Conjunctiva

Question 1

How many layers does the conjunctiva have?

Answer 1

2 layers-The epithelium and the stroma

Question 2

What is the epithelium made up of?

Answer 2

2-5 layers of non-keratinising cells

Question 3

Where does the conjunciva drain to?

Answer 3

The pre-auricular and submandibular LN

Question 4

What are the 3 layers of conjunctiva?

Answer 4

1. Palpebral conjunctiva
2. bulbar conjunctiva
3. forniceal conjunctiva or fornix

Question 5

What are the 3 factors you must consider in regards to the conjunctivitis?

Answer 5

1. The type of discharge
2. The appearance of the conjunctiva
3. The lymph nodes swollen

Question 6

What is each discahrage associated with:

water

mucoid

purulent

Answer 6

1. watery- allergic conjunctivitis, viral conjunctivitis
2. mucoid-vernal conjunctivitis, keratoconjunctivitis
3. purulent- bacterial conjunctivitis

Question 7

What is generalised conjunctival redness?

Answer 7

More redness near the fornices than the limbus

Question 8

Describe chemosis?

Answer 8

Chemosis is when the oedema is large enough to be seen on the naked eye

Question 9

Follicular conjunctivitis is common in?

Answer 9

Viruses and chlamydia and usually presents in the inferior fornix

Question 10

What does the image depict?

Answer 10

Conjunctival papillae which grow bigger enough to be seen with the naked eye. Uusally associated with cobblestone appearance

Question 11

What causes subconjuctival haemorrhages?

Answer 11

1. Trauma
2. vasalva maneovre
3. conjunctivitis
4. spontaneous
5. systemic vasculitis
6. coagulation defects

Question 12

Bacterial conjunctivitis is categorised as:

Answer 12

1. Acute bacterial conjunctivitis
2. Gonococcal conjunctivitis
3. chlamydial conjunctivitis
4. chronic blepharoconjuntivitis

Question 13

What are the signs of acute bacterial conjunctivitis?

Answer 13

1. redness
2. discharge that sticks the eyes togeher upon waking
3. scratching sensation

Question 14

How do you treat bacterial conjunctivitis?

Answer 14

Resolves by itself within 10-14 days

Chloramphenicol or tobramycin for 5-6 days

Hourly on the first day and then 2-6 hourly for 5 days

Question 15

How does gnococcal conjunctivitis present?

Answer 15

Very hyperaemic, oedematous, copious purlent discharge and eyelid swelling

Question 16

What is the Rx of gonococcal conjunctivitis?

Answer 16

3rd generation cefalosporin like ceftriaxone

Question 17

Which group fo people does chlamydial conjunctivitis affect?

Answer 17

Yound, sexually active adults- usually veneareal in origin

Question 18

What is chlamydial conjuctivitis usually associated with?

Answer 18

urethritis or cervicitis

Question 19

What is the treatement of chlamydial conjunctivitis?

Answer 19

It is treated with

1. tetracyclines 250 mg 4 times daily for 6 weeks
2. erythromycin 250 mg 4 times daily for 6 weeks

Question 20

What is a trachoma?

Answer 20

It is the most commonest form of preventable blindness in the world. It is caused by poor hygiene and the housefly. It starts out acute with follicles presenting and over time becomes linear scarring and then pannus

Question 21

What are the two groups of adenviral conjunctivitis?

Answer 21

1. pharyngoconjunctivitial fever
2. epidemic conjunctivitis

Question 22

pharyngoconjunctivitial fever:

Answer 22

• common in children
• 30% develop keratitis
• affects the upper repiratory system

Question 23

Epidemic conjunctivitis:

Answer 23

• keratitis 80% occurence
• No systemic effects
• Affects both children and adults equally

Question 24

Rx for viral conjunctivitis?

Answer 24

• Prophlactic antibiotics to prevent secondary bacterial infection
• vasoconstriction drops to make the eye more comfortable

Question 25

Acute haemorrhagic conjunctivitis

Answer 25

• Bilateral
• marked redness
• tearing
• eyelid oedema