Gradual loss of vision

Question 1

What is trachoma?

Answer 1

Non-purulent follicular chlamydial conjunctivitis

Third world disease

Question 2

How does trachoma cause loss of vision?

Answer 2

Follicles grow on lids
Conjunctival scarring causes inversion of eyelids, trichiasis and dry eye
These cause progressive corneal scarring and opacity
(new blood vessels also form)

Question 3

SAFE mnemonic for treatment of trachoma?

Answer 3

Surgery for trichiasis
Abx
Facial cleanliness
Environment improvement

Question 4

What is trichiasis?

Answer 4

Eyelashes growing towards the cornea

Question 5

What is onchocerciasis?

Answer 5

‘River blindness’
African endemic caused by black fly infestation
Incubation is 1 year

Question 6

Signs of onchocerciasis:

Answer 6

Lid nodules and depigmentation
Chronic conjunctivitis and punctate keratitis
Corneal opacification
Cataract
Glaucoma
Optic neuritis

Question 7

Treatment of onchocerciasis?

Answer 7

Ivermectin

Question 8

What is Xerophthalmia?

Answer 8

Vit A deficiency so no rhodopsin (photoreceptor)

Immunodeficiency and blindness

Question 9

Ocular complications of xerophthalmia?

Answer 9

Night blindness
Corneal and conjunctival dryness and keratinisation
Corneal ulcers and perforation
Advanced: progressive corneal necrosis

Question 10

Treatment of xerophthalmia:

Answer 10

Oral vitamin A
Ocular lubrication
Abx for infective keratitis

Question 11

Causes of gradual loss of vision:

Answer 11

AMD
Cataract
Primary open-angle glaucoma
Trachoma
Onchoceriasis
Xerophthalmia