Cornea-Conjunctiva Flashcards
Follicles vs Papillae
Follicles: blood vessels run around; lymphocytes; viral conj-chlamydial conj-perinaud oculoglandular syndrome-hypersensitivity to topical medications.
Papillae: vascular core; inflammatory cells; bacterial conj-allergic conj-chronic blepharitis-CL wear-superior limbic keratoconj-floppy eyelid syndrome.
Giant fornix syndrome
S.aureus
C.trachomatis serotipler
A-B-C: trachoma
D—K: other grnital, other systemic and ocular disease
Adenovirus serovars
PCF: 3-4-7
EKC: 8-19-37
Vernal keratoconjunctivitis lesions
Horner Trantas dots: transient limbal apically located white cellular collections.
Pseudogerontoxon: paralimbal band of superficial scarring resembling arcus senilis.
Acute haemmorrhagic conjunctivitis
Enterovirus
Coxsackievirus
Arlt line
Cicatricial trachoma
Broad confluent conjunctival scars
Horner Trantas dots
Vernal keratoconjunctivitis
Transient apically located white cellular collections
Pseudogerontoxon
Vernal keratoconjunctivitis
Paralimbal band of superficial scarring resembling arcus senilis
Dry eye investigation
BUT <10s is suspicious
Schirmer (after 5min):
- with anaesthesia: <10mm is abnormal
- without anaesthesia: <6mm is abnormal
Hertoghe sign
Atopic keratoconjunctivitis
Absence of the lateral portion of the eyebrows
Dennie-Morgan folds
Atopic keratoconjunctivitis
Lid skin folds caused by persistant rubbing
Cornea dimensions
Diameter: 11.5 mm vertical-12 mm horizontal
Thickness: 540 〽️m
Cell density: 3000 cells/mm2
Infectious scleritis-the most common cause
Herpes Zoster
Blue sclera
ROHEM:
Russell-Silver syndrome Osteogenesis imperfecta Hallermann-Streiff-François syndrome Ehler-Danlos type 6 Marshall-Smith syndrome
Bacteria- able to penetrate a healthy corneal epithelium
CeHeNNem:
C.diphteriae
H.influenza
N.gonorrhae
N.meningitidis
Peripheral ulcerative keratitis PUK
RA-most common Wegener PAN Relapsing polychondritis SLE
Yes scleritis-distinguishing from Mooren ulcer
No clear zone btw the ulcer and the limbus-distinguishing from marginal keratitis and Terrien marginal degeneration
Fortified antibiotics shelf life
Cephalosporins=Fortum: 4 days (refrigerated), unless 24 hours
Gentamicin: 14 days (refrigerated)
Wessely immune ring
Disciform keratitis (HSV)
Hutchinson sign
Herpes Zoster-involvement of the skin supplied by the external nasal nerve
SSSyphilis-ocular features
Salt and pepper pigmentary retinopathy
Salmon patch
Argyll-Robertson pupils
Acanthamoeba keratitis
Pain disproportionate to clinical signs
Perineural infiltrates-pathognomonic
Ring abcess
Furrow degeneration
Mild peripheral corneal thinning in the elderly, usually benign
Mooren ulcer
Autoimmune
Progressive circumferential peripheral stromal ulceration with later central spread
An undermined and infiltrated leading edge is characteristic
No scleritis-distinguishing from PUK
No clear zone btw the ulcer and the limbus-distinguishing from marginal keratitis and Terrien marginal degeneration
No clear zone
Mooren ulcer
PUK
Macular corneal dystrophy
Yes clear zone
Marginal keratitis Terrien Arcus senilis Vogt limbal girdle Band keratopathy
Infectious crystalline keratopathy
Streptococcus viridans
Bitot spots
Xerophthalmia
Keratoconus
Oil droplet red reflex Scissoring reflex in retinoscopy Vogt striae=deep stromal stress lines Fleisher ring=epithelial iron deposits Munson sign=bulging of the lower lid on downgaze
Epithelial dystrophies
Cogan Meesmann Lish Subepithelial mucinous Gelatinous drop-like
Bowman/anterior stromal dystrophies
Reis-Bucklers
Thiel-Behnke
Stromal dystrophies
Lattice Granular Macular Schnyder(crystalline) Francois Fleck Posterior amorphous
Descemet/endothelial dystrophies
Fuchs
Posterior polymorphous
Congenitalhereditary endothelial
Fuchs endothelial dystrophy
Women Mostly sporadic Open angle glaucoma risk Cornea guttata Beaten metal appearance
Microcornea
Diameter <10 mm (>2years) or <9 mm (newborn)
Other dimensions are normal
AD
Microphtalmus vs Nanopthalmus
Micro: short AL, entire eye is small; other features of dysgenesis; systemic abnormalities may be present
Nan: entirely small but structurally normal eye, bilateral
Megalocornea
Diameter >13 mm
Bilateral
LASIK-refractive error correction
Hypermetropia 4D
Astigmatism 5D
Myopia 12D
PRK-refractive error correction
Hypermetropia low-moderate
Astigmatism 3D
Myopia 6D
Cataract in systemic disease
DM
MD(myotonic dystrophy)
AD(atopic dermatitis)
NF
Suprachoroidal hemorrhage risk factors
Advanced age Glaucoma Increased AL Systemic cardiovascular disease Vitreous loss Conversion from phaco to ECCE
Acute postoperative endophthalmitis-risk factors
Posterior capsule rupture Prolonged procedure time Combined procedure Clear corneal sutureless incision Temporal incision Wound leak on the first day Delaying postop topical ab until the day after surgery Topical anesthesia Adnexal disease DM
Acute postoperative endophthalmitis-most common patogen
Staph epidermidis
Acute postoperative endophthalmitis-intravitreal treatment
Ceftazidime 2mg in 0.1 ml➡️gram➖
Vancomycin 2mg in 0.1 ml➡️gram➕
Delayed onset postoperative endophyhalmitis-patogens
P.acnes (low virulans)
Congenital cataract
2/3 bilateral
AD inheritance is the most common etiological factor
Congenital cataract-associated metabolic disorders
Galactosemia
Lowe syndrome
Fabry disease
Mannosidosis
Congenital cataract-treatment
<4 weeks:risk of glaucoma⚠️
Bilateral dense: surgery btw 4-10 weeks
Bilateral partial: may not require surgery
Unilateral dense: urgent❗️<6 weeks (4-6 weeks)
Unilateral partial: observe
Alport syndrome
Posterior polymorphous dystrophy
Anterior lenticonus
Fleck retina
Frosted branch angiitis
CMV retinitis
