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6
Q

Papillae - size, causes

A

vascular core, macro<1mm, giant>1mm. bacterial, allergic, chronic blepharitis, contact lens, superior limbic keratoconjunctivitis, floppy eyelid syndrome

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7
Q

Lymphadenopathy

A

viral, chlamydial, gonococcal, Parinaud oculoglandular syndrome

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8
Q

Systemic symptoms

A

gonococcus, meningococcus, Chamydia, H. influenzae

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9
Q

Gonococcal

A

true membranes, lymphadenopathy, systemic symptoms, eyelid edema and erythema, hyperacute purulent, peripheral corneal ulceration, gram(-) kidney-shaped intracellular diplococci (also meningococcal), chocolate agar, Thayer-Martin

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10
Q

Treatment gonococcal and meningococcal

A

1g of intramuscular ceftriaxone. quinolone, gentamicin, chloramphenicol, bacitracin + systemic (3g cephalosporin)

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11
Q

Treatment H. Influenzae

A

amoxicillin with clavulanic acid

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12
Q

Treatment Chlamydial

A

Azithromycin 1g (single dose) repeated after 1 week. Doxycycline 100mg 2x1 for 7-10 days. Erythromycin 500mg 4x1 for 7 days, amo, ciprofloxacine

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13
Q

Trachoma - chronic immune response

A

cell-mediated delayed hypersensitivity (Type IV)

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14
Q

Arlt line

A

broad confluent conjunctival scars

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15
Q

Herbert pits

A

row of shallow depressions after resolving of superior limbal follicles

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16
Q

Neonatal conjunctivitis (ophthalmia neonatorum) - causes and prophilaxis. Chlamydial treatment

A

C. trachomatis, N, gonorrhoeae, HSV-2, streptococci, staphylococci, H. influenzae, G(-), congenital nasolacrimal obstruction. povidone-iodine 2.5%, ery 0.5% / tetracycline 1% ointment, silver nitrate 1%. Chlamydial treatment - oral ery for 2 weeks

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17
Q

pharyngoconjunctival fever - serovars, keratitis

A

3, 4, 7. keratitis 30%

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18
Q

epidemic keratoconjunctivitis - serovars, keratitis

A

8, 19, 37. keratitis 80%

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19
Q

forms of viral conjunctivitis

A

non-specific acute follicular conjunctivitis, pharyngoconjunctival fever, epidemic keratoconjunctivitis, acute hemorrhagic conjunctivitis, chronic/relapsing adenoviral conjunctivtis, varicella, measles, mumps, molloscum contagiosum (poxvirus)

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20
Q

Seasonal allergic conjunctivtitis

A

sping, summer, common, tree and grass pollen. Sneezing, nasal discharge

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21
Q

Parennial allergic conjunctivtitis

A

throughout the year, worse in autumn, house dust mites, animal dander, fungal. Milder. Sneezing, nasal discharge

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22
Q

Vernal keratoconjunctivitis (VKC)

A

type I hypersensitivity, recurrent bi, boys, from 5yo remission late teens, warm dry climate, history asthma, eczema, late spring and summer. Palpebral (upper tarsal conj), Limbal (black, asian). Horner-Trantas dots, velvety papillary hypertrophy, giant papillae, ‘shield’ ulcer, HSV

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23
Q

Horner-Trantas dots

A

Gelatinous limbal conjunctival papillae in VKC

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24
Q

Atopic keratoconjunctivitis (AKC)

A

type I and IV hypersensitivity, rare bi, chronic unremitting, parennial worse in winter, 30-50yo, inferior palpebral, history atopic dermatitis (eczema), asthma. more severe than VKC, more skin changes, blepharitis, keratoconus, shield-like anterior or PSC, Hertoghe sign, Dennie-Morgan folds. cornea scarring more than VKC

