Exam 1 -- Corneal Disease Flashcards Preview

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Flashcards in Exam 1 -- Corneal Disease Deck (11)
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1
Q

Phlyctenular Keratoconjunctivitis

Etiology/Causes

A
  • Hypersensitivity response
  • More common in poor areas (sanitation, health care)
  • Women > men
  • Children, young adults
  • Major causes: staph and TB
2
Q

Phlyctenular Keratoconjunctivitis

Subjective findings

A
• Conjunctival symptoms
   - FB sensation, irritation
   - Itching
   - Occasional discharge
   - Tearing
• Corneal symptoms: same as conjunctiva plus:
   - Pain
   - Photophobia
   - Ciliary spasm
   - Blurry vision
3
Q

Phlyctenular Keratoconjunctivitis

Objective findings

A

• Nodular inflammation of perilimbal tissue
• Small pink lesions on conj, limbus, or cornea
• Conj signs
- Injection
- Lesions on conj
• Corneal signs
- More common?
- Wedge shaped white lesion
- Begins at limbus (inferior)
- Radial vascularization
- May result in ulcer, scar, perforation

4
Q

Phlyctenular Keratoconjunctivitis

Treatment

A
  • Rule out or treat TB
  • Treat staph bleph
  • Steroids (Pred Forte, Durezol, Lotemax)
  • Cycloplegic
  • Antibiotic/steroid combo (Zylet, Tobradex)
  • Oral antibiotic (tetracycline, doxycycline)
5
Q
Filamentary Keratitis (Corneal Mucous Plaques)
Causes
A
  • Aqueous deficient dry eyes cause corneal irregularities and increased mucin
  • Sjogren’s, SLK, RCE, neurotropic keratopathy, chronic bullous keratopathy, patching
  • Contact lens wear
  • Cataract / corneal graft surgery
  • Cronic use of medications
6
Q
Filamentary Keratitis (Corneal Mucous Plaques)
Subjective findings
A
  • Red eye
  • Pain
  • FB sensation
  • Photophobia
7
Q
Filamentary Keratitis (Corneal Mucous Plaques)
Objective findings
A
  • Mucus strands attached to cornea, grey subepithelial opacities, stain with Rose Bengal
  • Conjunctival injection
  • Poor tear film
  • PEE
8
Q
Filamentary Keratitis (Corneal Mucous Plaques)
Treatment
A
  • Lubrication (long term)
  • Punctal plugs
  • Mycomyst (acetylcystine) to dissolve mucus
  • Hypertonic solution
  • Bandage CL
  • Filaments resolve in 1-4 weeks
  • Treat underlying condition
  • Debridement of filaments
  • Steroids (Lotemax)
  • NSAIDs (Voltaren/diclofenac)
9
Q

Thygeson’s Superficial Punctate Keratitis

Etiology/Cause

A
  • Immune or inflammatory process

* assoication with HLA-DR3

10
Q

Thygeson’s Superficial Punctate Keratitis

Subjective findings

A
  • FB sensation, irritation
  • Photophobia
  • Slight decrease in VA
  • Redness
  • Dryness, burning, itching
  • May be asymptomatic
11
Q

Thygeson’s Superficial Punctate Keratitis

Objective findings

A
  • Bilateral
  • Recurrent, exacerbations and remissions
  • Multiple (average 20) epithelial lesions: round, grey/white, granular, raised, vary in size
  • More numerous centrally
  • Variable staining with NaFl
  • No conjunctival involvement, no stromal inflammation (eye white and quiet)
  • May have subepithelial opacities due to edema