#23. Allergic and autoimmune conjunctivitis. Vernal conjunctivitis. Lymphatic keratoconjunctivitis. Degenerations the conjunctiva - pinguecula and pterygium. Dry eye syndrome.

Question 1

What is ALLERGIC CONJUNCTIVITIS?

Answer 1

• INFLAMMATION of CONJUNCTIVA
• Due to ALLERGIC / HYPERSENSTIVITY Reactions

Question 2

What are the 6 TYPES of ALLERGIC CONJUNCTIVITIS?

Answer 2

1) SIMPLE ALLERGIC Conjunctivitis
2) VERNAL KERATOConjunctivitis
3) ATOPIC KERATOConjunctivitis
4) GIANT PAPILLARY Conjunctivitis
5) LYMPHATIC KERATOConjunctivitis
6) CONTACT DERMOConjunctivitis

Question 3

1| What is SIMPLE ALLERGIC Conjunctivitis?

Answer 3

MILD, NON-SPECIFIC Allergic Conjunctivitis

Question 4

1| What is the TYPES & CAUSES (Etiology) of SIMPLE ALLERGIC Conjunctivitis?

List them.

Answer 4

a. HAY FEVER Conjunctivitis
- Pollens
- Grass
- Animal Dandruff

b. SEASONAL ALLERGIC Conjunctivitis = RESPONSE to SEASONAL Allergens such as;
- Pollens
- Grass

c. PERENNIAL ALLERGIC Conjunctivitis = RESPONSE to PERENNIAL Allergens such as;
- House Dust
- Mite

Question 5

What are the CLINICAL MANIFESTATIONS of SIMPLE ALLERGIC Conjunctivitis?

Answer 5

• Eye Itching
• Hyperaemia
• Lid Oedema
• Conjunctival Oedema = CHEMOSIS

Question 6

1| What is the TREATMENT for SIMPLE ALLERGIC Conjunctivitis?

Answer 6

• ELIMINATING Allergens (IF Possible!)
• ANIT-HISTAMINES
• LOCAL Palliative Measures

Question 7

2| What is VERNAL KERATOConjunctivitis?

Answer 7

• RECURRENT
• BILATERAL
• SELF-LIMITING

AKA Warm Weather Conjunctivitis

Question 8

2| What is CAUSE (Etiology) of VERNAL KERATOConjunctivitis?

Answer 8

EXOGENOUS Allergens = Grass Pollens

Question 9

2| What are the CLINICAL MANIFESTATIONS of VERNAL KERATOConjunctivitis?

Answer 9

• MARKED Burning / Itching Sensation (INTOLERABLE)
• MILD Photophobia
• Lacrimation, Discharge
• Heaviness of Lids

Question 10

2| What is the TREATMENT for VERNAL KERATOConjunctivitis?

Answer 10

• TOPICAL / ORAL Steroids
• MAST CELL Stabilizers
• TOPICAL / SYTEMIC Anti-Histamines
• DARK GOGGLES = Prevent Photophobia

Question 11

5| What is LYMPHATIC KERATOConjunctivitis?

Answer 11

• Characteristic NODULAR INFECTION
• Occurring as ALLERGIC RESPONSE to Conjunctival / Corneal Epithelium
• TO ENDOGENOUS Allergens

Question 11

5| What is the CAUSE (Etiology) of LYMPHATIC KERATOConjunctivitis?

Answer 11

DELAYED HYPERSENSITIVITY Response (Type IV)

• TO ENDOGENOUS Microbial Proteins
  a. Tuberculous Proteins
  b. Staphylococcus Proteins

Question 12

5| What is the PATHOLOGY STAGES of LYMPHATIC KERATOConjunctivitis?

Answer 12

1) Stage of NODULE Formation

2) Stage of ULCERATION

3) Stage of GRANULATION

4) Stage of HEALING

Question 13

5| What is the CLINICAL MANIFESTATION of LYMPHATIC KERATOConjunctivitis?

Answer 13

• Eye Discomfort
• Irritation
• Reflex Watering
• Hyperaemia
• Presence of Nodules
• Ulceration

Question 14

5| What is the TREATMENT for LYMPHATIC KERATOConjunctivitis?

