Conjunctiva And Sclera Flashcards
Causes of conjunctival follicles
Viral, chlamydial, Trachoma and hypersensitivity
Causes of conjunctival papillae
ALLERGY
Bacterial
Contact lens
Floppy eyleid syndrome
Trachoma
Causes of allergic conjunctivitis
chemical irritation, vernal keratoconjunctivitis (VKC),
atopic keratoconjunctivitis (AKC), giant papillary conjunctivitis
(GPC)
Causative organisms of bacterial conjunctivitis
Strept. Pneumonia, Staph aureus, H. influenza, and
Others (N. Gonorrhea, N. meningitides)
Treatment of bacterial conjunctivitis
• Topical antibiotics usually 4 times per day (chloramphenicol, aminoglycosides,
Quinolones or macrolides)
• Systemic antibiotics are used only in case of:
1. Gonococcal infection use a 3rd generation cephalosporins.
2. H. influenza infection in children use amoxicillin/clavulanic acid.
3. Meningococcal infection benzyl penicillin, ceftriaxone or cefotaxime IM can be
used.
• Topical steroids
• Irrigation
Most common cause of non gonococcal urethristis in males
Chlamydia
Discharge of bacterial conjunctivitis
Micopurulent
In chlamydial conjunctivitis
• Tarsal conjunctival scrapings for Giemsa Stain show….
Intracytoplasmic inclusion bodies
Treatment of chlamydial conjunctivitis
Systemic antibiotics
Azithromycin 1 g repeated after 1 week is generally the treatment of choice with
some guidelines advocate only a single 1 g dose. Erythromycin, amoxicillin and
ciprofloxacin are alternatives.
• Topical antibiotics such erythromycin or tetracycline
Trachoma is associated principally with infection by serovars….
A, b, Ab, C
A pt with conjunctivitis presents with drye eyes, Arlts line and Herbert’s pits
What type of conjunctivitis are these sign relevant to?
cicatritial trachoma conjunctivitis
Management of Trachoma conjunctivitis
SAFE
Surgery
Antibiotics : single dose Azithromycin
Facial cleaness
Environmental improvement
Most common cause of viral conjunctivitis
Adenovirus
Discharge of viral conjunctivitis
Watery
Treatment of allergic conjunctivitis
Mild Symptoms: Artificial tears.
• Moderate Symptoms: Mast cell stabilizers or
Antihistamines in addition to preceding
medications.
• Severe Cases: Topical steroids
Conjunctival discharge in Vernal keratoconjunctivitis and atopic keratoconjunctivitis
Mucoid
Treatment of VKC & AKC
Mast cell stabilizers reduces the frequency of acute exacerbations and the
need for steroids.
• Topical antihistaminics are suitable for acute exacerbations but generally not
for continuous long-term use.
• Topical non-steroidal anti-inflammatory preparations may improve comfort
by blocking non-histamine mediators.
• Topical steroids especially if a corneal ulcer is present, They are usually
prescribed in short but intensive (e.g. 2-hourly initially) courses to avoid raised
intraocular pressure leading to steroid induced glaucoma.
• Oral antihistaminics
Surgery
Superficial keratectomy
Surface reatoration surgeries
Most important risk factor in giant papillary conjunctivitis
Contact lens wear
Discharge of giant papillary conjunctivitis
Mucoid
Treatment of giant papillary conjunctivitis
Topical drops as antihistamines, non-steroidal anti-inflammatory agents,
steroids and mast cell stabilizers should be non-preserved in patients
wearing soft contact lenses
What is the difference between pterygium and pinguecula
pterygium is histologically similar to a pinguecula
and shows elastotic degenerative changes In contrast
to pinguecula,
Pterygia encroach onto the cornea
Treatment of pterygium
Medical
Bare sclera thechnique surgery
A patient comes with Watery or mucopurulent discharge.
2. Tender preauricular lymphadenopathy.
3. Large follicles most prominent in the inferior fornix
These are signs of which type of conjunctivitis?
These are signs of chlamydial conjunctivitis
