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Conjunctiva Flashcards

1
Q

Types of discharge in different types of conjunctivitis

A

B – bacteria – Purulent
C – chlamydial – mucopurulent
B – viral – watery
E – allergic – watery

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2
Q

Main pathology of conjunctivitis

A

Follicular and papillary

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3
Q

Membranous conjunctivitis features

A

All common features (the 5) + inflammatory membrane formation

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4
Q

Cause of membranous conjunctivitis

A

Corynebacterium diphtheria

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5
Q

Characteristic of true membrane

A

True membrane bleeds on peeling

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6
Q

Pseudomembranous conjunctivitis

A

All features +membrane formation(Does not bleed on peeling)

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7
Q

Aetiology of pseudomembranous conjunctivitis

A
  1. mild diphtheria
  2. streptococcus haemolytic us
  3. severe Adenoviral infection
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8
Q

Other causes of pseudomembranous conjunctivitis

A

1.gonococcal
To.Staphylococcus aureus
3.HSV
4.chemical irritant

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9
Q

Causes of angular conjunctivitis

A
  1. moraxella axenfeld
  2. moraxella laumata
  3. moraxella catarrhalis

Staphylococcus aureus

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10
Q

Treatment of angular conjunctivitis

A
  1. antibiotic eyedrops

2. zinc oxide which is an inhibitor of proteolytic enzymes. (For excoriation )

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11
Q

Features of haemorrhagic conjunctivitis

A

All features + subconjunctival haemorrhage

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12
Q

Aetiology of haemorrhagic conjunctivitis

A 
Bacteria – pneumococcal us, haemophilus
Viral
1.enterovirus – 70
2.adenovirus
3.coxsackievirus-24
4.echo virus – 34
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13
Q

Causes of subconjunctival haemorrhage

A
  1. trauma
  2. hypertension
  3. bleeding diatheses
  4. haemorrhage and conjunctivitis
  5. pertusis(whooping cough)
  6. passive venous congestion
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14
Q

What is strains cause trachoma

A

Chlamydia trachomatis

A, B, Ba,C

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15
Q

What do you strains D to K cause

A

Adult inclusion conjunctivitis

Swimming pool conjunctivitis

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16
Q

Clinical features of trachoma

A

Intense itching and watering

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17
Q

Characteristic features on examination in trachoma

A

On palpable conjunctiva – Sago Grain like follicles, arlt’s line
Around the cornea – Herbert follicles, Herbert pits

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18
Q

WHO classification Of trachoma

A 
F – I – follicles
I – II – inflammatory
S –III– scarring
T – IV-Trichiasis
O– V– corneal opacity
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19
Q

Complication of trachoma

A

Corneal ulcer

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20
Q

Two main pathologies or off trachoma

A

Follicular + papillary reaction

Intra cytoplasmic inclusion body– Halbertsteiater prowasele

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21
Q

SAFE strategy

A 
WHO programme to control trachoma
S – surgery
A – antibiotics
F – facial hygiene
E – environmental cleanliness
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22
Q

