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OD2 (S1&2) > AED - Rarer Conjunctivis - Lid Disorders - Week 7 > Flashcards

AED - Rarer Conjunctivis - Lid Disorders - Week 7 Flashcards

1
Q

When does phthalmia neonatorum typically occur? Is it uni- or bilateral? What kind of infection is it? What is it mostly due to (2)?

A

A bilateral conjunctivitis which presents in the first four weeks of life
Most are due to pathogen/substance exposure at birth

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2
Q

What is the most common cause of ophthalia neonatorum and when does it usually manifest?

A

Chlamydial
-due to exposure to the pathogen during delivery
Usually manifests the second week after delivery

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3
Q

Aside from the most common cause, list 4 causes of ophthalmia neonatorum.

A

Gonococcal
Herpes simplex
Simple bacterial conjunctivitis
Chemical

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4
Q

What are silver nitrate drops typically used for in infants and what is a consequence of this?

A

A prophylaxis for gonococcal infection
Can result in chemical ophthalmia neonatorum

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5
Q

List a differential diagnosis for ophthalmia neonatorum.

A

Nasolacrimal duct obstruction

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6
Q

What is the treatment option for ophthalmia neonatorum (2)?

A

Irrigate with sterile saline and frequent use of sterile artificial tears

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7
Q

Should you refer for ophthalmia neonatorum?

A

Yes, for isolation of the pathogen and appropriate antibiotic treatment

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8
Q

List the two kinds of chlamydial conjunctivitis.

A

Adult inclusion conjunctivitis
Trachoma

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9
Q

Which species of chlamydia almost exclusively targets humans?

A

C. trachomatis

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10
Q

What are the agents of classic trachoma (4)?

A

C. trachomatis serotype A, B, Ba, C

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11
Q

What are the agents of inclusion conjunctivitis (7)?

A

C. trachomatis serotype D-K

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12
Q

What are serotypes L1. L2, and L3 responsible for (C. trachomatis) and what do they cause?

A

They infect tissues deeper to the epithelium and cause lymphogranuloma venereum

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13
Q

How is adult inclusion conjunctivitis typically transmitted and in which population are they most common?

A

Transmitted by infected genital secretions ( ͡° ͜ʖ ͡°)
Most common in young sexually active adults

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14
Q

Is ault inclusion conjunctivitis uni- or bilateral?

A

Can be either, but usually unilateral

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15
Q

How long does adult inclusion conjunctivitis typically last?

A

Many months

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16
Q

What is adult inclusion conjunctivitis associated with in women (3)?

A

Urethritis
Vaginitis
Cervicitis

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17
Q

Are chlamydial STDs typically symptomatic or asymptomatic?

A

High percentage asymptomatic

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18
Q

What kind of discharge is present in adult inclusion conjunctivitis (2)? what sensation is felt?

A

Mucopurulent (or watery)
Gritty FB sensation

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19
Q

Are follicles or papillae present with adult inclusion conjunctivitis? Particularly in which area?

A

Follicles, particularly in the upper tarsal conjunctiva - limbal follicles also possible

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20
Q

Is preauricular/submandibular lymphadenopathy common or rare with adult inclusion conjunctivitis?

A

Common

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21
Q

What can be seen in chronic prolonged cases of adult inclusion conjunctivitis (2)?

A

Marginal subepithelialcorneal infiltrate and superior pannus

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22
Q

List three differential diagnoses for adult inclusion conjunctivitis.

A

Adenoviral keratoconjunctivitis
Herpes simplex keratitis
Trachoma

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23
Q

What is the treatment option for adult inclusion conjunctivitis? What is recommended if chlamydia is confirmed?

A

Refer the patient and their sexual partner(s) to a GP or sexual health clinic for lab tests
Systemic macrolides or tetracyclines if chlamydia is confirmed

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24
Q

What antibiotic courses can be given for a chlamydial infection (name, dose and duration)?

