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Anterior Segment 2 > Differentials of Red Eyes, Conjunctiva > Flashcards

Differentials of Red Eyes, Conjunctiva Flashcards

1
Q

Caused by direct contact w/ infected secretions

A

Bacterial Conjunctivitis

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2
Q

Caused most commonly by contact w/ respiratory or ocular secretions.. (adenoviruses)

A

Viral Conjunctivitis

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3
Q

Rhinoconjunctivitis is the most common form of this type of conjunctivitis; found in 20% of population

A

Allergic Conjunctivitis

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4
Q

Results from a reaction to an outside agent, typically ocular medication

A

Toxic Conjunctivitis (medicamentosa)

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5
Q

What type of discharge is found with viral conjunctivitis?

A

Watery

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6
Q

What type of discharge is found with bacterial conjunctivitis?

A

Mucous/Muco-purulent

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7
Q

What are the top 6 symptoms of conjunctivitis?

A
  1. lids stuck together
  2. bilateral or unilateral
  3. burning
  4. itching
  5. grittiness
  6. discharge
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8
Q

How long does it take for a bacterial conjunctivitis to resolve on it’s own?

A

5 days, self-limiting condition

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9
Q

What is the hallmark sign of a bacterial conjunctivitis?

A

Acute onset

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10
Q

What type of discharge does a bacterial conjunctivitis present with?

A

Begins as watery then becomes mucopurulent

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11
Q

What are the top 4 bacteria that cause conjunctivitis?

A
  1. H. influenza
  2. S. pneumoniae
  3. S. Aureus
  4. Moraxelis Catarrhalis
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12
Q

What are the top 4 signs of bacterial conj.?

A
  1. Diffuse injection, worse in bulbar
  2. Intense papillary rxn (blood vessels in the center)
  3. Watery than mucopurulent discharge
  4. corneal PEE’s
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13
Q

How do we treat bacterial conjunctivitis? What’s the dosing?

A

Topical antibiotics (gentamicin/polymyxin) OR steroid/antibiotics (tobradex, zylet)…

QID 5x7 days

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14
Q

What is the hallmark sign of viral conj.? Will there be pre-auricular lymphadenopathy?

A

Watering

Yes

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15
Q

Patients w/ viral conjunctivitis will most often report what?

A

Recently had common cold (bc of adenovirus)

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16
Q

What are the top 5 signs of a viral conjunctivitis?

A
  1. Follicles (blood vessel around it)
  2. Conj. hemorrhages
  3. Chemosis
  4. Pseudomembranes
  5. Keratitis
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17
Q

What is the tx for viral conj.?

A

No tx needed.

Can use steroid to stop inflammation and reduce redness

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18
Q

Allergic conjunctivitis will present as an _____,____ _____.

A

Transient, acute attack

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19
Q

What type of discharge is found in allergic. cong? What’s the most significant sign?

A
  • Ropey discharge

- itching is most significant sign

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20
Q

T or F: Seasonal allergies are worse in the spring and summer (hay fever)… Perennial allergies area throughout the year but worse in the autumn.

A

True

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21
Q

What is the tx for allergic conj.?

A

Mast cell stabilizer/antihistamine combo.

Can use steroid in severe cases

22
Q

If dx is GPC, what are the top 3 things that should be done?

A
  1. D/c CL wear
  2. Begin MCS/AH combo (pataday qd)
  3. Maybe steroid qid
23
Q

What are the main offenders of toxic conjunctivitis?

A
  1. Preservatives in glaucoma drops

2. Neomycin + Tobramycin

24
Q

What type of discharge is found in toxic conj?

A

Watery discharge

25
Q

What is the tx for toxic conj.?

A
  1. identify and d/c medication that’s causing it

2. Steroids QID x 7 days (pred forte/durazol)

26
Q

This is an asymptomatic bubble on the bulbar conj. containing clear fluid

A

Retention of Inclusion Cyst

27
Q

Retention/Inclusion Cyst are found in patients with?

A

extreme allergies to something (i.e. shrimp)

28
Q

What is the tx for retention cysts?

A

may be punctured by a needle

29
Q

This is often seen in darker-skinned individuals, results from additional melanin and stabilizes by early adulthood.

A

Epithelial Melanosis

30
Q

Epithelial melanosis is usually benign, but if initially presents around age 30+, we must _____.

A

rule out malignancy

31
Q

This is most commonly seen in the elderly or those with chronic inflammatory conjunctival disease. Presents as small, chalky-yellow deposits just beneath the conj surface.

A

Concretions

32
Q

What is the tx for concretions

A

none necessary, but may be removed with needle or phenyl soaked cotton swab if irritating the patient

33
Q

This is when conjunctival tissue becomes redundant and excessive. Found to be a normal aging change or related to lid margin disease/DES.

A

Conjunctivochalasis

34
Q

What is the tx for conjunctivochalasis?

A
  1. Topical Lubricants
  2. Low Dose Doxy
  3. Surgical Resection
35
Q

Pinguecula/itis can be tx’d with?

A

topical steroids if inflamed or ATs.

36
Q

What’s better for a pinguecula, NSAIDs or Steroids? Why

A

NSAIDs - recurrence of inflammation is less when compared to steroids

37
Q

This is an inflammatory lesion of the conj that generally appears after surgery or minor trauma to conj. Appears as fleshy, fast growing, red, pedunculated vascular mass and bleeds easily.

A

Pyogenic Granuloma

38
Q

What is the tx for a pyogenic granuloma?

A
  1. Steroids
  2. Excision
  3. Cautery
39
Q

This occurs when the bulbar and palpebral conj stick together, preventing the eye from moving freely. Results in ocular motility disorders, diplopia, entropion and inadequate lid closure.

A

Symblepharon

40
Q

What are the top 5 etiologies for a symblepharon?

A
  1. DES
  2. SJ syndrome
  3. Cicatricial Pemphigoid
  4. Chemical Injury
  5. EKC or other conj. infection complicated by scarring
41
Q

What is the tx for a symblepharon?

A

Oculoplastics

42
Q

This is a well-circumscribed, yellow-white solid mass that involves the bulbar conj at the corneoscleral limbus. Dense fibrous tissue lined by conjunctival epithelium and may contain hair follicles and sebaceous glands.

A

Conjunctival Dermoid

43
Q

Where is a conj. dermoid usually found?

A

Inferotemporally w/ fine white hairs noted on SLE

44
Q

What is the tx for a conj. dermoid?

A 
1st = observation
2nd = excision for cosmesis
45
Q

This is metaplasia of the conj epithelium and tangles of keratin mixed w/ gas forming bacteria. This appears as dry, scaly, foamy patches on the bulbar conj, eyes may burn

A

Bitot’s Spot

46
Q

What is the name of the gas forming bacteria in a Bitot’s Spot?

A

Corynebacterium Xerosis

47
Q

This is highly suggestive of Vitamin A deficiency and occasionally chronic conj. inflammation

A

Bitot’s spot

48
Q

What is the tx for Bitot’s Spot?

A

Evaluate for Vit A Deficiency

49
Q

Papillae present with BVs where?

A

In the center

50
Q

Follicles present with BVs where?

A

surround the follicle

51
Q

What is the only drop FDA approved for allergic conjunctivitis use? This is used for GPC

A

Alrex

Anterior Segment 2 (14 decks)

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