Ocular disease Conjunctiva Flashcards
what is the difference between papillae VS Follicle ?
Papillae : in bacteria and allergy , vascular core
Follicales –> white , Lymphocytis
Virus
what viruses are associated with follicle ?
CHAT " C--> chlamydia H-->Herpes A-->A adreno virus T-->toxic
what is the differences between Conj nevus VS Primary aquired melanosis (PAM) Vs Melanomas
Nevus–>unilateral , flat , benign proliferation of melanocystes around Puberty
PAM –> uni, aquired pigmenation in elderly , Indistinct margins Premelgnant —> can lead to Melanoma
Melanoma –>uncontrolled proliferation of melanocystes
CONJ intraepithelial neoplasis ? =CIN
unilateral , premalignant ,
what is the most conj malignancy ?
CIN =CONJ intraepithelial neoplasis
what is CIN can become ?
What PAM can become ?
CIN CONJ intraepithelial neoplasis –>squamous cell carcenoma
PAM–> conj melanoma
what is the different between bacteria and viral conj?
Bacteria : either simple ( +) or gonococcal (-)
1- Acute onset redness , variable discharge( serous , mucopurulent
what is the most common cause of bacterial conju. in childer and in adult ?
H influenzae in children
S aureus, S epidermis in adult
what is the most common cause of blepharitis ?
Staph. aureus,
what is GOnococcal conju?
1- gram (-) bacteria infection thro. sexual transmitted , can pass thro vaginal birth canal to infant
2- sever purulent discharge
3- Preauricular lymph.pathy As in virus conju
which conj. infection can transmit to infant ?
GOnococcal conju
what most co infection with GOnococcal conju?
Chlamydial systemic infection
what viruses are associated with follicle ?
CHAT " C--> chlamydia H-->Herpes A-->Adenoviral conj T-->toxic -->allergic conj that is follicular reaction
Adenoviral conj?
1- many types but most one is upper respiratory tract infection , follicle , non specific
2- types PCF = pharyngoconjunctival fever ,
EKC =epidemic keratoconjunctivitis
what is pharyngoconjunctival fever ? =PCF
a type of Adenoviral conj( viral) swiming pool conj
what is the triad of PCF ?
1- acute follocular conj occasionally hemes
2- mild low fever
3- Phryngitis
NO CORNEA INVOLVED
what is the most serious type of Adenoviral conj?
EKC =epidemic keratoconjunctivitis Pain corneal involved SEI ( subepith infeltrates ) Preauricular lymph.pathy Psudomembrane formation Diffuse Keratitis ( mohem )
what is the hallmark of EKC?
Palpable node ( Preauricular lymph.pathy ) + suspected adenoviral infection = EKC
WHat is Molluscum contagiosum ?
(Dome shape umbilicated , waxy nodules , on the lid , viral conj. , Poor hygiene , DNA PoX virus
what to worry about if see multiple Molluscum contagiosum?
HIV
what test u do for HIV?
Elissa , Western blot
Chlamydial D-K ?
Follicular , sexually active , Inferior Palpebral conj and fornics
what is the most common sexualy transmitted disease viral ?
Chlamydia
what is the most common cause of preventable blindness in world ?
Trachoma = Chlamydia A-C
1- follicules , Arlt line , Herbert;s pits
SLK superior limbic keratoconjunctivitis ( part of allergic ) associate with ?
1- Thyroid, 2- K sicca, 3- CL wear ,
superior bulbar conj ( hero condition)
Phylyctenular keratoconjunctivitis ?
1- Type 4 Hypersenstivity to staphylococcus
2- can be in cornea or conj
3- most common in teenager , history of TB
what is the name of TB test?
PPD in 48-72 h
what is the difference between Conj Phlyctenules Vs Corneal Phlyctenules
Conj Phlyctenules : at the limbus as pink fresh nodule , with conj injection
corneal Phlyctenules: at limbus small white , nodule , with conj injection
Pinguescula : yellow white raised , at limbus ( NOT IN CORNEA )
Pterygium : triangle fibvascular growth in bulbar conj and extend to cornea ( IN BOEMAN Membrane ) WTR ASTIGMATISM , Stocker’s line –> iron deposite
phthiriasis paplpebraum ?
infection of lashes , lid , found in hair follicles of gential region , follicles, preauricular lymphadenopathy
Subconj heme?
