Ocular Allergy

Question 1

not normally found in conjunctiva unless you have allergy

Answer 1

eosinophils

Question 2

labs for AR

Answer 2

generally none – diagnosis is clinical

Question 3

a clinical presentation for AR (on the palpebra)

Answer 3

palpebral papillary hypertrophy

Question 4

for relief of itchiness, reduction of swelling, numb pain; cheap

Answer 4

cold compress

Question 5

flooding your eyes to wash away allergen

Answer 5

lubricant

Question 6

more for prophylaxis (use 2 weeks before expected allergy)

Answer 6

mast cell stabilizers

Question 7

for severe reactions

*monitor patient as it can lead to complications like inc intraocular pressure, cataracts, glaucoma

Answer 7

topical corticosteroids

Question 8

severe seasonal inflammation of the superior tarsal conjunctiva thought to be due to an allergic reaction (usually during?)

Answer 8

vernal keratoconjunctivitis

Question 9

vernal keratoconjunctivitis are what kind of reactions?

what new can be found in the conjunctiva?

Answer 9

type I, IV hypersensitivity reactions

eosinophils

Question 10

vernal keratoconjunctivitis: acute or chronic? what sex and age?

Answer 10

chronic, recurring

males less than 10 y/o

Question 11

vernal keratoconjunctivitis ddx

Answer 11

viral conjunctivitis

*(+) atopy hx

Question 12

some clinical presentations of vernal keratoconjunctivitis

Answer 12

itchiness
photophobia
blurred vision (tearing, possible corneal damage)
pp hypertrophy
superior tarsal conjunctiva

Question 13

viral vs allergy conjunctivitis

Answer 13

viral - follicular

allergy - papillary

Question 14

shield ulcers are found where? why?

Answer 14

cornea

cobblestones exert pressure on cornea -> pressure necrosis

Question 15

chalky mounds of conjunctiva around the limbus (collections of degenerated epithelial cells and eosinophils)

how long do they last

Answer 15

horner-trantas dots

rarely lasts >1wk

Question 16

hallmark for vkc

Answer 16

horner trantas dots

Question 17

mild management for vkc

Answer 17

topical AH
environmental change
topical mast-cell stabilizers

Question 18

severe management for vkc

Answer 18

topical corticosteroids (w pulse dosing?)

supratarsal injection of corticosteroids

Question 19

atopic keratoconjunctivitis - what kind of reaction

Answer 19

type IV

history of AD, depressed systemic cell-mediated immunity

Question 20

atopic keratoconjunctivitis: clinical presentation

Answer 20

year-round disease
older patients
small to medium sized papillae
hazy cornea (upon vascularization, becomes whitish)

Question 21

better than soft contacts

Answer 21

rigid gas contact lenses

better oxygenation so healthier

Question 22

contact lens-induced conjunctivitis

how long wear
biggest factor
stuff in tears

Answer 22

extended wear -> 8-10 hrs

debris

IgE, IgG, IgM, complement ptns

Question 23

hallmark of contact lens induced conjunctivitis

Answer 23

superior tarsal papillary hypertrophy

Question 24

sign of chronic conjunctivitis

Answer 24

corneal ulcers

Question 25

how often should you wash lenses

Answer 25

everyday, even if not used. evaporation of solution -> grime -> allergies

Question 26

giant papillary conjunctivitis

in what lens more common

Answer 26

soft contact > rgp

Question 27

gpc clinical presentation

Answer 27

large papillae (>0.3mm) on superior tarsus

Question 28

contact dermatoblepharitis

cause
type

Answer 28

topical meds, cosmetics

type i - anaphylactic
type iv - t-cell mediated or delayed hypersensitivity

Question 29

acute cd from topical anesthetics (3):

Answer 29

bacitracin
sulfacetamide
tetracycline

Question 30

delayed cd (w leathery thickening, scaling) meds…: (5)

Answer 30

atropine
neomycin
gentamycin
trifluridine
proparacaine (addictive anesthetic)

Question 31

cd 1st aid

Answer 31

cold compress

Question 32

eye drops r cool

Answer 32

no, they are useless for eyelid allergies. use cs ointments or creams instead

Question 33

for more severe cases mgt

Answer 33

oral meds

Question 34

typical sore eyes

Answer 34

viral conjunctivitis

Question 35

topical antihistamine

action, ex.

Answer 35

block h1, h2 receptors on nerve endings

OLAPATADINE (mast cell stabilizer + antihistamine) or KETOTIFEN

Question 36

mast cell stabilizer ex

Answer 36

sodium cromoglycate

olopatadine

Question 37

for cataract, glaucoma

Answer 37

short-term topical steroids

Question 38

dries nasal mucosa AND eye

Answer 38

epinephrine