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Opthalmology > Conjunctiva > Flashcards

Conjunctiva Flashcards

1
Q

Types of discharge in different types of conjunctivitis

A

B – bacteria – Purulent
C – chlamydial – mucopurulent
B – viral – watery
E – allergic – watery

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2
Q

Main pathology of conjunctivitis

A

Follicular and papillary

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3
Q

Membranous conjunctivitis features

A

All common features (the 5) + inflammatory membrane formation

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4
Q

Cause of membranous conjunctivitis

A

Corynebacterium diphtheria

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5
Q

Characteristic of true membrane

A

True membrane bleeds on peeling

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6
Q

Pseudomembranous conjunctivitis

A

All features +membrane formation(Does not bleed on peeling)

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7
Q

Aetiology of pseudomembranous conjunctivitis

A
  1. mild diphtheria
  2. streptococcus haemolytic us
  3. severe Adenoviral infection
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8
Q

Other causes of pseudomembranous conjunctivitis

A

1.gonococcal
To.Staphylococcus aureus
3.HSV
4.chemical irritant

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9
Q

Causes of angular conjunctivitis

A
  1. moraxella axenfeld
  2. moraxella laumata
  3. moraxella catarrhalis

Staphylococcus aureus

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10
Q

Treatment of angular conjunctivitis

A
  1. antibiotic eyedrops

2. zinc oxide which is an inhibitor of proteolytic enzymes. (For excoriation )

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11
Q

Features of haemorrhagic conjunctivitis

A

All features + subconjunctival haemorrhage

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12
Q

Aetiology of haemorrhagic conjunctivitis

A 
Bacteria – pneumococcal us, haemophilus
Viral
1.enterovirus – 70
2.adenovirus
3.coxsackievirus-24
4.echo virus – 34
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13
Q

Causes of subconjunctival haemorrhage

A
  1. trauma
  2. hypertension
  3. bleeding diatheses
  4. haemorrhage and conjunctivitis
  5. pertusis(whooping cough)
  6. passive venous congestion
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14
Q

What is strains cause trachoma

A

Chlamydia trachomatis

A, B, Ba,C

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15
Q

What do you strains D to K cause

A

Adult inclusion conjunctivitis

Swimming pool conjunctivitis

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16
Q

Clinical features of trachoma

A

Intense itching and watering

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17
Q

Characteristic features on examination in trachoma

A

On palpable conjunctiva – Sago Grain like follicles, arlt’s line
Around the cornea – Herbert follicles, Herbert pits

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18
Q

WHO classification Of trachoma

A 
F – I – follicles
I – II – inflammatory
S –III– scarring
T – IV-Trichiasis
O– V– corneal opacity
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19
Q

Complication of trachoma

A

Corneal ulcer

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20
Q

Two main pathologies or off trachoma

A

Follicular + papillary reaction

Intra cytoplasmic inclusion body– Halbertsteiater prowasele

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21
Q

SAFE strategy

A 
WHO programme to control trachoma
S – surgery
A – antibiotics
F – facial hygiene
E – environmental cleanliness
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22
Q

Indication of starting SAFE strategy

A

Prevalence of trachoma Follicles In 1 to 9 years of age is more than 10%

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23
Q

What is the strategy when the prevalence is 5 to 10% among children

A

Just FE

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24
Q

What is the strategy if the prevalence of trachoma in children is less than 5%

A

Nothing under the programme

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25
Q

What is the drug of choice for blanket therapy

A

Azithromycin

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26
Q

What are the diseases covered by a vision 2020 India

A

4+3

  1. cataract
  2. trachoma
  3. childhood blindness
  4. refractive error
  5. diabetic retinopathy
  6. glaucoma
  7. corneal blindness
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27
Q

Drug of choice for trachoma

A

Azithromycin

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28
Q

Treatment of trachoma

A

As it through Meissen

  1. Tetracycline
  2. Sulphacetamide Eyedrops
  3. Broad-spectrum antibiotics
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29
Q

Causes of phlyctenular conjunctivitis

A

Staphylococcus aureus

Tuberculosis

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30
Q

Pathology of phlyctenular keratoconjunctivitus

A

Type 4 hypersensitivity

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31
Q

Examination feature of phlyctenular keratoconjunctivitis

A

Fascicular ulcer
Phlycten
Ring ulcer
Conjunctival congestion

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32
Q

Treatment of phlyctenular keratoconjunctivitis

A

Anti allergic- olopatadine,epimastine

^^ dual action of
Antihistamine
Mast cell stabiliser

Mild steroid - fluoromethalone

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33
Q

Vernon keratoconjunctivitis AKA

A

Spring Catarrh

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34
Q

Aetiology of vernal keratoconjunctivitis

A
  1. Allergy to exogenous- dust,pollen
  2. in summers
  3. male children
  4. no follicles
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35
Q

Discharge in vernal keratoconjunctivitis

A

Ropy discharge

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36
Q

Examinational feature of vernal keratoconjunctivitis

A

Epithelial hyperplasia- cobblestone
Cupid’s bow/pseudogerontoxon
Horner trantas spots-aggregation of eosinophils