1- caused from cough , staining , medication as aspirin, coumadin, sickle cell , HTN ,
what tests for subconj ?
CBC , PT/PTT, sickledex ,
Pterygium/Pingueculum
UV exposure ,
what is the leading cause degenration of collegen fibrils with in conj stroma ?
UV exposure –> dry eye
Episcleral Vs scleritis ?
Episcleritis : sectoral injection , red, uni , mild pain common
Scleritis : diffuse , blue sclera, PAIN , rare, deep Bilateral
2.5% Phenylephrine –> blancing it is epi
what is associated with scleritis ? what kinds ?
NON necrotizing 80%–> 60%diffuse or nodular
Necrotizing 15%–> with inflammation , and without inflammation
what is associated with Necrotizing scleritis with inflammation Vs Non Inflammation ?
Necrotizing with inflammation –>worst , autoimmune problem , cause UVITIS , periphreral corneal melting , sclera thinning , cataract, glaucoma
Necrotizing with NO inflammation ->no pain , ( Scleromalacia perforans ( CHRONIC rheumatoid arthritis ) )
what is Scleromalacia perforans ?
scleritis in rheumatoid arthritis
Anterior Uvitis causes ?
frequently in young age
if occure > 70 yrs old it is because Herpes zoster
associated with anterior Uvititsn Non granulomous ?
CRAP C--> Crohn's disease R--> Reactive arthritis A--> Ankylosing spondyl P-->Psoriatic arthirists
anterior Uvitis granulomus ?
caused by Sarcoid, --> ACE increase TB ,--> + PPD Syphilis Herpes
what test to do for anterior Uveitis ?
HLA-B27
What symptoms of anterior Uveitis ?
pain, red, photophopia , CME , decrease VA ,
FLares WBC in anterior chamber
what you worry about in Anterior Uveitis ?
1- Posterior synechaie , peripheral anterior synechiae , CME , cataract
2- Decreases IOP
3- KP keratic percipitates in endothe.
where you find KP Keratic percipitats ?
1- Anterior Uveitis grano–> sarcoid , TB , Syphilis
2- Anterior Uveitis non granul–> CRAP
3- Stellate ( star shape ) –> in heterochromatic iritis , and herptic Uveitis
C–> Crohn’s disease
R–> Reactive arthritis
A–> Ankylosing spondyl
P–>Psoriatic arthirists
what is the enzyme level increase in sacoid and what it is associate with ?
ACE level increase , Anterior granul Uveitis and most time Posterior Uveitis
more common in females ,
what is the difference between congenital syphilis Vs aquired ?
Aquired rarly has Interstitial keratitis, unilateral , less severe
what hall mark of syphilis ?what tests for syphilis ?
Interstitial keratitis ,
maculopapular rash , + VDRL , + RPR, + FTA- ABS,
+ MHA-TP
what is Interstitial keratitis?
associate with syphilis granulomous Uveitis , it is an inflammation of stroma without primary involvment of epi and endo
what is the most common cause of Interstitial keratitis?
congenital syphilis
WHAT is the congenital Syphilis Triad? IMPRTANT !
1- Hutchinson’s teeth ( small widely spaced teeth)
2- Deafness
3- Interstitial keratitis
Also –> saddle nose , frontal bossing
what causes posterior Uveitis ?
breakdown in blood aqeous barrier , that result in WBC flares in vitreous
what is associated with posterior Uveitis?
1- toxoplasmosis
3- sarcoid
what is the most common cause of posterior uveitis ?
toxoplasmosis
what is toxoplasmosis ?
Parasitic infection
two types :
congenital –> most common transfer from mother
aquired–> result from inhalation of parasite ( cat feces or undercook meat
what is the most common cause of infectious retinitis ?
congenital ocular toxoplasmosis
signs and symp of toxoplasmosis ?
vitritis , unilateral redness , age 25 , headlights in the fog
Histoplasmosis can lead to posterior uveitis ?
NO , it causes choroiditis ( punched out yellow white lesion in peripheral and CNVM only in ohio
Sarcoid traid? and can lead to anterior and posterior Uveitis
cotton ball opacitis ( retinal vitritis )
candle wax droping ( retinal vasculitis ) excudates
optic nerve papiledema
associate with Bell’s palsy , lacrimal gland dacroadyntits
