Lecture 10: Occular surface inflammation and allergy Flashcards
Review the acute red eye chart
When looking at the sub conjunctiva what are the differences between the papilla and follicles?
Papillae:
- Sign of chronic inflammation
- Allergy
- Cobblestones
Follicular
- Acute inflammation
- Viral, chlamydia
- Pale lesions
- Surrounding injected
Whats this?
Conjunctival papillae
Whats this?
Conjunctival follicles
What are the levels of acute to chronic allergic conjunctivitis?
- Acute hayfever conjunctivitis
- Seasonal allergic conjunctivitis
- Perennial allergic conjunctivitis
- Vernal keratoconjunctivitis
- Atopic keratoconjunctivitis
Whats this and what causes it?
Corneal shield ulcer
- Persistent Epithelial defect
- Physical trauma from papillae, rubbing
- Chemical trauma from inflammatory
mediators - Mucous plaque formation
Whats this?
Atopic kertaoconjunctivitis
What are the therapeutic options for mild allergy conjunctivitis?
- Avoidance of allergens and rubbing
- Cold compresses
- Topical antihistamines: rapid onset
- Systemic antihistamines: slower onset
- Mast cell stabilisers: preventative use
- Topical NSAIDs: Acular has some effect
- Dual action agents: best current therapy e.g. Patanol
What are the treatment options for vision threatening allergic conjunctivitis?
- Topical corticosteroids
o Introduce at high frequency, tail off rapidly - Topical cyclosporine 2% ointment
- Systemic immunosuppression
- Surgery:
o Excision of papillae
o Superficial keratectomy
Whats this?
Marginal keratitis:
hypersensitivity reaction
to staph. toxins
Whats this?
Adenovirus kertaoconjunctivitis
Whats this?
Adenovirus kertaoconjunctivitis with
Pseudomembranous conjunctivitis
Whats this?
Adenovirus keratoconjuntivitis with Corneal subepithelial infiltrates
Whats this?
Herpes simplex
blepharo-conjunctivitis
50% develop
keratitis
