Antibiotic-Steroid Combos, Antifungals, ans Antiprotozoals (M2)

Question 1

What is a collection of WBC at the limbus that is a direct inflammation response to Staph?

Answer 1

phlyctenule

Question 2

What are the two forms of Acanthamoeba? 1. Which form is medication useful against? 2

Answer 2

1. trophozoite and cyst

2. trophozoite

Question 3

What are the ways toxoplasmosis is transmitted?

Answer 3

1. cat feces ingested after not washing hands
2. soil into livestock which then is undercooked meat
3. mother to child

Question 4

When is toxoplasmosis OK to monitor?

Answer 4

1. no loss of VA
2. lesions peripheral
3. lesion less than 1DD
4. resolves on own in 1-2 months

Question 5

How long is PK delayed following a Acanthamoeba keratitis?

Answer 5

3-12 months to avoid recurrence

Question 6

What ocular findings are in a patient with active toxoplasmosis?

Answer 6

1. retinochoroiditis (#1 cause of posterior uveitis)

2. vitreal blur (headlight in the fog)

Question 7

What are the conditions for the use of stand alone topical ophthalmic steroid use?

Answer 7

1. uveitis
2. allergic eye disease (with conj chemosis)
3. episcleritis and inflammed pinguecula
4. Non-infectious keratitis (Thygeson’s, solution toxicity, SLK, dry eye)
5. post-surgical maintenance

Question 8

What are the hallmark signs of fungal keratitis?

Answer 8

1. satellite lesions

2. feathery central lesions

Question 9

What are the conditions for the use of stand alone topical ophthalmic antibiotic use that are true infections?

Answer 9

1. bacterial conjunctivitis

2. microbial keratitis

Question 10

What are the ways that people generally get Acanthamoeba keratitis?

Answer 10

1. CL wearer that exposed lens

2. painful redeye misdiagnosed and not responding to Tx

Question 11

What is commonly found in swimming pools, hot tubs, lakes, streams, saliva, tap water and homemade saline?

Answer 11

Acanthamoeba

Question 12

What are the conditions for the use of stand alone topical ophthalmic antibiotic use that are not true infections?

Answer 12

1. anterior blepharitis
2. MGD
3. prophylaxis

Question 13

What is the histoplasmosis triad?

Answer 13

1. histo spots, punched out lesions
2. peripapillary atrophy 360deg
3. Maculopathy

Question 14

When does toxoplasmosis warrant treatment?

Answer 14

1. any lesion inside posterior pole
2. lesion larger than 1DD
3. significant vitritis causing a 2 line dec in VA
4. no resolution for 1 month

Question 15

What are the hallmark features of Acanthamoeba keratitis?

Answer 15

1. more pain than expected

2. presence of ring infiltrate

Question 16

What are the main characteristics of antifungal agents?

Answer 16

1. less selectively toxic so high side effects

2. poorly absorbed

Question 17

When are fungal keratitis’ classically seen?

Answer 17

1. secondary to trauma with vegetative matter
2. poor CL hygiene “topping off”
3. systemic immunocompromised
4. misdiagnosed as bacterial and other treatments failing