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25
Hertoghe sign
AKC, absence of the lateral portion of the eyebrows
26
Non-allergic eosinophilic conjunctivitis
common, chronic non-atopic, middle-aged women, dry eye, rhinitis, no IgE
27
Mucous membrane pemphigoid (cicatricial pemphigoid)
type II (cytotoxic) hypersensitivity, old, F:M 2:1, insidious or relapsing-remitting non-specific bi conjunctivitis, papillary
28
cicatricial pemphigoid - treatment
dapsone, antimetabolites, steroids, iv immunoglobulin therapy, rituximab, artificial tears, ciclosporin, tacrolimus, retinoic acid, lid hygiene, subconj mitomycin C/steroid injection,lysis of symblaphara with sterile glass rod, scleral ring, punctal occlusion, lateral tarsorrhaphy, botulinum toxin-induced ptosis, mucous membrane autografting or amniotic membrane transplantation, limbal stem cell transfer, keratoprosthesis
29
Stevens-Johnson syndrome - other name, type sensitivity, factors
toxic epidermal necrolysis (Lyell syndrome). type IV cell-mediated delayed hypersensitivity. antibiotics (sulfonamides and trimethoprim), analgesics (paracetamol), cold remedies, anticonvulants, Mycoplasma pneumoniae, HSV, cancer
30
Superior limbic keratoconjunctivitis
uncommon, uni or bi, middle-aged F, 50% thyroid, symptoms more than signs, remission eventually, blink-related trauma between upper lid and superior bulbar conj, tear film insufficiency, excess of lax conj tissue, papillary hypertrophy, sup punc erosions, filamentary, sup pannus
31
Superior limbic keratoconjunctivitis - treatment
lubricants, acetylocysteine, mast cell stabilizers, steroids, rebamipide, ciclosporin, retinoic acid, soft CL, supratarsal steroid injection, punctal occlusion, resection fo sup limbal conj, conj ablation by silver nitrate 0.5% or thermocautery
32
Ligneous conjunctivitis
recurrent, bi, fibrin-rich pseudomembranous, mainly tarsal conj, onset 5yo, deficiency in plasmin-mediated fibrinolysis, red-white lobular masses, yellow-white mucoid, amorphous subepithelial deposits of eosinophilic material
33
Ligneous conjunctivitis - treatment
stop antifibrinolytic therapy, diathermy, topical plasminogen to soften then remove, after-hourly heparin and steroids. recur: long-term ciclosporin and steroids
34
Parinaud oculoglandular syndrome
rare, chronic low fever, uni granulomatous conjunctivitis, ipsi preauricular, B. henselae, tularemia, insect hairs (ophthalmia nodosum), T. pallidum, sporotrichosis, tuberculosis, C. trachomatis
35
Factitious conjunctivitis
inferior conjunctival injection, rose Bengal
36
Pinguecula
elastotic degeneration, nasal, actinic damage. Thermal laser ablation
37
Stocker line
iron deposition in the corneal epithelium anterior to the head of the pterygium
38
Fuchs islets
small discrete whitish flecks consisting of clusters of pterygial epithelium at advancing edge
39
Pseudopterygium
away from the horizontal, firm attachment to the cornea only at its apex
40
Elastoid degenerations
conjunctivochalasis, pinguecula, pterygium, spheroid degeneration, white limbal girdle of Vogt
41
Hemorrhagic conjuctivitis
Coxsackie A24, Picorna, Adenovirus 8, 19
42
Inclusion conjunctivitis - serovars
Chlamydia D-K
43
Halber-Staedtler and Prowazek
initial bodies in epithelial cells (basophilic intraCYTOplasmic inclusions) in trachoma
44
Leber's cells
macrophages in the conjunctival stroma with phagocytosed debris in trachoma
45
extensive molloscum lesions - what to do
workup for HIV
46
Treatment for gonorrhea conjunctivitis
IM injection of 1gram cefriaxone, eye lavage every hour, +treatment for concurrent chlamydia
47
Acute Hemorrhagic conjunctivitis - causes
Coxackie variant A24, Enterovirus type 70, rarely adenovirus type 11
48
giant papillary conjunctivitis
Vernal keratoconjunctivitis (VKC)
49
Horner-Trantas dots
Vernal keratoconjunctivitis (VKC)
50
shield ulcer - where and location
Vernal keratoconjunctivitis (VKC), upper half of cornea
51
Trachoma - serovars
Chlamydia A-C (trAChoma)
52
Adult and neonatal inclusion conjuntivitis - serovars
Chlamydia D-K (DicK)
53
Lymphangioma venereum - serovars
Chlamydia L1-L3
54
Bitot spot - where and what
foamy lesion on bulbar conjuctiva. vit A deficiency. Corynebacterium xerosis
55
Pharyngoconjunctival fever - serotypes
3, 7
56
Epidemic keratoconjunctivitis - serotypes
8, 19, 37, subgroup D
57
Epidemic keratoconjunctivitis - when infiltrates
7-14 days after ocular symptoms start
58
AKC
anterior shield-shaped or posterior subcapsular cataract, HSV, S. aureus
59
Halberstaedter-Prowazek Bodies
trachoma
60
Initially resemble band keratopathy
Gelatinous drop-like
61
Mulberries
Gelatinous drop-like
62
Chlamydia trachoma - most characteristic
LIMBAL follicles+sequelae (Herbert pits), TARSAL conj scarring, vascular pannus (most marked on the superior limbus), conj follicules most numerous on the superior tarsus
63
Pyogenic granuloma - most common causes
pterygium removal or strabismus surgery
64
Pyogenic granuloma - histo
fibroblasts and proliferating capillaries, "spoke-wheel" vascular pattern
65
Parinaud's ocularglandular syndrome
Granulomatous conjunctivitis with regional lymphadenopathy+constitutional symptoms. 1 week after exposure. Mostly cat-scratch disease
66
Parinaud's ocularglandular syndrome - causes
cat-scratch disease, tularemia, sporotrichosis, tuberculosis, syphilis

Cornea (10 decks)

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