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eye > conjunctivitis > Flashcards

conjunctivitis Flashcards

1
Q

inflammation of mucous membrane that lines surface of eyeball and inner eyelids

A

conjunctivitis (pink eye)

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2
Q

other causes of conjunctivitis

A

keratoconjunctivitis sicca
allergy
chemical irritants
trauma

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3
Q

causes of conjunctivitis

A

direct contact with contaminated fingers or objects

respiratory secretions

contaminated eye drops

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4
Q

conjunctivitis differentials

A

acute uveitis
acute glaucoma
corneal disorders

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5
Q

usually bilateral* with copious watery discharge*
crusty in morning but goes away through the day*
may have foreign body sensation
can get follicles on inferior on inferior palpebral conjunctival surface
highly contagious
disease usually lasts about 10-14 days
pharyngitis, fever, malaise, periauricular adenopathy may occur with certain types of adenovirus

A

viral conjunctivitis

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6
Q

MC of viral conjunctivitis

A

adenovirus

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7
Q

viral conjunctivitis can also be due to

A

HSV
varicella zoster
herpes zoster

(often unilateral with lid vesicles)

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8
Q

viral conjunctivitis treatment

A

cold compress and artificial tears

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9
Q

is viral conjunctivitis contagious?

A

yes highly
avoid sharing linens, good hand hygiene, etc

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10
Q

viral conjunctivitis treatment if HSV, shingles, or chickenpox infection

A

topical ganciclovir 0.15% gel
and/or oral acyclovir or valacyclovir
optho consult and follow up

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11
Q

MC organisms of bacterial conjunctivitis

A

staph (MRSA)
streptococci (strep pneumo)
haemophilus species
pseudomonas (contacts)
moraxella

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11
Q

copious purulent discharge and eye matting*
blurring of vision and discomfort (mild)
self limited (10-14 days if untreated)

A

bacterial conjunctivitis

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12
Q

bacterial conjunctivitis treatment

A

topical antibiotic (trimethoprim with polymyxin B or azithromycin)

fluoroquinolones for moderate/severe cases or contact lens wearers (ciprofloxacin)

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13
Q

usually acquired through contact with genital secretions (usually hands to eyes)

EMERGENCY!

A

Gonococcal conjunctivitis

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14
Q

Gonococcal conjunctivitis diagnosis is confirmed by

A

stained smear and culture of discharge

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14
Q

why is Gonococcal conjunctivitis an opthalmologic emergency

A

corneal involvement may rapidly lead to corneal perforation and can lead to vision loss

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15
Q

Gonococcal conjunctivitis symptoms

A

copious purulent discharge (striking amount)
chemosis (conjunctival edema)
lid swelling
preauricular adenopathy

16
Q

Gonococcal conjunctivitis smear shows

A

gram negative intracellular diplococci and polymorphonuclear leukocytes

17
Q

Gonococcal conjunctivitis treatment

A

IM ceftriaxone 1 g as single dose*

topical antibiotics (erythromycin and bacitracin)

eye irrigation

other STDs should be considered for treatment (chlamydia)

all partners must be notified and treated

18
Q

after contact with contaminated genital secretions

acute redness, purulent vs sometimes non purulent, irritation, follicular involvement

immune stimulation causes the lymphoid follicles on the eye to become enlarged causing raised follicles

not always acute and can present as a chronic, indolent conjunctivitis

mild keratitis

nontender preauricular lymph node may be palpated

A

chlamydia conjunctivitis/ inclusion conjunctivitis

19
Q

how is chlamydia conjunctivitis/ inclusion conjunctivitis diagnosis confirmed

A

immunologic tests or PCR on conjunctival samples

20
Q

chlamydia conjunctivitis/ inclusion conjunctivitis treatment

A

doxycycline 100 mg PO BID x 7 days

check for genital infection; treat other possible STIs

all partners must be notified and treated

21
Q

MC infectious cause of blindness worldwide

chronic keratoconjunctivitis from recurrent infection with

A

chlamydial conjunctivitis/ trachoma

22
Q

is chlamydial conjunctivitis/ trachoma sexually transmitted

A

NO, not sexually transmitted strain of chlamydia

22
Q

how is trachoma shared

A

direct personal contact

shared towels and cloths

flies that have come in contact with the eyes or nose of an infected person

22
Q

how to confirm chlamydial conjunctivitis/ trachoma

A

immunologic tests or PCR on conjunctival samples

23
Q

recurrent episodes of infection (trachoma) in childhood goes through stages that result in

A

corneal scarring
cloudy cornea

24
Q

chlamydial conjunctivitis/ trachoma treatment

A

single 1 gram dose of oral azithromycin

surgical treatment, if needed:
- correction of lid deformities
- corneal transplantation

improve hygiene/living conditions

25
Q

benign disease

usually occurs in late childhood and early adulthood

may be seasonal– hay fever

conjunctival hyperemia and chemosis

itching, tearing, redness, stringy discharge*

bilateral

A

allergic conjunctivitis

26
Q

how does allergic conjunctivitis look on an exam

A

bumpy or follicular appearance to tarsal conjunctiva

27
Q

allergic conjunctivitis treatments

A

antihistamines
(levocabastine solution, emedastine solution)

mast cell stabilizers
(cromlyn)

combined antihistamines and mast cell stabilizers
(olopatadine)

lubricating eye drops

systemic antihistamines: loratadine 10 mg daily

28
Q

what should you avoid with allergic conjunctivitis

A

triggers

29
Q

dryness, redness, foreign body sensation

Common and chronic disorder

severe cases –> persistent marked discomfort, with photophobia, difficulty in moving the lids, excessive mucus secretion

A

keratoconjunctivitis sicca

30
Q

hypofunction of lacrimal glands

A

loss of aqueous component of tears

31
Q

hypofunction of lacrimal glands may be caused by

A

aging
hereditary disorders
systemic disease (sjogren syndrome)
systemic drugs

32
Q

excessive evaporation of tears

A

environmental factors
excessive screen time
windy climate

33
Q

keratoconjunctivitis sicca inspection

A

usually normal

34
Q

keratoconjunctivitis sicca slit lamp

A

abnormalities of tear film stability and volume

severe: loss of corneal luster and ulcers

35
Q

keratoconjunctivitis sicca fluorescein

A

stains damaged corneal and conjunctival cells

36
Q

keratoconjunctivitis sicca schirmer test

A

determines amount of tears; overproduction/underproduction

37
Q

keratoconjunctivitis sicca treatment

A

artificial tears
(but preservatives can cause reactions that mimic dry eyes)

visine not recommended

stop potentially drying medications

humidifiers

blink more

optho may recommend occasional short term topical steroid use but there are risks such as developing a cataract or glaucoma

eye (9 decks)

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