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HEENT Clin Med > conjunctiva disorders > Flashcards

conjunctiva disorders Flashcards

(81 cards)

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1
Q

What are pinguecula and pterygium

A

benign growths of the conjunctiva that can result for chronic actinic irritation

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2
Q

What is a pinguecula

A

raised yellowish-white mass within the bulbar conjunctiva, adjacent to the cornea

*does NOT grow onto the cornea

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3
Q

What is a pterygium

A

Fleshy triangular growth of bulbar conjunctiva that may spread across and distort cornea, induced astigmatism, change refractive power of the eye

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4
Q

What are the symptoms of pterygium

A

Decreased vision and foreign body sensation

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5
Q

Where do pterygium occur more commonly in the US

A

sunny, hot, dry climates

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6
Q

How do you treat pterygium

A

artificial tears or short period of steroid drops or ointments

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7
Q

When is a removal of a pterygium indicated

A

documented growth
cosmetic concerns
reduce irritation
improve/preserve vision

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8
Q

What is the most common cause of eye redness

A

conjunctivitis

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9
Q

How is conjunctivitis characterized

A

Acute (1-2 weeks)
Chronic (>4weeks)
Infectious
Non- infectious

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10
Q

What is the conjunctiva

A

transparent, lubricating mucous membrane covering the outer surface of the eye

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11
Q

What are the 2 parts of the conjunctiva

A

bulbar conjunctiva (covers globe)
Tarsal (Lines inner eyelid)

