Conjunctiva and lacrimal system

Question 1

Conjunctival fornix

Answer 1

The area where palpebral conjunctiva meets bulbar conjunctiva

Question 2

Palpebral and Bulbar conjunctiva

Answer 2

Conjunctiva that lines the inner surface of the eyelid and the anterior aspect of the globe respectively

Question 3

Epiphora

Answer 3

Abnormal overproduction of tears. This is a common response to ocular irritation

Question 4

Conjunctival lymphoid follicles

Answer 4

a response to non-specific antigenic stimulation. Presence of these follicles anywhere but the bulbar surface of the third eyelid is considered abnormal and consistent with a diagnosis of conjunctivitis

Question 5

Goblet cells

Answer 5

These are present in conjunctival epithelium and have produce the innermost mucous layerof the three-layered tear film. Patients with conjunctivitis will often overproduce mucus, conventionally referred as mucoid discharge.

Question 6

Mucoid discharge

Answer 6

a very common clinical sign with conjunctivitis

Question 7

Mucopurulent discharge

Answer 7

most commonly found in cases of keratoconjunctivitissicca(KCS), due to loss of the aqueous portion of the tear film which then causes mucous overproduction, bacterial overgrowth and subsequent white blood cell recruitment. This is a classic feature of KCS and will be very important to remember.

Question 8

Conjunctival hyperemia

Answer 8

This term is used to describe congestion of the superficial vessels of the conjunctiva. Predominance of this finding suggests superficial disease. For instance, tear film disorders (KCS), primary conjunctivitis, eyelid disorders causing secondary conjunctivitis, a response to superficial cornea ulceration etc.

Question 9

Episcleral injection

Answer 9

This term refers to congestion of deep conjunctival vessels, known as episcleralvessels. Predominance of this clinical sign suggests deeper disease processes. For instance uveitis, glaucoma, and deep/complicated corneal ulceration.

Question 10

Keratitis

Answer 10

Inflammation of the cornea. Clinical signs include corneal neovascularization (most common), corneal pigmentation, corneal fibrosis, corneal ulceration and white blood cell infiltration.

Question 11

Symblepharon

Answer 11

permanent adhesion between the conjunctiva and the cornea

Question 12

Ghost vessels

Answer 12

non-perfused corneal blood vessels. These vessel tracks provide evidence of previous keratitis

Question 13

Chemosis

Answer 13

edema of the conjunctiva