Answer 14

• TOPICAL Steroids
• Antibiotics DROPS
• Ointment = Treat SECONDARY Infx
• ATROPINE

Question 15

What are the 2 DEGENERATIONS of the Conjunctiva?

Answer 15

1) Pinguecula

2) Pterygium

Question 16

What is PINGUECULA?

Answer 16

• A COMMON Degenerative Condition of the Conjunctiva
• The FORMATION of YELLOWISH-WHITISH Patch on BULBAR Conjunctiva
• NEAR the LIMBUS
• NO Treatment !

Question 17

What is the CAUSE of PINGUECULA?

Answer 17

• Unknown Cause
• Associated with
  a. EXPOSURE to STRONG Sunlight (UV Rays)
  b. Dust
  c. Wind

Question 18

What is the PATHOLOGY of PINGUECULA?

Answer 18

1) DEGNERATION of COLLAGEN Fibres of SUBSTANTIA PROPRIA of Conjunctiva

2) ALONG with DEPOSITION of AMORPHOUS HYALINE Material in SUBSTANCE of Conjunctiva

Question 19

What are the CLINICAL FEATURES of PINGUECULA?

Answer 19

• BILATERAL = Yellow-whitish TRIANGULAR Patch near LIMBUS
• APEX of Triangle is AWAY FROM the Cornea

Question 20

What is PTERYGIUM?

Answer 20

• A WING-SHAPED FOLD of the Conjunctiva
• APEX being TOWARDS the Cornea

Question 21

What is the CAUSE of PTERYGIUM?

Answer 21

• Unknown Cause
• MORE COMMON in individuals living in HOT CLIMATES
• Associated with:
  a. PROLONGED EXPOSURE to Sun (UV Rays)
  b. HIGH Heat
  c. Wind
  d. Dust

Question 22

What are the CLINICAL FEATURES of PTERYGIUM?

Answer 22

• Either UNILATERAL / BILATERAL
• TRIANGLE FOLD of Conjunctiva, ENCROACHING the Cornea on the NASAL SIDE!
• Asymptomatic in EARLY Stages
• Visual Disturbances (Encroaching)

Question 23

What is DRY EYE SYNDROME?

Answer 23

• A SYNDROME COMPLEX (NOT a Disease!)
• DUE to DEFICIENCY / ABNORMALITIES of Tear Film

Question 24

What are the GENERAL FUNCTIONS of Tears?

Answer 24

• WITHIN EACH Blink, tears SPREAD ACROSS the Cornea
• Provide:
  a. Lubrication
  b. REDUCE RISK of Eye Infection
  c. WASH AWAY Foreign Matter
  d. KEEP SURFACE Smooth + Clear

Question 25

What are the 2 MAIN DERIVATIVES of DRY EYE SYNDROME?

Answer 25

1. INADEQUATE PRODUCTION of Tears
   - Age
   - Medical Conditions = SJOGREN SYNDROME
   - Environmental Conditions = Windy + Dry
2. POOR QUALITY of Tears = MORE FREQUENT

Question 26

What are the 3 MAIN LAYERS of Tears?

Describe their Role

Answer 26

Tears are Made of 3 LAYERS, where EACH component PROTECTS + NOURISES the FRONT SURFACE of the eye.

1) OIL = PREVENTS Evaporation of Water Layer

2) MUCUS = SPREADS Tears EVENLY OVER Surface of Eye

3) WATER

** DRY EYE SYNDROME can develop IF Tears:
0 EVAPORATE TOO QUICKLY
0 NOT EVENLY SPREAD over Cornea

Question 27

What is are the CAUSES of DRY EYE SYNDROME?

Answer 27

1) AQUEOUS TEAR Deficiency

2) MUCIN Deficiency = DAMAGED Goblet Cells

3) LIPID Deficiency / Abnormalities

4) IMPAIRED Eye Function

Question 28

What are the CLINICAL FEATURES of DRY EYE SYNDROME?

Answer 28

• Irritation
• FOREIGN BODY Sensation
• Dry Feeling
• Itching

Question 29

What is the TREATMENT for DRY EYE SYNDROME?

Answer 29

LUBRICATING Supplements to PREVENT:

• Corneal ULCERS
• Scarring

** SURGICAL ALTERNATIVES too!