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Conjunctiva Flashcards

1
Q

What is the conjunctiva?

A

A translucent mucous membrane that lines the posterior surface of eyelids and anterior aspects of the eyeball.

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2
Q

What are the parts of the conjunctiva?

A
  1. Bulbar: covering the sclera
  2. Palpebral: lining the eyelid (a) Marginal (b) Tarsal (c) Orbital (preseptal)
  3. Forniceal: in the conjunctival fornix.
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3
Q

What is the histology of the conjunctiva?

A

It consists of surface epithelium, a superficial adenoid layer (which forms after the first 3 months of life), and a deep fibrous layer.

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4
Q

What is conjunctivitis?

A

An inflammation of the conjunctiva.

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5
Q

What are the etiologies of conjunctivitis?

A

A) Infective
1. Bacterial mucopurulent conjunctivitis
2. Chlamydial infections.

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6
Q

What are the types of chlamydial conjunctivitis?

A
  1. Trachoma caused by Chlamydia trachomatis serotypes (A-C)
  2. Acute inclusion conjunctivitis caused by Chlamydia oculogenitalis (serotypes D-K), also known as swimming pool conjunctivitis.
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7
Q

What are the types of infectious conjunctivitis?

A
  1. Viral
    • Herpes simplex
    • Molluscum contagiosum (pox virus)
    • Adenoviral (i) Serovars 3,4,7 = pharyngoconjunctival fever; (ii) Serovars 8,19 = epidemic keratoconjunctivitis

None

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8
Q

What are the types of non-infective conjunctivitis?

A
  1. Spring catarrh (vernal keratoconjunctivitis)
  2. Phlycten

None

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9
Q

What are the types of bacterial conjunctivitis?

A
  1. Simple bacterial conjunctivitis
  2. Gonococcal keratoconjunctivitis

None

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10
Q

What is the most common causative organism of simple bacterial conjunctivitis?

A

Staphylococcus epidermidis and Staphylococcus aureus.

None

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11
Q

What are the symptoms of simple bacterial conjunctivitis?

A
  1. Acute onset of redness, gritty and burning sensation, and discharge
  2. Sticking of the lids in the morning and gluing or matting of the lashes
  3. Usually bilateral

None

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12
Q

What are the signs of simple bacterial conjunctivitis?

A
  1. Eyelids are crusted, edematous (chemosis)
  2. Mucopurulent discharge
  3. Velvety beefy-red appearance, maximal in the fornices
  4. Papillae: Epithelial proliferation with a vascular CT core seen as red bumps with a central vascular core
  5. Corneal involvement is uncommon, may present as superficial punctate epitheliopathy and peripheral corneal infiltrate.

None

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13
Q

What is the treatment for simple bacterial conjunctivitis?

A
  1. Bathe (wash) all discharge
  2. Broad-spectrum antibiotic drops during the day (frequency according to severity) and ointment at night
  3. Hot fomentations to increase blood flow

None

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14
Q

Gonococcal keratoconjunctivitis

A

Venereal genitourinarytract infection
Adults bad unhygienic habits). The newly born can catch the infection during childbirth from the maternal passages.

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15
Q

Symptoms:

A
  1. Hyperacute ～メー
  2. Extremely profuse and thick creamy
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16
Q

Signs:

A

Edematous and tender eye lids
2. Profuse purulent discharge »
3. Frequent pseudo membrane
4. Keratitis with ulceration in severe cases

17
Q

Treatment:

A

Treatment:
As MPC + Systemic antibiotic therapy

18
Q

NB:

A

NEVER bandage or patch if discharge is present

19
Q

Viral conjunctivitis:
Etiology:

A
  1. Herpes simplex
  2. Molluscum contagiosum (pox virus)
  3. Adenoviral
    a) Serovars 3,4,7 = pharyngoconjunctival fever
    b) Serovars 8,19 = epidemic keratoconjunctivitis
20
Q

Symptoms:

A

Symptoms:
1. Acute onset of watering, redness, discomfort, and marked photophobia.
2. Bilateral in 60% of cases

21
Q

Signs:

A

Lids: edematous, vesicles (in herpes, unilateral), mollusca lesion (umblicated pearly nodule) which may denote immunosuppression eg AIDS
• Discharge: watery
• Conjunctival chemosis and follicles (focal collections of lymphocytes that appear as gelatinous whitish elevations)
• Subconjunctival hemorrhages and pseudomembranes in severe cases
• Lymphadenopathy (preauricular) with tender lymph nodes
• Cornea: it may show either focal or diffuse punctate epithelial keratitis or sometimes subepithelial infiltrates

22
Q

TTT:

A
  1. Largely symptomatic and supportive (lubricants)
  2. Spontaneous resolution within 2 weeks
  3. NSAIDs
  4. Topical antibiotics to guard against secondary infection
23
Q

NB:

A

NB: fluorescein stain in any conjunctivitis esp if presenting with blepharospasm, lacrimation, photophobia, +/- pain

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