Ocular Allergy Flashcards
not normally found in conjunctiva unless you have allergy
eosinophils
labs for AR
generally none – diagnosis is clinical
a clinical presentation for AR (on the palpebra)
palpebral papillary hypertrophy
for relief of itchiness, reduction of swelling, numb pain; cheap
cold compress
flooding your eyes to wash away allergen
lubricant
more for prophylaxis (use 2 weeks before expected allergy)
mast cell stabilizers
for severe reactions
*monitor patient as it can lead to complications like inc intraocular pressure, cataracts, glaucoma
topical corticosteroids
severe seasonal inflammation of the superior tarsal conjunctiva thought to be due to an allergic reaction (usually during?)
vernal keratoconjunctivitis
vernal keratoconjunctivitis are what kind of reactions?
what new can be found in the conjunctiva?
type I, IV hypersensitivity reactions
eosinophils
vernal keratoconjunctivitis: acute or chronic? what sex and age?
chronic, recurring
males less than 10 y/o
vernal keratoconjunctivitis ddx
viral conjunctivitis
*(+) atopy hx
some clinical presentations of vernal keratoconjunctivitis
itchiness photophobia blurred vision (tearing, possible corneal damage) pp hypertrophy superior tarsal conjunctiva
viral vs allergy conjunctivitis
viral - follicular
allergy - papillary
shield ulcers are found where? why?
cornea
cobblestones exert pressure on cornea -> pressure necrosis
chalky mounds of conjunctiva around the limbus (collections of degenerated epithelial cells and eosinophils)
how long do they last
horner-trantas dots
rarely lasts >1wk
hallmark for vkc
horner trantas dots
mild management for vkc
topical AH
environmental change
topical mast-cell stabilizers
severe management for vkc
topical corticosteroids (w pulse dosing?)
supratarsal injection of corticosteroids
atopic keratoconjunctivitis - what kind of reaction
type IV
history of AD, depressed systemic cell-mediated immunity
atopic keratoconjunctivitis: clinical presentation
year-round disease
older patients
small to medium sized papillae
hazy cornea (upon vascularization, becomes whitish)
better than soft contacts
rigid gas contact lenses
better oxygenation so healthier
contact lens-induced conjunctivitis
how long wear
biggest factor
stuff in tears
extended wear -> 8-10 hrs
debris
IgE, IgG, IgM, complement ptns
hallmark of contact lens induced conjunctivitis
superior tarsal papillary hypertrophy
sign of chronic conjunctivitis
corneal ulcers
how often should you wash lenses
everyday, even if not used. evaporation of solution -> grime -> allergies
giant papillary conjunctivitis
in what lens more common
soft contact > rgp
gpc clinical presentation
large papillae (>0.3mm) on superior tarsus
contact dermatoblepharitis
cause
type
topical meds, cosmetics
type i - anaphylactic
type iv - t-cell mediated or delayed hypersensitivity
acute cd from topical anesthetics (3):
bacitracin
sulfacetamide
tetracycline
delayed cd (w leathery thickening, scaling) meds…: (5)
atropine neomycin gentamycin trifluridine proparacaine (addictive anesthetic)
cd 1st aid
cold compress
eye drops r cool
no, they are useless for eyelid allergies. use cs ointments or creams instead
for more severe cases mgt
oral meds
typical sore eyes
viral conjunctivitis
topical antihistamine
action, ex.
block h1, h2 receptors on nerve endings
OLAPATADINE (mast cell stabilizer + antihistamine) or KETOTIFEN
mast cell stabilizer ex
sodium cromoglycate
olopatadine
for cataract, glaucoma
short-term topical steroids
dries nasal mucosa AND eye
epinephrine
