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CPD > Eyes- Conjunctiva & Cornea > Flashcards

Eyes- Conjunctiva & Cornea Flashcards

1
Q

what is acute conjunctivitis? cause? predisposing factors? vision change?

A
  • 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
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2
Q

Ssxs of acute conjunctivitis?

A

usu bilaterally superficial dilated vessels (conjunctival injection)

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3
Q

PE findings of acute conjunctivitis?

A

-normal intraocular pressure, PERRLA, normal vision

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4
Q

what are the 3 forms of acute conjunctivitis?

A
  • allergic
  • viral
  • bacterial
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5
Q

what is acute allergic conjunctivitis? SSxs? PE findings?

A
  • 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
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6
Q

PE findings for acute allergic conjunctivitis?

A
  • preauricular adenopathy absent
  • chemosis common
  • discharge usu sparse, usu clear, thin, stringy
  • moderate conjunctival injection
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7
Q

what is chronic allergic conjunctivitis?

A
  • 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**
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8
Q

what is giant papillary conjunctivitis due to? cause physiologically?

A
  • allergy to soft contact lenses
  • slow to develop
  • autoimmune response to pts own proteins or trauma or lens wear
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9
Q

SSxs of giant papillary conjunctivitis?

A

-excessive pruritis, mucus production, increased intolerance to contact use

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10
Q

PE findings for giant papillary conjunctivitis?

A
  • inflamed conjunctiva
  • red, itchy, irritated
  • thick d/c possibly, worse in morning
  • eyelid eversion shows giant papillae usu on upper palpebral conjunctiva (cobblestone granulations)
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11
Q

what causes viral conjunctivitis?

A
  • adenovirus

- lasts 1-2 wks

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12
Q

SSxs of viral conjunctivitis?

A
  • pruritus, minimal pain, clear, thin, watery d/c

- occasionally severe photophobia & foreign-body sensation occurs

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13
Q

PE findings of viral conjunctivitis?

A
  • 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
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14
Q

how does herpes simplex virus conjunctivitis present?

A
  • 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”
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15
Q

SSxs of herpes simplex virus conjunctivitis?

A
  • early: foreign body sensation, photophobia, lacrimation, conjunctival injection
  • late: anesthesia of cornea and dendritic keratitis lesion diagnositc, ulceration & permanent scarring of cornea (vision loss)
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16
Q

triggers of HSV conjunctivitis?

A

-fever, stress, sunlight, trauma, associated w/oral and genital herpes, immunocompromised pts, migratory zosters infxn

17
Q

what causes bacterial conjunctivitis?

A

-staph & strep

18
Q

SSxs of bac conjunctivitis?

A
  • acute onset
  • minimal pain
  • occasional pruritus
19
Q

PE findings of bac conjunctivitis?

A
  • 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
20
Q

how does bac conjunctivitis from n.gonorrhea present in adults? in neonates?

A
  • 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
21
Q

what are the two forms of c. trachomatis conjunctivitis?

A
  • 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
22
Q

what is trachoma (granular) conjunctivitis?

A
  • chronic infxn of cornea & conj by chlamydia endemic in africa, asia, middle east, etc
  • most common in preschool
23
Q

SSxs of trachoma conjunctivitis?

A
  • 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
24
Q

PE findings of trachoma conjunctivitis?

A
  • conjunctival surface of upper eyelid shows follicular/inflammatory response
  • cornea may have limbal follicles, sueprior neovascularization & punctat keratitis
  • concurrently occurs in nasopharynx
25
Q

what is a pinguecula?

A
  • harmless slightly raised bumps (fatty deposits) under conjunctiva
  • no tendency to grow onto cornea
  • may become red and inflamed
26
Q

what is a pterygium?

A
  • conjunctival thickening from chronic inflammation from wind, dush
  • often distinct triangular lesions which may grow over cornea & affect vision
27
Q

what are SSxs of corneal trauma? PE findings?

A
  • SSxs: pain, photophobia, blepharospasm, may be blurred vision
  • PE: evert eyelid to inspect for foreign body, check cornea for foreign body and hemorrhage, fluroescein stain picked up by blue lens, check PERRLA
28
Q

what are causes of a corneal ulcer?

A
  • HSV (most common)
  • traumatic corneal injury
  • varicella-zoster virus
  • contact lenses
  • chronic topical steroid use
  • bacterial infxns: staph spp., pseudomonas, strep pneu, moraxella
29
Q

what are SSxs of a corneal ulcer?

A
  • erythema of lids & conj
  • foreign body sensation
  • photophobia
  • mucopurulent d/c
  • blurred vision
  • pain
30
Q

what is band keratopathy?

A
  • hard, white calcified plaques at 2, 5, 7, 10 o’clock of limbus
  • may be hypercalcemia secondary to kidney dz
31
Q

what is arcus senilis?

A
  • whitish deposits around limbus usu in elderly

- may be related to hyperlipoproteinemia

32
Q

what causes UV keratitis?

A

-exposure to UV lights, welding arcs, snow blindness

33
Q

SSxs of UV keratitis? PE findings?

A
  • onset of foreign body sensation, irritation, pain, photophobia, tearing, blepharospasm, decreased visual acuity 6-12 hrs after exposure
  • lid edema, conjunctival hyperemia variable

CPD (7 decks)

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