Disorders of the Conjunctiva & Sclera

Question 1

What is the bulbar conjunctiva?

Answer 1

• conjunctiva on surface of eye

Question 2

What is the palpebral conjunctiva?

Answer 2

• conjunctiva on surface of eyelid

Question 3

What is the medical terminology for ‘pink eye’?

Answer 3

• viral conjunctivitis

Question 4

viral conjunctivitis (symptoms)

Answer 4

• acute onset
• redness
• watery d/c
• soreness
• general ocular discomfort

Question 5

viral conjunctivitis (signs)

Answer 5

• diffuse injection of conjunctiva
• erythema and edema of lids
• follicles on palpebral conjunctiva
• pre-auricular lymphadenopathy

Question 6

viral conjunctivitis (etiology)

Answer 6

• adenovirus

Question 7

viral conjunctivitis (tx)

Answer 7

• self-limiting
• cold compress
• pt education: HIGHLY CONTAGIOUS

Question 8

How are bacterial and viral conjunctivitis ddx’d?

Answer 8

• bacterial has pus, viral has watery discharge

- viral will have pre-auricular adenopathy, viral will not

Question 9

bacterial conjunctivitis (symptoms)

Answer 9

• red
• irritation
• adhesion of lids, worse in am

Question 10

bacterial conjunctivitis (signs)

Answer 10

• mucopurulent exudate in fornix and lid margins

Question 11

bacterial conjunctivitis (etiology)

Answer 11

• bacteria (i.e. staph, haemophilus, strep)

Question 12

bacterial conjunctivitis (workup)

Answer 12

• gram stain

- culture if ? Neisseria

Question 13

bacterial conjunctivitis (tx)

Answer 13

• broad spec abx drops

Question 14

Define keratoconjunctivitis sicca

Answer 14

• no tear production or excessive production of poor quality tears

Question 15

keratoconjunctivitis sicca (symptoms)

Answer 15

• FB sensation
• dry eye
• irritation
• symptoms worsen as day progresses

Question 16

keratoconjunctivitis sicca (signs)

Answer 16

• mild erythema
• bilateral
• excessive mucus
• punctate staining of cornea w/ fluorescein dye

Question 17

keratoconjunctivitis sicca (risk factors)

Answer 17

• contact wearers
• collagen diseases
• sarcoidosis
• anticholinergic property drugs

Question 18

keratoconjunctivitis sicca (workup)

Answer 18

• Schirmer test

Question 19

Describe Schirmier test

Answer 19

• time it takes for tears to diffuse up the test paper dipped into the eye

Question 20

keratoconjunctivitis sicca (tx)

Answer 20

• artificial tears (i.e. Restasis)

Question 21

Describe pinguecula

Answer 21

• elevated fleshy conjunctival mass

- mostly found on medial conjunctiva

Question 22

pinguecula (symptoms)

Answer 22

• asymptomatic

Question 23

pinguecula (signs)

Answer 23

• yellow to light brown fleshy mass on sclera, adjacent to cornea

Question 24

pinguecula (etiology)

Answer 24

• chronic exposure to dry windy conditions

Question 25

pinguecula (tx)

Answer 25

• none necessary

- if any, it will be cosmetic

Question 26

What is the episclera?

Answer 26

• fascial sheet that encases the eye

Question 27

Define episcleritis

Answer 27

• inflammation of the episclera

Question 28

What is the most common primary tumor of the eye?

Answer 28

• melanoma

Question 29

melanoma of the eye (S&S)

Answer 29

• asymptomatic

- discoloration over cornea or iris

Question 30

Why is a workup of suspected eye melanoma needed?

Answer 30

• r/o metastasis

Question 31

eye melanoma tx

Answer 31

• resection v. enucleation
• radiation
• refer