Lecture VI

Question 1

What is the usual incubation period for viral conjunctivitis?

Answer 1

5-12 days

Question 2

What are s/sx of viral conjunctivitis?

Answer 2

Watery d/c irritations, and hyperemia

Palpable preauricular LAD

Question 3

When should viral conjunctivitis be referred? (2)

Answer 3

Pain or Decreased VA

Question 4

How is viral conjunctivitis transmitted?

Answer 4

Fomites and droplets to the eye

Question 5

How long can viruses live for on fomites with viral conjunctivitis?

Answer 5

a week

Question 6

What is the usual cause of viral conjunctivitis?

Answer 6

Adenovirus

Question 7

Conjunctivitis traveling from one eye to the other indicates what etiology?

Answer 7

Viral

Question 8

What is the symptomatic treatment for viral conjunctivitis?

Answer 8

• antihistamines

- cool compresses

Question 9

What is the complication that can occur with steroids in treating viral conjunctivitis?

Answer 9

Recurrence and cushing problems

Question 10

What is the topical treatment for viral conjunctivitis?

Answer 10

Povidone iodine

Question 11

What is zirgan?

Answer 11

Ocular ganciclovir for HSV

Question 12

What are the s/sx of herpes simplex eye disease? (3)

Answer 12

• Vesicles on skin or eyelid margin
• Epithelial keratitis
• Preauricular LAD

Question 13

What is the role of oral antivirals with HSV blepharoconjunctivitis?

Answer 13

Speed resolution, but is self limited

Question 14

What are the s/sx of bacterial conjunctivitis?

Answer 14

• Bilateral mucopurulent d/c

- Lid crusting

Question 15

Should you culture bacterial conjunctivitis?

Answer 15

no–will not change treatment or alter outcomes the vast majority of the time

Question 16

What is the treatment for bacterial conjunctivitis? (3)

Answer 16

• Topical abx QID
• Cleansing
• Warm moist compresses

Question 17

What are the ab that should be used to bacterial conjunctivitis?

Answer 17

-Aminoglycosides (tobramycin/neomycin)

Question 18

What are the causes of neonatal conjunctivitis? (3)

Answer 18

• Gonorrhea
• Chlamydia
• HSV

Question 19

What is the definition of neonatal conjunctivitis?

Answer 19

Conjunctivitis in a neonate (less than 1 month)

Question 20

What is the only conjunctivitis that should be cultured?

Answer 20

Neonatal conjunctivitis

Question 21

Any contact lens wearer who develops ocular symptoms probably has what, cause by what?

Answer 21

Corneal ulcer caused by pseudomonas

Question 22

What is the leading infectious cause of blindness in the US?

Answer 22

HSV eye disease

Question 23

What type of infection usually occurs with the primary, and secondary episodes of herpetic conjunctivitis?

Answer 23

Primary = unilateral blepharoconjunctivitis

Secondary= bilateral above,or epithelial keratitis

Question 24

What is the fluorescence pattern that is seen with HSV infections?

Answer 24

branching with terminal end bulbs

Question 25

Why should you avoid topical steroids with herpes keratitis?

Answer 25

- Elevates intraocular pressure - Causes cataracts - May potentiate fungal corneal ulcers

Question 26

What is the treatment for HSV conjunctivitis?

Answer 26

Trifluorothymidine or ganciclovir

Question 27

What can cause conjunctival hemorrhage?

Answer 27

Coughing, sneezing, valsalva

Question 28

What is the treatment for conjunctival hemorrhage?

Answer 28

Nothing

Question 29

What are pinguecula?

Answer 29

a common type of conjunctival degeneration in the eye., usually caused by UV light and wind exposure

Question 30

How do you manage pinguecula? (3)

Answer 30

- Artificial tears - Topic vasoconstrictors if inflamed - Sunglasses

Question 31

What is episcleritis?

Answer 31

Inflammation of the sclera, usually causing raised, hyperemic lesions

Question 32

Why is there pain with EOM with episcleritis?

Answer 32

Inflammation over the area of insertion of the EOMs

Question 33

Pouching of the uveal tract = ?

Answer 33

Scleritis 2/2 RA

Question 34

What is iritis?

Answer 34

Circumcorneal injection, usually 2/2 trauma

Question 35

What is the classic s/sx of iritis?

Answer 35

Photophobia

Question 36

What are the signs of iritis?

Answer 36

- White cells in anterior chamber - Hypopyon - Keratic precipitates

Question 37

How do you treat uveitis?

Answer 37

Topic steroids

Question 38

When are topical anesthetics prescribed with uveitis?

Answer 38

NEVER--inhibit the growth of the epithelium

Question 39

What happens to the cornea with viral conjunctivitis that causes decreased visual acuity? What is the treatment for this?

Answer 39

Antibody deposits in the cornea Steroids, but these have their own problems

Question 40

What are the common bacterial causes of bacterial conjunctivitis?

Answer 40

- Staph - Strep - Haemophilus - Pseudomonas

Question 41

Branching pattern with terminal bulbs on fluorescence = ?

Answer 41

HSV infections

Question 42

What is endophthalmitis?

Answer 42

an inflammation of the internal coats of the eye. It is a possible complication of all intraocular surgeries, particularly cataract surgery, with possible loss of vision and the eye itself. Infectious etiology is the most common and various bacteria and fungi have been isolated as the cause of the endophthalmitis. Other causes include penetrating trauma and retained intraocular foreign bodies.

Question 43

What are the three indications for pterygium?

Answer 43

1. interferes with vision 2. Causes astigmatism 3. Cosmetic reasons

Question 44

What is episcleritis associated with?

Answer 44

Autoimmune inflammation

Question 45

What is Hypopyon?

Answer 45

Inflammatory cells in the anterior chamber of the eye. It is a sign of inflammation of the anterior uvea and iris, i.e. iritis, which is a form of anterior uveitis.

Question 46

What are the fundus findings of optic atrophy?

Answer 46

Excessively pale optic disc

Question 47

What type of imaging should be obtained to evaluate orbital trauma

Answer 47

noncontrast CT

Question 48

Should you assess VA with eye trauma?

Answer 48

Yes

Question 49

Why should you not attempt to move a clot from a traumatic eye?

Answer 49

May cause excessive bleeding

Question 50

What should be done with a severe traumatic eye?

Answer 50

Shield and immediate referral

Question 51

What is lagophthalmos?

Answer 51

The inability to close the eyelids completely.

Question 52

A flat anterior chamber indicates what?

Answer 52

Loss of aqueous humor

Question 53

What happens to the pupil with trauma?

Answer 53

Will point to the trauma

Question 54

Should a TDaP be given with ocular trauma?

Answer 54

Yes