- Flashcards
Define trichiasis
Eyelashes growing into the globe instead of away from it
Management of adult NLDO?
Dacryocystorhinostomy
Management of congenital NLDO?
- Conservative management (90% resolve within their first year )
• Sac compression and massage
• Antibiotics if needed ( tobramycin / erythromycin )
• warm compresses - Surgery :
• Probing and dilatation
• Stent insertion
Finding in CNIII Palsy
- dilated pupil (ciliary muscles)
- ptosis (levator)
- abducted eye, looking slightly downwards (function of SO + LR)
- no diplopia since there is complete ptosis
D.D. Eye pain on occular movement
Optic neuritis
Scleritis
D.D RAPD
Optic neuritis
Angle closure glaucoma
Symptoms of optic neuritis
Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss
Symptoms of optic neuritis
Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss
Symptoms of optic neuritis
Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss
Why do we give cycoplegics (atropine) in anterior uveitis?
Relieve pain
Relieve photophobia
Slight anti microbial effect
Prevent posterior synechia
How do we exclude corneal ulcers?
Fluorescin staining under slit lamps.
State two findings in cicatricial trachoma
Arlt’s line (band of fibrous tissue in tarsal Conjuctivita)
Herbert’s pits (superior limbal depressions post follicular healing)
Management of trachoma
SAFE!
Surgery is aimed at relieving entropion and trichiasis and
maintaining complete lid closure.
• Antibiotics should be administered to those affected and to all
family members, A single dose of azithromycin (20 mg/kg up to 1
g) is the treatment of choice, Erythromycin 500 mg twice daily for
14 days, Topical 1% tetracycline ointment is less effective than oral
treatment.
• Facial cleanliness is a critical preventative measure.
• Environmental improvement, such as access to adequate water
and sanitation, and control of flies.
Management of viral Conjuctivitis
pontaneous resolution of adenoviral infection usually occurs within 2–
3 weeks
• Viral conjunctivitis is highly contagious so reduction of transmission risk
should be done by proper hand hygiene, avoiding eye rubbing and
towel sharing
• For Molluscum contagiosum, Although lesions are self-limiting removal
is often necessary to address secondary conjunctivitis or for cosmetic
reasons.
• Discontinuation of contact lens wear until resolution of symptoms.
• Preservative-free artificial tears four times daily may be useful for
symptomatic relief
Presentation and treatment of allergic Conjuctivitis?
Presented with acute itching and watering but
the hallmark is chemosis. Treatment is usually not required except for cold compresses
Mild Symptoms: Artificial tears.
• Moderate Symptoms: add Mast cell stabilizers or
Antihistamines
• Severe Cases: Topical steroids in addition to
preceding medications and oral antihistamines may
be indicated.
Management of VKC/ AKC?
- GENERAL (ABC)
Avoid allergens
Bandage contact lenses to heal epithelial defect
Cool compress
They both have the same treatment however AKC is unremitting - MEDICAL ( mast cell stabilizers / topical steroids if corneal ulcer/ topical antihistamines in acute exacerbation / topical NSAIDS/ oral antihistamine to help sleep and avoid eye rubbing)
- SURGICAL ( uperficial keratectomy to debride ulcers and allowing reepithelization.
• Surface restoration surgeries as amniotic membrane grafting or eyelid
procedure as botulinum induced ptosis in severe cases of persistent epithelial
defects)
Findings in patient of AKC
- Other atopic conditions (AD)
- . Eyelid erythema and scaling.
2. Conjunctival discharge (mucoid) , hyperemia and papillae with cicatrization
in sever cases with symblepharon formation.
3. Corneal keratopathy including vascularization, epithelial defect and
keratoconus is common in 15%.
4. Presenile subcapsular cataract and may be related to long term steroids use.
5. Retinal detachment is more common than in general population.
What must we exclude in a child w/ buphthalmous
Retinoblastoma
How can we confirm the diagnosis of retinoblastoma?
Ocular US
Treatment of central vs peripheral retinoblastoma?
Central: systemic chemo followed by laser
Peripheral: systemic chemo followed by cryotherapy/ brachytherapy
Presentation, investigations and treatment of rhabdomyosarcoma?
Presentation: proptosis, but with no pain
Investigations: CT orbit + biopsy
Treatment: very good response to radiotherapy
Management of ocular malignancies arising from adnexa?
Removal w/ safety margin + lid reconstruction
What investigations are required for a secondary ocular malignancy?
CT orbit + incisional biopsy.
Which 2ry ocular malignancy is associated with hyperviscosity + low platelets?
Leukemia
Presentation of 2ry metastasis of eye?
Raccoon eyes
Squint
Proptosis