A

Azithromycin 1g PO or
Erthromycin 250mg q.i.d for 2-6 weeks

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25
What is a common risk factor for trachoma and what is it transmitted by?
Result of poor hygiene Transmitted by the common fly
26
What disease is one of the leading causes of preventable blindness?
Trachoma
27
In what regions is trachoma most common?
Africa India Middle East Asia South America Aboriginal communities in northern and northwestern Australia
28
Is trachoma usually uni- or bilateral?
Often unilateral initially
29
What kind of discharge is present with trachoma? What sensation is felt?
Mucopurulent Gritty FB sensation
30
What can tracoma lead to, and what is a consequence of this?
Can lead to scarring, which can lead to trichiasis
31
What is the main sign of trachoma?
Superior bulbar and palpebral conjunctival follicular response
32
What does chronic inflammation over many years (or quicker) eventually lead to (5)?
Conjunctival scarring -> trichiasis -> ocular surface irritation -> corneal opacities -> vision loss
33
What are herbert's pits and in what disease can they be found?
Scarring of limbal follicles in trachoma
34
What 5 aspects of a trachoma case are graded and under what kind of scale?
TF - trachomatous inflammation: follicular TI - trachomatous inflammation: intense TS - trachomatous scarring TT - trachomatous trichiasis CO - corneal opacity 0-3 scale
35
List 4 differential diagnoses for trachoma.
Adult inclusion conjunctivitis Other causes of conjunctival cicatrisation Other causes of recurrent conjunctivitis Other causes of superior corneal pannus
36
What is the tratment option for trachoma (3)?
Refer for lab tests and surgery Inactivate scarring using lubricants Advise on prevention by improving hygiene and fly reduction programs
37
Define the possible components of anterior blepharitis (2).
One or a combination of: -staphylococcal anterior blepharitis -seborrhoeic anterior blepharitis
38
What is posterior blepharitis?
Meibomian gland dysfunction
39
Is anterior blepharitis common or rare?
Common
40
What part of the lid margin is inflammed in anterior blepharitis?
Anterior to the meibomian glands and includes the lashes
41
Is anterior blepharitis usually uni- or bilateral? Is the onset symmetrical? Is it acute or chronic?
Usually bilateral, symmetrical, and cronic
42
What does anterior belpharitis occur in conjunction with?
Seborrhoeic dermatitis
43
What happens to the skin with seborrhoeic dermatitis? What does this promote?
Skin and lid margins become scaly and oily Promotes excess growth of staph. colonies
44
List three symptoms of anterior blepharitis.
Ocular surface burning FB sensation Sticky crusting along the lid margins Mild photophobia
45
Can removl of lid crusting in anterior blepharitis cause bleeding or do they just fall off?
Can cause bleeding
46
What is the tear flims like in anterior blepharitis?
Poor
47
List three signs of anterior blepharitis.
Redness Telangiectasia Thickening of the anterior lid margin
48
What 5 things may be observed in long-standing cases of anterior blepharitis?
Mild, chronic papillary conjunctivitis Trachiasis Recurrent bacterial conjunctivitis External/internal hordeola Lid/lash base ulceration Bacterial keratitis
49
Define madarosis.
Lash loss
50
Define poliosis.
Lash pigment loss
51
List 5 differential diagnoses for anterior blepharitis.
Posterior blepharitis Basal, squamous, or sebaceous cell carcinoma Dry eye
52
List the four components of an anterior blepharitis workup.
Careful symptomatology Slit lamp with fluorescein Tear work up Skin assessment
53
What is the main treatment option for anterior blepharitis? List 3 additional options.
Lid therapy -scrubbing the margins with a low irritant surfactant (baby shampoo) up to 4 times a day until under control Lid supplements Antibiotic ointment Mild steroids
54
Is posterior blepharitis common?
Yes
55
Is posterior uni- or bilateral? Is onset symmetrical?
Bilateral and symmetrical
56
How does posterior blepharitis affect the tear film?
Results in a poor/unstable tear film
57
List 4 symptoms of posterior blepharitis.
Gritty/burning sensation Crusting/redness on the lid margin Symptoms worse in dry/air-conditioned environment Photophobia (if corneal involvement - SPK)
58
List three signs of posterior blepharitis.
Posterior lid margin thickened Telangiectasia PEE/SPK due to corneal irritation
59
What are the seborrhoeic characteristics of posterior blepharitis and what do they result in?
Excess secretions appear as oil droplets capping meibomian glands Creates oily or foaming tear film
60
A high proportion of individuals with posterior blepharitis have what two diseases?
Acne rosacea or seborrhoeic dermatitis
61
List 6 differential diagnoses for posterior blepharitis.
Anterior blepharitis Posterior blepharitis Basal, squamous, or sebaceous cell carcinoma Dry eye
62
List the five components of an posterior blepharitis workup.
Careful symptomatology Slit lamp with fluorescein Tear work up Skin assessment Gland expression
63
What are the main treatment options for posterior blepharitis (2)? List 3 additional options.
Lid therapy -scrubbing the margins with a low irritant surfactant (baby shampoo) up to 4 times a day until under control Hot compresses and lid massage essential to improve gland function (4 times daily) Lid supplements Antibiotic ointment Mild steroids
64
How does intense pulse light work and what is it used for? How often is it used?
Good for blocked meibomian glands Acts like a heat lamp, melts secretions and opens glands Three or four treatments over several months
65
Are demodex infestations a sign of poor hygiene?
Not necessarily
66
What is used to kill demodex? Is it toxic to the cornea/conjunctiva? How should it be applied and how often?
TTO but is toxic Weekly application of 50% TTO
67
Is acne rocasea common or rare?
Common
68
What is the cause of acne rocasea?
Unknown
69
What is classic of acne rocasea?
Butterfly rash across the nose and cheeks
70
List three signs of acne rocasea (aside from its characteristic sign).
Mild erythema with telangiectasia to nodular eruptions of cheeks and nose
71
Does acne rocasea affect males or females more? What age group is it more common in?
Males > females, most commonly 30-40 years
72
What two foods can exacerbate acne rocasea?
Alcohol and spicy food
73
What may acne rosacea result in (2)?
Pustules and scarring
74
In what percent of cases of acne rocasea is there ocular involvement?
5-10%
75
List 5 symptoms of ocular rocasea.
Red eye Recurrent styles and chalazia Burning/gritty sensation Photophobia Facial flush
76
List 5 signs of ocular rocasea.
Blepharitis (posterior) Telangiectasis of the lid margin Conjunctivitis Chalazion/internal hordeolum Keratitis
77
What three things can ocular rocasea rarely cause?
Corneal scarring Corneal neovascularisation Corneal thinning/perforation
78
List three differential diagnoses for ocular rocasea.
Blepharitis without rosacea Other forms of non-infective conjunctivitis Keratitis
79
List 5 treatment options for ocular rosacea.
Topical antibiotic Oral tetracycline/macrolide (mainstay) Lid therapy as for anterior/posterior blepharitis Tear supplements Mild topical steroids

OD2 (S1&2) (174 decks)

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