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37
Q

Maxwell lyon sign

A

Presence of eosinophils in ropy discharge

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38
Q

What is shield ulcer

A

Epithelial micro erosion which
Macro erosion
Fibrin and mucus gets deposited on this

39
Q

Pathology of vernal keratoconjunctivitis

A

Type 1 hypersensitivity

40
Q

Ophthalmia neonatorum

What age

A

Less than 1 months

41
Q

MC aetiology of ophthalmia neonatorum

A

Chlamydia

42
Q

Most dangerous etiologyof ophthalmia neonatorum

A

Gonorrhoea

Why? Leads to corneal perforation

43
Q

Crede’s method of prevention

A

1 % AgNO3 to prevent gonorrhoeal conjunctivitis

44
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

45
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

46
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

47
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

48
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

49
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

50
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

51
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

52
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

53
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

54
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

55
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

56
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

57
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

58
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

59
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

60
Q

Causes of parenchymatous conjunctival xerosis

A

Trachoma
Burns
Steven Johnson syndrome

61
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

62
Q

Which is more dangerous

acid or alkali type of burn?

A

Alkali is more dangerous as it can penetrate the cornea and go inside whereas the acid coagulates the protein forming a layer

63
Q

Causes of epithelial conjunctivital xerosis

A

Xerophthalmia (vit A deficiency)

64
Q

Causes of parenchymatous conjunctival xerosis

A

Steven Johnson syndrome
Burns
Trachoma

65
Q

Xerophthalmia stages

A

XN- night blindness (earliest)

XIa- conjunctival xerosis
XIb- bitots spot

XII- corneal xerosis

XIIIa- keratomalacia (less than 1/3rd)
XIIIb- keratomalacia (more than 1/3rd)

XS- xerophthalmic scarring

XF- fundus (white spotted fundus)

66
Q

Dose of vitamin A

A

Above 1 yr - 1 lakh unit (0,1,14th day)

Less than 1 yr - half the dose

67
Q

What is pterygium

A

Subconjunctival fibrovascular tissue encroaching the cornea

NOT inflammatory

68
Q

To prevent recurrence of pterygium what to do

A

Mitomycin C

Autografting

69
Q

PERFECT surgery

A

Pterygium extended resection followed by extended conjunctival transplantation

70
Q

What is pseudopterygium

A

Any scar tissue that resembles pterygium

71
Q

How to differentiate between pterygium and pseudopterygium

A

Glass rod test

Passes under the tissue in pseudopterygium
Does not for pterygium

72
Q

What are the different iron deposition in the eye called

A

Stockers line
Ferry’s line
Hudson stahli line
Flescher’s ring

Know where they are found 🙈

73
Q

What is pinguecula

A

Elastotic degeneration of conjunctiva and hyaline infiltration
Consist of fat,protein and calcium

74
Q

Most common site of pterygium

A

Nasal part of eye

75
Q

What eye conditions do UV-B rays cause

A

Pterygium
Pinguecula
Snow-blindness/photophthalmia

76
Q

What is photoretinitis

A

Injury by infrared rays
Directly looking at the solar eclipse with unaided eye

C/F- macular burn—> macular scar

77
Q

Layers of tear film
Secreted by
Functions

A 
Lipid layer (meibomian gland)
Prevents evaporation
Aqueous layer (lacrimal gland)
Lubrication
Mucin layer (goblet cells)
Helps to spread tear
78
Q

Where is the maximum density of goblet cells

A

Inferonasal quadrant

79
Q

What is dry eye

A

Deficiency of any three layer

80
Q

What is keratoconjunctivitis sicca

A

Deficiency of aqueous layer

81
Q

Primary Sjögren’s syndrome

A

keratoconjunctivitis (dry eye) + dry mouth (xerostomia)

82
Q

Secondary Sjögren’s syndrome

A

KCS (dry eye)+ dry mouth + RA/connective tissue disorders

83
Q

Schirmers test

A

Tear slip on lower lid for 5 min

Less than 5 mm wetting- severe dry eye

84
Q

Phenol red thread test

A

Put on lower lid for 15 sec

Less than 9 mm change to red colour then dry eye

85
Q

Tear break up time test

A

If absence of mucin layer
Time from last blink to first dry spot on cornea
Less than 10 sec - severe dry eye

86
Q

What does rose Bengal stain

A

Stains dead cells and mucus

87
Q

Medical and surgical management of dry eye

A

Medical-lubricating eye drops

Surgical - lacrimal punctual occlusion (silicone plug)

88
Q

Causes of nyctalopia

A

Xerophthalmia
Retinitis pigmentosa
High myopia
Late stage of POAG

89
Q

Congenital stationary night blindness causes

A

Find us albipunctatus
(NB+ white spotted fundus)

Oguchi’s disease
(NB+ pale fundus)
Mizous phenomenon

90
Q

Choroidal dystrophy

A

Choroideremia

Gyrate atrophy

91
Q

Cause of choroidal dystrophies

A

Deficiency of enzyme ornithine aminotransferase

92
Q

Mizous phenomenon

A

Feature of oguchi’s disease

1 hr in the dark there is no Night blindness and fundus is normal

Cause: overestimation of rods

93
Q

Causes of hamarlopia

A

Central corneal opacity
Central lenticular opacity
Congenital absence of cones

Opthalmology (10 decks)

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