Indication of starting SAFE strategy

A

Prevalence of trachoma Follicles In 1 to 9 years of age is more than 10%

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23
Q

What is the strategy when the prevalence is 5 to 10% among children

A

Just FE

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24
Q

What is the strategy if the prevalence of trachoma in children is less than 5%

A

Nothing under the programme

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25
What is the drug of choice for blanket therapy
Azithromycin
26
What are the diseases covered by a vision 2020 India
4+3 1. cataract 2. trachoma 3. childhood blindness 4. refractive error 1. diabetic retinopathy 2. glaucoma 3. corneal blindness
27
Drug of choice for trachoma
Azithromycin
28
Treatment of trachoma
As it through Meissen 1. Tetracycline 2. Sulphacetamide Eyedrops 3. Broad-spectrum antibiotics
29
Causes of phlyctenular conjunctivitis
Staphylococcus aureus | Tuberculosis
30
Pathology of phlyctenular keratoconjunctivitus
Type 4 hypersensitivity
31
Examination feature of phlyctenular keratoconjunctivitis
Fascicular ulcer Phlycten Ring ulcer Conjunctival congestion
32
Treatment of phlyctenular keratoconjunctivitis
Anti allergic- olopatadine,epimastine ^^ dual action of Antihistamine Mast cell stabiliser Mild steroid - fluoromethalone
33
Vernon keratoconjunctivitis AKA
Spring Catarrh
34
Aetiology of vernal keratoconjunctivitis
1. Allergy to exogenous- dust,pollen 2. in summers 3. male children 4. no follicles
35
Discharge in vernal keratoconjunctivitis
Ropy discharge
36
Examinational feature of vernal keratoconjunctivitis
Epithelial hyperplasia- cobblestone Cupid’s bow/pseudogerontoxon Horner trantas spots-aggregation of eosinophils
37
Maxwell lyon sign
Presence of eosinophils in ropy discharge
38
What is shield ulcer
Epithelial micro erosion which Macro erosion Fibrin and mucus gets deposited on this
39
Pathology of vernal keratoconjunctivitis
Type 1 hypersensitivity
40
Ophthalmia neonatorum | What age
Less than 1 months
41
MC aetiology of ophthalmia neonatorum
Chlamydia
42
Most dangerous etiologyof ophthalmia neonatorum
Gonorrhoea Why? Leads to corneal perforation
43
Crede’s method of prevention
1 % AgNO3 to prevent gonorrhoeal conjunctivitis
44
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
45
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
46
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
47
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
48
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
49
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
50
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
51
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
52
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
53
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
54
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
55
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
56
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
57
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
58
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
59
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
60
Causes of parenchymatous conjunctival xerosis
Trachoma Burns Steven Johnson syndrome
61
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
62
Which is more dangerous | acid or alkali type of burn?
Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer
63
Causes of epithelial conjunctivital xerosis
Xerophthalmia (vit A deficiency)
64
Causes of parenchymatous conjunctival xerosis
Steven Johnson syndrome Burns Trachoma
65
Xerophthalmia stages
XN- night blindness (earliest) XIa- conjunctival xerosis XIb- bitots spot XII- corneal xerosis XIIIa- keratomalacia (less than 1/3rd) XIIIb- keratomalacia (more than 1/3rd) XS- xerophthalmic scarring XF- fundus (white spotted fundus)
66
Dose of vitamin A
Above 1 yr - 1 lakh unit (0,1,14th day) Less than 1 yr - half the dose
67
What is pterygium
Subconjunctival fibrovascular tissue encroaching the cornea NOT inflammatory
68
To prevent recurrence of pterygium what to do
Mitomycin C | Autografting
69
PERFECT surgery
Pterygium extended resection followed by extended conjunctival transplantation
70
What is pseudopterygium
Any scar tissue that resembles pterygium
71
How to differentiate between pterygium and pseudopterygium
Glass rod test Passes under the tissue in pseudopterygium Does not for pterygium
72
What are the different iron deposition in the eye called
Stockers line Ferry’s line Hudson stahli line Flescher’s ring Know where they are found 🙈
73
What is pinguecula
Elastotic degeneration of conjunctiva and hyaline infiltration Consist of fat,protein and calcium
74
Most common site of pterygium
Nasal part of eye
75
What eye conditions do UV-B rays cause
Pterygium Pinguecula Snow-blindness/photophthalmia
76
What is photoretinitis
Injury by infrared rays Directly looking at the solar eclipse with unaided eye C/F- macular burn—> macular scar
77
Layers of tear film Secreted by Functions
``` Lipid layer (meibomian gland) Prevents evaporation ``` ``` Aqueous layer (lacrimal gland) Lubrication ``` ``` Mucin layer (goblet cells) Helps to spread tear ```
78
Where is the maximum density of goblet cells
Inferonasal quadrant
79
What is dry eye
Deficiency of any three layer
80
What is keratoconjunctivitis sicca
Deficiency of aqueous layer
81
Primary Sjögren’s syndrome
keratoconjunctivitis (dry eye) + dry mouth (xerostomia)
82
Secondary Sjögren’s syndrome
KCS (dry eye)+ dry mouth + RA/connective tissue disorders
83
Schirmers test
Tear slip on lower lid for 5 min | Less than 5 mm wetting- severe dry eye
84
Phenol red thread test
Put on lower lid for 15 sec | Less than 9 mm change to red colour then dry eye
85
Tear break up time test
If absence of mucin layer Time from last blink to first dry spot on cornea Less than 10 sec - severe dry eye
86
What does rose Bengal stain
Stains dead cells and mucus
87
Medical and surgical management of dry eye
Medical-lubricating eye drops | Surgical - lacrimal punctual occlusion (silicone plug)
88
Causes of nyctalopia
Xerophthalmia Retinitis pigmentosa High myopia Late stage of POAG
89
Congenital stationary night blindness causes
Find us albipunctatus (NB+ white spotted fundus) Oguchi’s disease (NB+ pale fundus) Mizous phenomenon
90
Choroidal dystrophy
Choroideremia | Gyrate atrophy
91
Cause of choroidal dystrophies
Deficiency of enzyme ornithine aminotransferase
92
Mizous phenomenon
Feature of oguchi’s disease 1 hr in the dark there is no Night blindness and fundus is normal Cause: overestimation of rods
93
Causes of hamarlopia
Central corneal opacity Central lenticular opacity Congenital absence of cones

Opthalmology (10 decks)

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