Lecture VI Flashcards
What is the usual incubation period for viral conjunctivitis?
5-12 days
What are s/sx of viral conjunctivitis?
Watery d/c irritations, and hyperemia
Palpable preauricular LAD
When should viral conjunctivitis be referred? (2)
Pain or Decreased VA
How is viral conjunctivitis transmitted?
Fomites and droplets to the eye
How long can viruses live for on fomites with viral conjunctivitis?
a week
What is the usual cause of viral conjunctivitis?
Adenovirus
Conjunctivitis traveling from one eye to the other indicates what etiology?
Viral
What is the symptomatic treatment for viral conjunctivitis?
- antihistamines
- cool compresses
What is the complication that can occur with steroids in treating viral conjunctivitis?
Recurrence and cushing problems
What is the topical treatment for viral conjunctivitis?
Povidone iodine
What is zirgan?
Ocular ganciclovir for HSV
What are the s/sx of herpes simplex eye disease? (3)
- Vesicles on skin or eyelid margin
- Epithelial keratitis
- Preauricular LAD
What is the role of oral antivirals with HSV blepharoconjunctivitis?
Speed resolution, but is self limited
What are the s/sx of bacterial conjunctivitis?
- Bilateral mucopurulent d/c
- Lid crusting
Should you culture bacterial conjunctivitis?
no–will not change treatment or alter outcomes the vast majority of the time
What is the treatment for bacterial conjunctivitis? (3)
- Topical abx QID
- Cleansing
- Warm moist compresses
What are the ab that should be used to bacterial conjunctivitis?
-Aminoglycosides (tobramycin/neomycin)
What are the causes of neonatal conjunctivitis? (3)
- Gonorrhea
- Chlamydia
- HSV
What is the definition of neonatal conjunctivitis?
Conjunctivitis in a neonate (less than 1 month)
What is the only conjunctivitis that should be cultured?
Neonatal conjunctivitis
Any contact lens wearer who develops ocular symptoms probably has what, cause by what?
Corneal ulcer caused by pseudomonas
What is the leading infectious cause of blindness in the US?
HSV eye disease
What type of infection usually occurs with the primary, and secondary episodes of herpetic conjunctivitis?
Primary = unilateral blepharoconjunctivitis
Secondary= bilateral above,or epithelial keratitis
What is the fluorescence pattern that is seen with HSV infections?
branching with terminal end bulbs
Why should you avoid topical steroids with herpes keratitis?
- Elevates intraocular pressure
- Causes cataracts
- May potentiate fungal corneal ulcers
What is the treatment for HSV conjunctivitis?
Trifluorothymidine or ganciclovir
What can cause conjunctival hemorrhage?
Coughing, sneezing, valsalva
What is the treatment for conjunctival hemorrhage?
Nothing
What are pinguecula?
a common type of conjunctival degeneration in the eye., usually caused by UV light and wind exposure
How do you manage pinguecula? (3)
- Artificial tears
- Topic vasoconstrictors if inflamed
- Sunglasses
What is episcleritis?
Inflammation of the sclera, usually causing raised, hyperemic lesions
Why is there pain with EOM with episcleritis?
Inflammation over the area of insertion of the EOMs
Pouching of the uveal tract = ?
Scleritis 2/2 RA
What is iritis?
Circumcorneal injection, usually 2/2 trauma
What is the classic s/sx of iritis?
Photophobia
What are the signs of iritis?
- White cells in anterior chamber
- Hypopyon
- Keratic precipitates
How do you treat uveitis?
Topic steroids
When are topical anesthetics prescribed with uveitis?
NEVER–inhibit the growth of the epithelium
What happens to the cornea with viral conjunctivitis that causes decreased visual acuity? What is the treatment for this?
Antibody deposits in the cornea
Steroids, but these have their own problems
What are the common bacterial causes of bacterial conjunctivitis?
- Staph
- Strep
- Haemophilus
- Pseudomonas
Branching pattern with terminal bulbs on fluorescence = ?
HSV infections
What is endophthalmitis?
an inflammation of the internal coats of the eye. It is a possible complication of all intraocular surgeries, particularly cataract surgery, with possible loss of vision and the eye itself. Infectious etiology is the most common and various bacteria and fungi have been isolated as the cause of the endophthalmitis. Other causes include penetrating trauma and retained intraocular foreign bodies.
What are the three indications for pterygium?
- interferes with vision
- Causes astigmatism
- Cosmetic reasons
What is episcleritis associated with?
Autoimmune inflammation
What is Hypopyon?
Inflammatory cells in the anterior chamber of the eye.
It is a sign of inflammation of the anterior uvea and iris, i.e. iritis, which is a form of anterior uveitis.
What are the fundus findings of optic atrophy?
Excessively pale optic disc
What type of imaging should be obtained to evaluate orbital trauma
noncontrast CT
Should you assess VA with eye trauma?
Yes
Why should you not attempt to move a clot from a traumatic eye?
May cause excessive bleeding
What should be done with a severe traumatic eye?
Shield and immediate referral
What is lagophthalmos?
The inability to close the eyelids completely.
A flat anterior chamber indicates what?
Loss of aqueous humor
What happens to the pupil with trauma?
Will point to the trauma
Should a TDaP be given with ocular trauma?
Yes
