Conjunctiva Flashcards
Parts of conjunctiva
- Palpebral - Orbital, Tarsal, Marginal
- Bulbar
- Forniceal
Histo:
1.Epithelium
- Adenoid layer
- Fibrous layer
2 specialised membranes in conjunctiva
- Pelican semilunaris
2. Caruncle
Cells present in epithelium of conjunctiva
- Goblet cells
- Melanocytes
- Langerhan cells
Goblet cells form which part of tear film
Mucin layer of tear film
Only part of eye which has LYMPHATIC drainage
CONJUNCTIVA
Medial - Submandibular LN
Lateral - Preauricular nd superficial parotid LN
Significance of adenoid layer of conjunctiva
It consists of lymphoid tissue which shows follicular reaction.
It develops only after 3 months….so no rn in infants.
Glands seen in conjunctiva
- Mucin secreting = Goblet cells, Crypts of Henle, Glands of Manz
- Accessory lacrimal= Glands of Krause, Glands of Wolfring
Arterial supply of conjunctiva
1.Peripheral arterial arcade of eyelid - palpebral nd fornix
2.Marginal arterial arcade—> Post conj A.— bulbar
Anterior ciliary artery —>Ant conj A.—— “
Common symptoms of conjunctivitis
- Redness
- Discharge
- FBS
- Lacrimation
- Itching….mainly in allergic
***If pain nd loss of vision +nt=> corneal involved
Common signs of conjunctivitis
- Hyperemia
- Subconj Hmg
- Chemosis
- Discharge
- Inflammatory rn= papillae or follicles
Coloured halos are seen in?
- Glaucoma
- Cataract
- Mucopurulent conjunctivitis
Papillary Follicular
MP 1 2
Watery 3 4
1= Bacterial
2= Chlamydial
3= Allergic
4= Viral
MCC of Acute bacterial conjunctivitis
Specific symptoms
Staph aureus
Assoc with Mucopurulent discharge nd coloured halos
Epidemics of MP conjunctivitis or Red eye are caused by?
Hemophilus influenza or KOCH-WEEKS bacillus
Treatment for Acute conjunctivitis
1% chloramphenicol or 0.3%Tobramycin
If not respond - cipro0.3% or moxi0.5%.
Acute purulent or Hyperacute conjunctivitis
Cause?
Symptoms?
Signs?
Aka Blenorrhoea
*caused by N.gonorrhoea
Symptoms
- Copies purulent discharge
- Intense pain***
- Stickiness,PP
Signs
- Swollen eyelids
- Conj-chemosis nd congestion= Bright red velvety*
- Pseudomembrane formation freq
- Preauricular LA***
Treatment for Acute purulent conjunctivitis
1.Systemic - IM ceftriaxone 1g /Norfloxacin 1g for 5 days
+
Erythromycin 500mg or Doxycycline 100mg for 1 week
- Topical - ofl/cipro/E ointment init 2hrly later 5/day.
- Eye irrigation
- Top atropine
- T/t partner
MCC of chronic conjunctivitis
Symptoms
Staph aureus
Other - proteus,E coli,Klebsiella
- Redness
- Mucoid discharge @ canthi
- Burning sensation
Causes of Acute membranous conjunctivitis
Unimmunised child = C.diphtheriae
MCC in adults = Pneumococcus
MCC of Angular conjunctivitis
Other name?
Moraxella lacunata (or) Axenfield bacillus
Diplobacillary conjunctivitis
Symptoms of angular conjunctivitis
Signs “ “
- Redness @ angles
- Foamy white discharge @ angles
- Irritation
- Excoriation of skin @ canthi
- Hyperemia of bulbar C @ canthi
- Freq assoc with Blepharitis
Treatment for Angular conjunctivitis
- Tetracycline 1% ointment for 2 weeks
2. Zinc lotion @ day nd ointment @ night
Which Conjunctival diseases are caused by which serovars of Chlamydia?
- Trachoma by A,B,Ba,C
- Ophthalmia neonatorum by D-K
- Adult inclusion conjunctivitis by D-K serovars
***MCC of preventable blindness.