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12
Q

What are the three most common types of conjunctivitis

A

Viral
Allergic
Bacterial

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13
Q

What is the most common cause of Viral conjunctivitis

A

adenovirus

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14
Q

What is the most common form of conjunctivitis

A

non-infectious

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15
Q

Who is at higher risk of bacterial conjunctivitis

A

Adults

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16
Q

What are the causes of bacterial conjunctivitis in adults

A

S. pneumoniae
H. influenza

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17
Q

What are the causes of pediatric conjunctivitis

A

H. influenza
S. Pneumoniae

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18
Q

What is the most common cause of conjunctivitis in neonates

A

N. gonorrhea

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19
Q

What is the epidemiology with conjunctivitis

A

Varies by age, sex, and time of year

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20
Q

How much of the conjunctiva is involved with conjunctivitis

A

Entire conjunctiva, often with discharge

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21
Q

How long is viral conjunctivitis contagious

A

10-14 days

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22
Q

What is Picornavirus

A

acute hemorrhagic conjunctivitis
*highly infectious

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23
Q

What is HIV conjunctivitis

A

Protracted course marked by irritation, redness, and tearing

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24
Q

Which patient population is most susceptible to viral conjunctivitis

A

Peds

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25
How will patients present with viral conjunctivitis
Foreign body sensation red, itchy eyes light sensitivity burning watery discharge *Usually with a recent URI or sick contact
26
What occurs with HSV conjunctivitis
vesicles may appear on face/eyelids and vision changes and corneal involvement possible
27
What occurs if someone gets conjunctivitis with Zoster
vesicular dermatomal pattern with a red conjunctiva with mucopurulent discharge
28
What is the clinical presentation of viral conjunctivitis
Injected conjunctiva small, dome shaped nodules without prominent central vessels on palpebral conjunctiva Preauricular lymph nodes may be reactive and tender
29
What helps differentiate between bacterial and viral conjunctivitis
Preauricular lymph nodes being reactive and tender
30
When is lab testing indicated with viral conjunctivitis
not resolving sus. chlamydial inf. (newborns) Excesses amount of discharge Sus. gonorrhea co-infection immunocompromised
31
How long can it take for viral conjunctivitis to clear
up to 3 weeks *generally within 14 days
32
What are some ophthalmologic interventions for viral conjunctivitis
Membrane / pseudo-membrane may be peeled off with cotton swab Topical steroid (can cause prolonged viral shedding)
33
What are the common complaints with bacterial conjunctivitis
redness tearing discharge from 1 or both eyes *glued eyes*
34
When a child has conjunctivitis, what other symptoms should be checked
otic may have a concurrent OM
35
When are cultures drawn with bacterial conjunctivitis
Copious discharge (gonorrhea) Ophthalmia neonatorium inclusion bodies on immunofluorescents (Chlamydia)
36
How do you treat bacterial conjunctivitis
Dont need treatment, will resolve in 1 week *if complicated, can give topical antibiotics
37
What are topical antibiotic choices for bacterial conjunctivitis
Polymyxin B/ Trimethoprim Fluoroquinolones
38
Which types of bacterial conjunctivitis require systemic treatment
gonococcal or chlamydial
39
How do you treat ophthalmia neonatorium
Gonorrhea: admit, single dose IV/IM ceftriaxone and eye irrigation Chlamydia: PO/IV erythromycin + topical erythromycin x14days
40
What is Keratoconjunctivits
Inflammatory process involving both conjunctiva and superficial cornea
41
What are the most common causes of keratoconjunctivitis
Viral and bacterial Viral>>Bacterial
42
What is the cause of epidemic keratoconjunctivitis (EKC)
Adenovirus
43
What causes vernal keratoconjunctivitis (VKC)
Severe allergic conjunctivitis
44
What is superior limbic keratoconjunctivitis (SLK)
Chronic inflammatory condition
45
Keratoconjunctivitis sicca (Dry eye syndrome - DES)
Various etiologies including primary autoimmune and systemic conditions
46
What is SLK associated with
Thyroid disfunction and keratoconjunctivitis sicca
47
What are the symptoms of keratoconjunctivitis
Eye discomfort/irritation pruritis light sensitivity minor blurring epiphora
48
What are common signs of keratoconjunctivitis
Conjunctival injection conjunctival chemises eye discharge
49
If someone presents with keratoconjunctivitis, what questions must be asked
Contact lenses? Systemic conditions?
50
What is viral conjunctivitis
Initially unilateral with spread to contralateral side
51
How does viral conjunctivitis present
ocular discomfort/itching light sensitivity conjunctival injection chemoses watery discharge
52
What occurs with the palpebral conjunctiva with viral keratoconjunctivitis
Follicular reaction petechial hemorrhage pseudomembrane
53
How long to s/sx last with keratoconjunctivitis
7-21 days and may remain infectious for 10-14 days
54
What occurs with keratoconjunctivits sicca
Chronic intermittent, bilateral burning, stinging, foreign body sensation, photophobia
55
What is the symptoms with keratoconjunctivitis sicca
eye fatigue sense of eyelid heaviness pruritus epiphoria watery discharge blurred vision
56
What will be seen on exam with keratoconjunctivitis sicca
Conjunctival injection eyelid margin telangiectasia erythema decrease tear lake and production
57
What is SLK
Bilateral burning, irritation, foreign body sensation asymmetric involvement
58
What are characteristic findings of SLK
Watery discharge epiphora superior palpebral and bulbar conjunctival injection chemosis
59
What tests can be done for keratoconjunctivitis
Fluoroscein staining with woods lamp / slit lamp
60
How do you workup keratoconjunctivitis
Acuity motion pupillary reaction visual fields IOP Eyelid exam + eversion
61
How do you treat keratoconjunctivitis sicca
artificial tear, gels, ointments warm compress lid scrub
62
What are medications for keratoconjunctivitis sicca
topical cyclosporin / tacrolimus Topical steroid (monitor IOP) PO doxy
63
What is a procedural treatment for keratoconjunctivits sicca
punctual plugs to prevent lacrimal drainage of tear film
64
What is the first line treatment for SLK
Preservative free artificial tears, cells, ointments
65
What is second line treatment for SLK
Mast cell stabilizers antihistamines, Vit A, NSAIDS
66
What are the 3 subtypes of allergic conjunctivitis
Acute seasonal perennial
67
What is atopic keratoconjunctivits
Combination of allergen exposure and atopic dermatitis
68
What is giant papillary conjunctivitis
Allergen exposure and response to ocular foreign body
69
What population is simple allergic conjunctivitis most common in
<20y/o
70
What population is vernal keratoconjunctivitis most common in
males in warm, dry climates <10yo w/ hx atopy or asthma
71
What population is atopic keratoconjunctivitis common in
30-50y/o males
72
What patient population is giant papillary conjunctivitis most common in
teens / young adults *generally seen 1-2 years after starting soft contact lenses
73
What type of immune reaction is simple allergic conjunctivitis
IgE mediated hypersensitivity
74
What type of immune reaction is atopic keratoconjunctivitis
combination of delayed type iV and immediate type I
75
What is the most common symptoms of allergic conjunctivitis with all subtypes
Itchiness and diffuse conjunctival injection
76
What is seen on physical exam with simple allergic conjunctivitis
clear, water discharge bilateral minimal crusting chemosis and eyelid edema
77
What is seen on physical exam with renal keratoconjunctivitis
thick mucus discharge pain photophobia blurred vision corneal ulcers
78
What is seen on physical exam with renal keratoconjunctivitis
thick mucus discharge pain photophobia blurred vision corneal ulcers
79
What is seen on physical exam with atopic keratoconjunctivitis
Perennial pain blurry vision photophobia
80
What is seen on physical exam with giant papillary conjunctivitis
Itch (worse than simple allergic) Thick mucus discharge worsening pain/ blurry vision
81
What is the initial treatment for vernal and atopic keratoconjunctivitis
Topical combo of AH/mast cell stabilizer

HEENT Clin Med (7 decks)

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