Eyes- Conjunctiva & Cornea Flashcards
what is acute conjunctivitis? cause? predisposing factors? vision change?
- pink eye
- allergic, viral, bacterial
- predisposed by: irritation from wind, dust, smoke, air pollution, common cold, corneal irritation, reflection from snow
- no change unless cloudy exudate
Ssxs of acute conjunctivitis?
usu bilaterally superficial dilated vessels (conjunctival injection)
PE findings of acute conjunctivitis?
-normal intraocular pressure, PERRLA, normal vision
what are the 3 forms of acute conjunctivitis?
- allergic
- viral
- bacterial
what is acute allergic conjunctivitis? SSxs? PE findings?
- vernal conjunctiviti
- spring through summer
- sudden mild to moderate bilateral severe swelling of conjunctiva and lids
- conjunctiva pale but easily visible blood vessels
- not painful
- clear watery discharge typical
PE findings for acute allergic conjunctivitis?
- preauricular adenopathy absent
- chemosis common
- discharge usu sparse, usu clear, thin, stringy
- moderate conjunctival injection
what is chronic allergic conjunctivitis?
- non-seasonal
- no inflammation, but itching, burning & photophobia possibly
- eyelid eversion may show velvety projections on palpebral conjunctiva
- *may be diagnosed as dry eye syndrome**
what is giant papillary conjunctivitis due to? cause physiologically?
- allergy to soft contact lenses
- slow to develop
- autoimmune response to pts own proteins or trauma or lens wear
SSxs of giant papillary conjunctivitis?
-excessive pruritis, mucus production, increased intolerance to contact use
PE findings for giant papillary conjunctivitis?
- inflamed conjunctiva
- red, itchy, irritated
- thick d/c possibly, worse in morning
- eyelid eversion shows giant papillae usu on upper palpebral conjunctiva (cobblestone granulations)
what causes viral conjunctivitis?
- adenovirus
- lasts 1-2 wks
SSxs of viral conjunctivitis?
- pruritus, minimal pain, clear, thin, watery d/c
- occasionally severe photophobia & foreign-body sensation occurs
PE findings of viral conjunctivitis?
- pre-auricular adenopathy common in epidemic keratoconjunctivitis and herpes
- chemosis variable
- d/c moderate or sparse, thin & seropurulent
- conjunctival injection moderate to marked
- concomitants: sore throat, nasal d/c
how does herpes simplex virus conjunctivitis present?
- affects only 1 eye usu
- most often occurs on cornea= herpes keratitis
- recurrence appears as dendritic keratitis= characteristic raised lesion of cornea “veins of a leaf”
SSxs of herpes simplex virus conjunctivitis?
- early: foreign body sensation, photophobia, lacrimation, conjunctival injection
- late: anesthesia of cornea and dendritic keratitis lesion diagnositc, ulceration & permanent scarring of cornea (vision loss)
triggers of HSV conjunctivitis?
-fever, stress, sunlight, trauma, associated w/oral and genital herpes, immunocompromised pts, migratory zosters infxn
what causes bacterial conjunctivitis?
-staph & strep
SSxs of bac conjunctivitis?
- acute onset
- minimal pain
- occasional pruritus
PE findings of bac conjunctivitis?
- preauricular adenopathy
- chemosis common
- copious thick & purulent d/c
- conjunctival injection marked to moderate
- chronic may produce little to no d/c except for crusting of eyelashes in AM
how does bac conjunctivitis from n.gonorrhea present in adults? in neonates?
- adults: rare, 12-48 incubation, severe, purulent d/c usu unilateral, lids swollen, can result in corneal ulceration, abscess, blindness
- neonate: purulent d/c, 2-5 d after birth, severe lid edema possibly
what are the two forms of c. trachomatis conjunctivitis?
- adult inclusion conjunctivitis: swimming pool conjunctivitis, sharing eye make-up, d/c scant, seropurulent, conjunctival injection moderate
- neonatal inclusion conjunctivitis: from exposure to cervix, 5-14 d incubation, sx mild to severe, chemosis, mucopurulent d/c, bilateral, no corneal damage
what is trachoma (granular) conjunctivitis?
- chronic infxn of cornea & conj by chlamydia endemic in africa, asia, middle east, etc
- most common in preschool
SSxs of trachoma conjunctivitis?
- often asx
- incubation 7 d, most contagious in early stages
- usu bilateral mucopurulent keratoconjunctivitis
- conj congestion, eyelid edema, photophobia, lacrimation, pain
- 7 to 10 d follicles develop in upper lid, gray-yellow granules
PE findings of trachoma conjunctivitis?
- conjunctival surface of upper eyelid shows follicular/inflammatory response
- cornea may have limbal follicles, sueprior neovascularization & punctat keratitis
- concurrently occurs in nasopharynx
