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Ophthalmo > cornea (keratitis) > Flashcards

cornea (keratitis) Flashcards

1
Q

Predisposing factors of fungal Keratitis

A

Trauma with object of plant source (organic matter)
More common in urban / agriculture
Immunocompromised patient

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2
Q

about the fungal keratitis:

what is the Causetive organisms:

A
  1. Aspergillus (most common)
  2. Candida
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3
Q

In case of fungal infection,
Patients come with:

A

Pain
Lacrimation
Photophobia
Red eye

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4
Q

about the fungal keratitis:

Signs that you can discover

A

Signs of inflammation
Blepharospasm
Corneal opacity
Cicrumcorneal injection
Hypopyon

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5
Q

the Prognosis of fungal keratitis

A

Bad

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6
Q

How to dx the fungal keratitis:

A

Hx of plant trauma comes with pain and photophobia
Culture: Corneal scraping

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7
Q

Treatment of fungal keratitis

A

Hospital addmision
Topical natamycin
Systemic Amphotericin B
Therapeutic Keratoplasty
Steroid is Contraindicated

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8
Q

about parasitic Keratitis:

Caustive organism

A

Acanthamoeba
normally lives in tap water

So you can expect risk factors and medical history.

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9
Q

about parasitic Keratitis:

Predisposing factors

A

Contact lens wear with bad cleaning : using of tap water

Exposure to contaminated water or soil : in non-contact lens users

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10
Q

about parasitic Keratitis:

Symptoms:

A

Severe Pain disproportionate with clinical findings
Photophobia
Lacrimation
Red eye

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11
Q

about parasitic Keratitis:

Signs:

A

Blepharospasm
Circumcorneal injection
Conreal opacity
Epithelial Pseudodendrites
Ring corneal infiltrate
Radial keratoneuritis

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12
Q

How to diagnose the parasetic keratitis:

A
  1. Hx of exposure to contaminated water
  2. comes with severe pain disproportionate with clinical finding
    corneal scarping and culture
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13
Q

Prognosis of parasetic keratitis

A

Bad

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14
Q

How to manage parasetic keratitis:

A

Hospital admission
Debridement
Topical Polyhexamethylenebiguanide(PHMB)
Topical Brolene
Topical steroid : low dose may be useful for persistent inflammation
Therapeutic keratoplasty

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15
Q

viral keratitis

Types

A

Herpes simplex keratitis
Herpes zoster ophthalmicus

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16
Q

viral keratitis

Which one cause Dendritic ulcer

A

HSV

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17
Q

viral keratitis

Which one precedes neuralgia

A

Varicella (primary infection)

18
Q

viral keratitis

Which one is always comes unilateral (Doesn’t cross midline of the face)

A

VZV
NB: HSV comes bilateral in some cases

19
Q

Predisposing factors of Viral keratitis

A

Fevere
Overexposure to UV light
Trauma
Stress
Menstruation
Immunosuppression

20
Q

Which one follow distribution of nerve (easy)

A

HZV

21
Q

Ocular manifestations of HZ keratitis

A

Multiple vesicles on skin
Conjunctivitis
Scleritis and episcleritis
Keratitis
uvitis lead to Glaucoma & iris atrophy
Optic neuritis
Retinal necrosis & Detachment
Cranial nerve palsy

22
Q

Cranial nerve palsy that result from VZV infection can lead to:

A

3rd: paralytic squint, Ptosis
4th, 6th: paralytiv squint
7th: Ectropion & lagophthalmos

23
Q

Ocular manifestations of HSV infection

A

Vesicle on the eyelid
(BlepharoConjunctivitis)
Keratitis
Superficial punctuate keratits
Dendritic ulcer
Uveitis
Discform ulcer
Geographic ulcer

24
Q

Which type of HSV cause Dendritic ulcer:

A

Type 1

Type 2 cause genital ulcer (Herpes genetalis)

25
Q

Primary HSV infection causes:

A

Vesicles on eyelid (BlepharoConjunctivitis)
Stomatitis
Gengivitis

No Dendritic ulcer in 1ry infection

26
Q

After primary infection
HSV become dormant in:

A

Trigeminal ganglia

27
Q

Factors that cause reactivation of HSV infection

A

Influenza
Inflammation
Stress from the opthalmology exam (keep calm)

28
Q

What do you think about treating viral corneal ulcer with steroids?

A

Contraindicationed, What kind of idiot would do that?

It will turn into geographic ulcer

You can do topically for skin
Or in case of disciform ulcer

29
Q

BTW, what is dendritic ulcer?

A

type of corneal ulcer characterized by feather-like or tree-like patterns on the surface of the cornea
Cuased by HSV

30
Q

Dendritic ulcer comes with

A

superfacial branching ulcer
No perforation
No vascularizarion
Hypesthesia of cornea
Terminal bulb

31
Q

Which virus cause permanent scar?

A

VZV

32
Q

Treatment of viral keratitis:

A

Acyclovir ointment (zovirax)
5 times/day for (7-10days)
Or systemic Acyclovir

Cycloplegic ED for pain
Tear substitute to promotes epithelialisation
Antibiotics to prevent 2ry infection

33
Q

Discifrom keratitis cause by

A

Virus immune-mediated reaction
Antibody-Antigen reaction

NB: The only indication for steroids

34
Q

Ocular involvement is usually associated with eruption of vesicles on the skin of tip of nose (Nasociliaru branch) during attack of herpes zoster:

A

Hutchinson’s signs

35
Q

Corneal ulceration which occur in lagophthalmos:

A

Exposure keratitis
Keratitis with lagophthalmos

36
Q

Clinical picture of exposure keratitis

A

Ulceration invelve the lower 1/3 of cornea which is exposed during night as eye rolls up (bell’s phenomenonL

37
Q

Treatment of exposure keratitis

A

Treat underlying cause (the cause of lagophthalmos)
In mild cases: artificial tear+ antibiotics
In severe cases: lateral tarsorrhaphy

38
Q

Corneal ulceration due to loss of corneal sensation

A

Neuroparalytic keratitis

39
Q

Causes of neuroparalytic keratitis

A

Trigeminal nerve dysfunction due to:
Trauma
Tumor
Surgery
Inflammation
HSV, HZV
DM
Leprosy

40
Q

Clinical feature of neuroparalytic keratitis:

A

No corneal sensation, even severe keratitis may produce little discomfort
Reduced vision

41
Q

Treatment of neuroparalytic keratitis

A

Treatment underlying cause
Keep the eye closed by median Tarsorrhaphy or by ptosis induced with botulinum toxin

Ophthalmo (48 decks)

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