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Cornea > Conjunctiva > Flashcards

Conjunctiva Flashcards

1
Q

Goblet cells most dense where

A

inferonasally and in the fornices

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2
Q

Krause and Wolfring - where

A

stroma

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3
Q

Subacute or chronic chemosis

A

thyroid, allergic, meningitis, vasculitis, superior vena cava syndrome, right-sided heart failure, nephrotic syndrome

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4
Q

True membranes

A

adenoviral, gonococcal, Streptococcus, Corynebacterium, ligneous, Stevens-Johnson

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5
Q

Follicles

A

vessels around, lymphoid germinal centre. viral, chlamydial, Parinaud oculoglandular syndrome, hypersensitivity to topical medications

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6
Q

Papillae - size, causes

A

vascular core, macro<1mm, giant>1mm. bacterial, allergic, chronic blepharitis, contact lens, superior limbic keratoconjunctivitis, floppy eyelid syndrome

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7
Q

Lymphadenopathy

A

viral, chlamydial, gonococcal, Parinaud oculoglandular syndrome

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8
Q

Systemic symptoms

A

gonococcus, meningococcus, Chamydia, H. influenzae

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9
Q

Gonococcal

A

true membranes, lymphadenopathy, systemic symptoms, eyelid edema and erythema, hyperacute purulent, peripheral corneal ulceration, gram(-) kidney-shaped intracellular diplococci (also meningococcal), chocolate agar, Thayer-Martin

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10
Q

Treatment gonococcal and meningococcal

A

1g of intramuscular ceftriaxone. quinolone, gentamicin, chloramphenicol, bacitracin + systemic (3g cephalosporin)

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11
Q

Treatment H. Influenzae

A

amoxicillin with clavulanic acid

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12
Q

Treatment Chlamydial

A

Azithromycin 1g (single dose) repeated after 1 week. Doxycycline 100mg 2x1 for 7-10 days. Erythromycin 500mg 4x1 for 7 days, amo, ciprofloxacine

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13
Q

Trachoma - chronic immune response

A

cell-mediated delayed hypersensitivity (Type IV)

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14
Q

Arlt line

A

broad confluent conjunctival scars

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15
Q

Herbert pits

A

row of shallow depressions after resolving of superior limbal follicles

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16
Q

Neonatal conjunctivitis (ophthalmia neonatorum) - causes and prophilaxis. Chlamydial treatment

A

C. trachomatis, N, gonorrhoeae, HSV-2, streptococci, staphylococci, H. influenzae, G(-), congenital nasolacrimal obstruction. povidone-iodine 2.5%, ery 0.5% / tetracycline 1% ointment, silver nitrate 1%. Chlamydial treatment - oral ery for 2 weeks

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17
Q

pharyngoconjunctival fever - serovars, keratitis

A

3, 4, 7. keratitis 30%

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18
Q

epidemic keratoconjunctivitis - serovars, keratitis

A

8, 19, 37. keratitis 80%

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19
Q

forms of viral conjunctivitis

A

non-specific acute follicular conjunctivitis, pharyngoconjunctival fever, epidemic keratoconjunctivitis, acute hemorrhagic conjunctivitis, chronic/relapsing adenoviral conjunctivtis, varicella, measles, mumps, molloscum contagiosum (poxvirus)

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20
Q

Seasonal allergic conjunctivtitis

A

sping, summer, common, tree and grass pollen. Sneezing, nasal discharge

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21
Q

Parennial allergic conjunctivtitis

A

throughout the year, worse in autumn, house dust mites, animal dander, fungal. Milder. Sneezing, nasal discharge

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22
Q

Vernal keratoconjunctivitis (VKC)

A

type I hypersensitivity, recurrent bi, boys, from 5yo remission late teens, warm dry climate, history asthma, eczema, late spring and summer. Palpebral (upper tarsal conj), Limbal (black, asian). Horner-Trantas dots, velvety papillary hypertrophy, giant papillae, ‘shield’ ulcer, HSV

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23
Q

Horner-Trantas dots

A

Gelatinous limbal conjunctival papillae in VKC

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24
Q

Atopic keratoconjunctivitis (AKC)

A

type I and IV hypersensitivity, rare bi, chronic unremitting, parennial worse in winter, 30-50yo, inferior palpebral, history atopic dermatitis (eczema), asthma. more severe than VKC, more skin changes, blepharitis, keratoconus, shield-like anterior or PSC, Hertoghe sign, Dennie-Morgan folds. cornea scarring more than VKC

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25
Q

Hertoghe sign

A

AKC, absence of the lateral portion of the eyebrows

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26
Q

Non-allergic eosinophilic conjunctivitis

A

common, chronic non-atopic, middle-aged women, dry eye, rhinitis, no IgE

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27
Q

Mucous membrane pemphigoid (cicatricial pemphigoid)

A

type II (cytotoxic) hypersensitivity, old, F:M 2:1, insidious or relapsing-remitting non-specific bi conjunctivitis, papillary

28
Q

cicatricial pemphigoid - treatment

A

dapsone, antimetabolites, steroids, iv immunoglobulin therapy, rituximab, artificial tears, ciclosporin, tacrolimus, retinoic acid, lid hygiene, subconj mitomycin C/steroid injection,lysis of symblaphara with sterile glass rod, scleral ring, punctal occlusion, lateral tarsorrhaphy, botulinum toxin-induced ptosis, mucous membrane autografting or amniotic membrane transplantation, limbal stem cell transfer, keratoprosthesis

