Conjunctiva Flashcards
Pilca semilunaris
Small fold of bulbar conjunctiva
T/f. Pilca semilunaris is a vestigial organ.
True. It’s a fold that related to body part that has become small and lost its use due to evolution.
A caruncle is a
Mucocutaneous junction btwn bulbar conj and skin
T/f the conjunctiva has normal flora on it.
True. Staphylococcus epidermis is the #1 microbe on conju. The #1 anaerobes is propionibacterium acne.
Who has more anaerobes on the conjunctiva: adults or children?
Adults have more anaerobes. Children have more strep. It shifts as we age
What is the leading cause of unscheduled office visits?
Conjunctival disorders
___ ____ is a limited response of conjuncct.
Red eye
Possible etiologies of conj disorders is
Allergic, viral, infection, inflammation, bacterial
T/F you should look before instillation of anesthetic or dyes
True. Phenyleprine is good at constricting blood vessels . Minutes later it will disappear.
Anytime you have conj office visit, check where the the redness is.
True. It can help you narrow down which one it is.
T/f on checking IOP, you should check the worse eye first
False. Check the good eye first so you dont spread to the other eye
Examining the Conjunct.you don’t need to palpate the periauricular or submandibular noes.
False. It’s good to palpate because the lymph drainage is in the nodes. Helps to know if viral infection.
In slit lamp examination of conjunctiva can involve (4)
Everting UL, dyes (rose bengal), check before drops,
List the different types of conjunctival responses:
Papillae, follicles, membranes/pseudomembranes, chemists, hypermedia, exudates, symblepharon
Papillae are usually found on the:
The upper palpebral but can be in lower palpebral
T/F papillae are velvety red with vascular network surrounding the papillae.
False. Papillae have a CENTRAL fibrovascular core, but they are velvety red. Follicles have vascular network surround the follicles
Papillae are associated with what etiologies
Bacterial, allergic
Why do Steriods work well with patients who have papillae?
Because the papillae have an infiltration of inflammatory cells (eosinophils, lymphocytes, )
Septa e
Things that seperate papillae, deeper in tissue. Rupture of septa Create giant papillae
What color are follicles? Red or white.
White, milky, and transluncent
Follices are associated with what type of etiologies?
Viral infections, toxic rxn, chlamydial infection.
Follices are more found on upper lid or lower lid?
Follices are more found on lower lid
Follicles are
Discrete, round, elevated lesions. -focal hyperplasia of lymphoid tissue. Center is immature lymphocytes and macrophages, periphery is mature lymphocytes
Kids tend to have a. Papillae b. Follices
B. Follicles
The difference btwn pseudomembrane vs true membrane?
Pseudomembrane is not adherent to epithelium (easy to remove). True membranes is very tightly adherent to epithelium
Membranes/pseudomembranes are a conjunctival response composed of
Fibrin and cellular debris
Swelling of conjunctiva
Chemiosis
The etiology of chemosis
Increased vascular permeability
Pic of chemosis. Most common in …..
This conjunc response is most common in allergic responses
Pic hyper me Mia
Etiology: pathophysiologice response to injury . Blood still in blood vessels. This can be diffuse or focal.
Another word for discharge
Exudates
Serous exudate. Etiology? Common in ?
Clear and watery. Etiology: increase vascular permeability. More common in allergic or viral conditions
Mucoid exudate. Etiology?
Increased mucus from globet cell irritation . It’s clear to yellow but translucent
Pt comes in complaining eyes feel stuck together in am. What type of exudate do you expect?
Mucopurlent-sticky, thicker, more yellow. Etiology: increased mucus combined with inflammatory cells (eosinophils and macrophages)
Pur u-lent exudate
Yellow-white to yellow green; opaque, thick. Etiology:high concentration of inflammatory cells(PMNS and macrophages)
Fibrinous exudate
Stringy, ropes d/c appearance: white, opaque, follows contour of conjunctiva. Etiology: high degree of fibrin mixed with inflammatory cells ( PMNS and macrophages)
Hemorrhagic exudate
Blood is no longer in blood vessels; etiology: RBS in d/c from increased vascular permeability or trauma
What is a symblepharon?
A type of conjunctival response that’s an adhesion between bulbar and palpebral conjunctiva
Conjunctival chal-asis is
redundant conjunc. More temperol, loss of tenons fascia
management of conjun chalasis
supportive lubricants and topical NSAIDS Proslena( not if sulfa allergy) , nevanc, or acular/avail
Conjunctival chal-asis looks like
extra tears
concreations
small, white to yellow, hard elevations; superficially buried within and beneath the palpebral conjunctiva
concreations
recurrent or chronic conjunctivitis
Kaposi’s sarcoma
common in patients with AIDs
Originate in fornices
Conj. Lymphoma
