Disorders of the Conjunctiva Flashcards
conjunctival disorders
- infections
- allergic/inflammatory disorders
- subconjunctival haemorrhage
- degenerations
- muco-cutaneous disorders
- pigmented and non pigmented lesions
different infections
- bacterial conjunctivitis
- viral conjucntivitis
- chlamydial conjucntivitis
bacterial conjunctivitis general points
- can occur at any age but occurs most freq in kids
- predisposition in px taking topical/systemic steroids, or immunocompromised patients and px with poor gen health
- usually bilateral (one eye may precede the other)
list the 4 symptoms of bacterial conjunctivitis
- grittiness
- burning
- eyelids stuck together in morning
- blurred vision - no permanent/lasting effects on va
list the 6 signs of bacterial conjunctivitis
- purulent or mucopurulent discharge
- conjunctival hyperaemia maximal at the fornicles
- lid crusting
- mild papillary reaction
- usually no corneal involvement
- usually no pre auricular lymphadenopathy (swollen lymph nodes in front of the ears)
- in viral conj nodes near ears are usually raised
bacterial conjucntivitis management
- antibiotic drops - chloramphenicol or fusidic acid
- self limiting condition: consider no treatment or delayed treatment
- advise as to the contagious nature of the condition
- refer if condition does not respond to treatment within 5-7 days or if condition worsens
viral conjunctivitis aetiology
- adenovirus most common cause (also causes cold and flu)
- adenoviruses cause 2 ocular syndromes: pharyngoconjunctival fever (PCF) and epidemic keratoconjunctivitis (EKC)
- caused by airbourne respiratory droplets or direct transfer of ocular secretions
list the 5 symptoms of viral conjunctivitis
- epiphora
- dicomfort
- photophobia
- reduced acuity (with corneal involvement)
- bilateral in 60%
list the 8 signs of viral conjunctivitis
- conjunctival injection
- swollen lids
- serous discharge
- conjunctival follicles (raised bumps)
- pre auricular lymphadenopathy
- pseudomembrane
- keratitis (more common in EKC (80%)
- epithelial lesions with or without subepithelial infiltrate
viral conjunctivitis management
- self limiting 1-3 weeks
- artificial tears may improve comfort
- antibiotics in children due to difficult in distinguishing between bac and viral conj
- refer if sig corneal involvement
- warn of highly contagious nature of condition
chlamydial conjunctivitis
- sexually transmitted disease
- caused by chlamydia thracomatis
- px usually young with concomitant genital infection
- follicular conjunctivitis with mucopurulent discharge
classification of allergic eye disease
- acute allergic conj (aac)
- seasonal (hay fever) allergic conj (sac)
- perennial allergic conj (pac)
- giant papillary conj (gpc)
- contact allergic conj
seasonal/perennial allergic conjunctivitis aetiology
- type 1
- seasonal: seasonal allergens
- perennial: allergens such as house dust mite, symptoms throughout the year
- predisposing factor is family history
list the 2 symptoms of seasonal/allergic conj
- itching
- epiphora
list the 5 signs of seasonal/perennial allergic conj
- hyperaemia
- chemosis
- lid oedema
- diffuse papillary reaction
- no corneal involvement
management of seasonal/perennial allergic conj
- allergen avoidance
- cool compresses
- mast cell stabiliser eg sodium cromoglicate
- topical or systemic anthistamines
subconjunctival haemorrhage
- presents as a bright red patch under the conj caused by a rupture of a small conj vessel
- may arise spontaneously, following slight trauma, or as a result of raised central venous pressure due to ocughing or sneezing
- condition is usually unilateral
- can usually see posterior border (excludes intracranial source)
- recurrent or bilateral haemorrhages suggests htn ot coagulation disorder (px may be taking an anticoagulant eg warfarin - have to have levels checked every week)
- consider gp referral
- typically resolves in 5-10 days
- usually no treatment required
what is pterygium (degeneration)
= an elevated, superficial, external ocular mass that usuallly forms over the perilimbal conj and extends onto corneal surface
- risk factors include increased exposure to uv light
- managament: lubricants, surgical excision
what is pinguecula
= a benign yellow-white conj lesion
-generally doesnt affect vision and usually does not require treatment
name 2 muco cutaneous disorders
- cicatricial pemphigoid
- stevens-johnson syndrom
