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Eye Disease > Disorders of the Conjunctiva > Flashcards

Disorders of the Conjunctiva Flashcards

1
Q

conjunctival disorders

A
  • infections
  • allergic/inflammatory disorders
  • subconjunctival haemorrhage
  • degenerations
  • muco-cutaneous disorders
  • pigmented and non pigmented lesions
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2
Q

different infections

A
  • bacterial conjunctivitis
  • viral conjucntivitis
  • chlamydial conjucntivitis
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3
Q

bacterial conjunctivitis general points

A
  • 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)
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4
Q

list the 4 symptoms of bacterial conjunctivitis

A
  • grittiness
  • burning
  • eyelids stuck together in morning
  • blurred vision - no permanent/lasting effects on va
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5
Q

list the 6 signs of bacterial conjunctivitis

A
  • 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
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6
Q

bacterial conjucntivitis management

A
  • 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
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7
Q

viral conjunctivitis aetiology

A
  • 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
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8
Q

list the 5 symptoms of viral conjunctivitis

A
  • epiphora
  • dicomfort
  • photophobia
  • reduced acuity (with corneal involvement)
  • bilateral in 60%
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9
Q

list the 8 signs of viral conjunctivitis

A
  • 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
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10
Q

viral conjunctivitis management

A
  • 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
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11
Q

chlamydial conjunctivitis

A
  • sexually transmitted disease
  • caused by chlamydia thracomatis
  • px usually young with concomitant genital infection
  • follicular conjunctivitis with mucopurulent discharge
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12
Q

classification of allergic eye disease

A
  • acute allergic conj (aac)
  • seasonal (hay fever) allergic conj (sac)
  • perennial allergic conj (pac)
  • giant papillary conj (gpc)
  • contact allergic conj
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13
Q

seasonal/perennial allergic conjunctivitis aetiology

A
  • type 1
  • seasonal: seasonal allergens
  • perennial: allergens such as house dust mite, symptoms throughout the year
  • predisposing factor is family history
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14
Q

list the 2 symptoms of seasonal/allergic conj

A
  • itching

- epiphora

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15
Q

list the 5 signs of seasonal/perennial allergic conj

A
  • hyperaemia
  • chemosis
  • lid oedema
  • diffuse papillary reaction
  • no corneal involvement
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16
Q

management of seasonal/perennial allergic conj

A
  • allergen avoidance
  • cool compresses
  • mast cell stabiliser eg sodium cromoglicate
  • topical or systemic anthistamines
17
Q

subconjunctival haemorrhage

A
  • 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
18
Q

what is pterygium (degeneration)

A

= 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
19
Q

what is pinguecula

A

= a benign yellow-white conj lesion

-generally doesnt affect vision and usually does not require treatment

20
Q

name 2 muco cutaneous disorders

A
  • cicatricial pemphigoid

- stevens-johnson syndrom

Eye Disease (4 decks)

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