29
Q

Stevens-Johnson syndrome - other name, type sensitivity, factors

A

toxic epidermal necrolysis (Lyell syndrome). type IV cell-mediated delayed hypersensitivity. antibiotics (sulfonamides and trimethoprim), analgesics (paracetamol), cold remedies, anticonvulants, Mycoplasma pneumoniae, HSV, cancer

30
Q

Superior limbic keratoconjunctivitis

A

uncommon, uni or bi, middle-aged F, 50% thyroid, symptoms more than signs, remission eventually, blink-related trauma between upper lid and superior bulbar conj, tear film insufficiency, excess of lax conj tissue, papillary hypertrophy, sup punc erosions, filamentary, sup pannus

31
Q

Superior limbic keratoconjunctivitis - treatment

A

lubricants, acetylocysteine, mast cell stabilizers, steroids, rebamipide, ciclosporin, retinoic acid, soft CL, supratarsal steroid injection, punctal occlusion, resection fo sup limbal conj, conj ablation by silver nitrate 0.5% or thermocautery

32
Q

Ligneous conjunctivitis

A

recurrent, bi, fibrin-rich pseudomembranous, mainly tarsal conj, onset 5yo, deficiency in plasmin-mediated fibrinolysis, red-white lobular masses, yellow-white mucoid, amorphous subepithelial deposits of eosinophilic material

33
Q

Ligneous conjunctivitis - treatment

A

stop antifibrinolytic therapy, diathermy, topical plasminogen to soften then remove, after-hourly heparin and steroids. recur: long-term ciclosporin and steroids

34
Q

Parinaud oculoglandular syndrome

A

rare, chronic low fever, uni granulomatous conjunctivitis, ipsi preauricular, B. henselae, tularemia, insect hairs (ophthalmia nodosum), T. pallidum, sporotrichosis, tuberculosis, C. trachomatis

35
Q

Factitious conjunctivitis

A

inferior conjunctival injection, rose Bengal

36
Q

Pinguecula

A

elastotic degeneration, nasal, actinic damage. Thermal laser ablation

37
Q

Stocker line

A

iron deposition in the corneal epithelium anterior to the head of the pterygium

38
Q

Fuchs islets

A

small discrete whitish flecks consisting of clusters of pterygial epithelium at advancing edge

39
Q

Pseudopterygium

A

away from the horizontal, firm attachment to the cornea only at its apex

40
Q

Elastoid degenerations

A

conjunctivochalasis, pinguecula, pterygium, spheroid degeneration, white limbal girdle of Vogt

41
Q

Hemorrhagic conjuctivitis

A

Coxsackie A24, Picorna, Adenovirus 8, 19

42
Q

Inclusion conjunctivitis - serovars

A

Chlamydia D-K

43
Q

Halber-Staedtler and Prowazek

A

initial bodies in epithelial cells (basophilic intraCYTOplasmic inclusions) in trachoma

44
Q

Leber’s cells

A

macrophages in the conjunctival stroma with phagocytosed debris in trachoma

45
Q

extensive molloscum lesions - what to do

A

workup for HIV

46
Q

Treatment for gonorrhea conjunctivitis

A

IM injection of 1gram cefriaxone, eye lavage every hour, +treatment for concurrent chlamydia

47
Q

Acute Hemorrhagic conjunctivitis - causes

A

Coxackie variant A24, Enterovirus type 70, rarely adenovirus type 11

48
Q

giant papillary conjunctivitis

A

Vernal keratoconjunctivitis (VKC)

49
Q

Horner-Trantas dots

A

Vernal keratoconjunctivitis (VKC)

50
Q

shield ulcer - where and location

A

Vernal keratoconjunctivitis (VKC), upper half of cornea

51
Q

Trachoma - serovars

A

Chlamydia A-C (trAChoma)

52
Q

Adult and neonatal inclusion conjuntivitis - serovars

A

Chlamydia D-K (DicK)

53
Q

Lymphangioma venereum - serovars

A

Chlamydia L1-L3

54
Q

Bitot spot - where and what

A

foamy lesion on bulbar conjuctiva. vit A deficiency. Corynebacterium xerosis

55
Q

Pharyngoconjunctival fever - serotypes

A

3, 7

56
Q

Epidemic keratoconjunctivitis - serotypes

A

8, 19, 37, subgroup D

57
Q

Epidemic keratoconjunctivitis - when infiltrates

A

7-14 days after ocular symptoms start

58
Q

AKC

A

anterior shield-shaped or posterior subcapsular cataract, HSV, S. aureus

59
Q

Halberstaedter-Prowazek Bodies

A

trachoma

60
Q

Initially resemble band keratopathy

A

Gelatinous drop-like

61
Q

Mulberries

A

Gelatinous drop-like

62
Q

Chlamydia trachoma - most characteristic

A

LIMBAL follicles+sequelae (Herbert pits), TARSAL conj scarring, vascular pannus (most marked on the superior limbus), conj follicules most numerous on the superior tarsus

63
Q

Pyogenic granuloma - most common causes

A

pterygium removal or strabismus surgery

64
Q

Pyogenic granuloma - histo

A

fibroblasts and proliferating capillaries, “spoke-wheel” vascular pattern

65
Q

Parinaud’s ocularglandular syndrome

A

Granulomatous conjunctivitis with regional lymphadenopathy+constitutional symptoms. 1 week after exposure. Mostly cat-scratch disease

66
Q

Parinaud’s ocularglandular syndrome - causes

A

cat-scratch disease, tularemia, sporotrichosis, tuberculosis, syphilis

Cornea (10 decks)

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