Conjunctiva And Sclera

Question 1

T/F The palpebral conjunctiva covers the sclera

Answer 1

False: The palpebral conjunctiva covers the lids while the bulbar conjunctiva covers the sclera

Question 2

T/F The sclera is vascularized and therefore you see infection there commonly

Answer 2

False! It is non-vascular and infection usually happens in the episclera or conjunctiva

Question 3

What will you see with jaundice?

Answer 3

Yellowing of the sclera from excess bilirubin in the blood

Question 4

What is the cause of jaundice in the sclera?

Answer 4

Excess bilirubin in the blood

Question 5

T/F Inflammation of the episcleral tissue is localized and can be idiopathic

Answer 5

True! It could also be d/t systemic inflammatory diseases

Question 6

T/F The conjunctivae are highly vascularized

Answer 6

True!

Question 7

T/F Conjunctival injection (red eyes d/t dilation of blood vessels in the conjunctiva) may spare the limbus, leaving a white ring around the iris

Answer 7

True! Not always the most reliable diagnostic tool

Question 8

What are the 3 types of conjunctivitis?

Answer 8

Allergic
Viral
Bacterial

Question 9

T/F If the eye is painful, think conjunctivitis

Answer 9

FALSE (not well innervated)

Question 10

Patient complains of grittiness in their eye, like something is scratching it. The sclera is red and you can see vessels.There is no change to vision and their pupils appear normal. What are you thinking?

Answer 10

Conjunctivitis

Question 11

Patient claims eyes are itchy. They have no fever. What do they have?

Answer 11

Allergic conjunctivitis - MOST important feature is eye itching! No eye itching = Not allergic conjunctivitis

Question 12

What is chemosis?

Answer 12

Edema of bulbar conjunctiva

Question 13

Which form of conjunctivitis could cause a cobblestone appearance or lymphoid follicular response of palpebral conjunctiva?

Answer 13

Allergic conjunctivitis

Question 14

Could you give patients with “Pink Eye” an antibiotic?

Answer 14

Nope - it’s VIRAL

Question 15

What does adenovirus most commonly the infectious agent of?

Answer 15

Viral conjunctivitis

Question 16

Patient presents to you with fever, mild itching and lots of watery discharge of the eyes. It started out in the right eye and now the left eye is starting to look the same. What are you thinking?

Answer 16

Viral conjunctivitis

Question 17

Which lymph nodes should you check to help the diagnosis of viral conjunctivitis?

Answer 17

Pre-auricular lymph nodes for lymphadenopathy

Question 18

Patient presents with pus oozing out of their eyeballs. This morning it had crusted over and they couldn’t open their eye. What do they have?

Answer 18

Bacterial conjunctivitis

Question 19

T/F Pre-auricular lymphadenopathy is associated with bacterial conjunctivitis

Answer 19

FALSE: viral conjunctivitis

Question 20

Which form of conjunctivitis is a clinical emergency that you would refer your patient to the eye doctor?

Answer 20

Gonococcal conjunctivitis (this is gonorrhea)

Question 21

Patient presents with a red sclera in one eye that suddenly occurred with deep aching pain in the eye. Their vision has become blurred. What is this and what should you do?

Answer 21

Acute Angle Closure Glaucoma - medical emergency!

Question 22

What causes acute angle closure glaucoma?

Answer 22

Incr in intraocular pressure in the anterior chamber of the eye

Question 23

T/F Subconjunctival hemorrhage is a ophthalmological emergency

Answer 23

False! But it looks scary

Question 24

Patient says they coughed really hard while choking on a piece of carrot and the next time they looked in the mirror they had a massive red spot in their eye! Should they be worried? Why or why not?

Answer 24

No, it’s a subconjunctival hemorrhage or a leakage of blood outside a vessel. It will clear up on its own

Question 25

T/F Subconjunctival hemorrhages are associated with pain and changes to vision

Answer 25

False

Question 26

What is the term for a yellowish nodule of the bulbar conjunctiva?

Answer 26

Pinguecula

Question 27

What is the term for a triangular thickening of bulbar conjunctiva growing across the outer surface of the cornea?

Answer 27

Pterygium

Question 28

T/F Pinguecula are more common with age

Answer 28

True

Question 29

Which of the following have a localized appearance on the sclera? Episcleritis, Conjunctivitis, Pink Eye, Pinguecula

Answer 29

Episcleritis

Pinguecula