Slit Lamp Exam (diseases) Flashcards
the most common lid disease is
blepharitis
what causes blepharitis?
staph bacteria that is normally on skin but builds up
sign of blepharitis is
flakes like dandruff
meibomitis is:
congestion of the meibomian glands from retention and over-production of oils
how do you grade meibomitis?
there are 3 stages and it is related to dry eye
what is trichiasis and what can it causes?
it is interned lashes that can cause foreign body sensation, increased tearing, and scratches that lead to corneal scarring (blindness)
what is a chalazion? what are some possible symptoms and side effects?
non-infectious granuloma from clogging of zeiss or meibomian glands
-should be no pain and possible induced astigmatism if pushing on cornea
what causes a hordeolum “stye”?
staph infection affecting zeiss, moll, and meibomian glands
what is different about a hordeoum versus a chalazion?
hordeolum is acute, painful red, hot and infectious but a hordeolum can turn into a chalazion
types of conjunctiva
- palpebral (underside of eyelid)
- bulbar (white part of eye, on the globe)
what is a pinguecula?
degeneration of elastic tissue, fragmentation of collagen fibers often caused by UV and wind exposure
what is the appearance and signs of pinguecula?
whitish/yellowish elevation that has a nasal/temporal “base in” (wider towards cornea)
what is a pterygium?
a fibroelastic ingrowth that invades into the peripheral cornea at level of Bowman’s layer
what are the signs and results of pterygium?
it can induce astigmatism, it is mostly nasa/temporal, and it can cause drying in adjacent area
what is axenfeld’s loop?
black ciliary nerve loops on scleral surface, benign (no need for documentation in chart)
what is melanosis?
extra melanocytes (pigmentation) -document ABCDEs
what is subconjunctival hemorrhage?
loose blood in the bulbar conjunctival space
from trauma or valsalva maneuver
how can hyperemia/injection be graded?
localized, diffuse, sector, circumlimbal, 1+ to 4+
caused by: infection, inflammation, foreign body, toxic, allergy
what is chemises and what is it associated with?
it is temporary breakdown of cellular structure (edema, swelling) associated with allergy
what are follicles?
infiltration of lymphocytes (WBCs) that look like cobblestone and have vessels surrounding the mound
what are follicles associated with?
viral infection “pink eye” and toxic eye conditions
what are papillae?
inflammatory cells that look like “goose bumps” and have a central vascular core
what are papillae associated with?
immune response to bacteria or allergens
GPC is associated with
CL wear or sutures
they can be >0.5mm to 3mm
what are concretions?
yellow/white degenerations from keratin, calcium and epithelial debris commonly seen (esp. in elderly)
what are inclusion cysts?
lymphatic, water fluid cyst usually in the palpebral conjunctiva that are translucent and clear
how do you view the episclera/sclera?
manual oscillation and blanch with 2.5% phenylephrine because episclera blanches and sclera won’t
what is superficial punctate keratitis and what are some causes?
it is epithelial surface irregulars, edema, pinpoint cysts, infiltration of WBC, proteins, debris, cells that results in decreased VAs and irritated feeling
what is a dellen?
a dry, thinned, depressed spot at the peripheral cornea that is 0.5-1 mm
what other things can dellen be associated with?
dry eye, SPK, and surface irregularity
what beam set up is the best to view corneal stroma?
parallelepiped or optic section to determine depth (optic section best)
what are some things to determine is someone has an abrasion/ penetration/ perforation?
determine depth, stain, look for Seidel sign, check IOP
cornea stroma scars pass through what layer?
Bowman’s membrane
what are subepithelial infiltrates and what causes them?
diffusion and accumulation of WBCs that move to site of antigen (think viral)
what is unique about the subepithelial infiltrates?
does not stain in fluorescein (mostly true)
what is the definition of a pannus?
a superficial vessel tuft grows over cornea in response to inflammation or as an immune response to infection
what is the definition of neovascularization?
new blood vessel growth in response to hypoxia from CL wear or staph infection
what are keratitic precipitates?
accumulation of WBC and epitheliod cells at level of corneal endothelium associated with inflammation
what is krunkenberg’s spindle?
linear/vertical spindle on corneal endothelium, deposition of pigment by convection current
what is krukenberg’s spindle associated with? what are the signs?
pigment dispersion syndrome, signs: transillumination defects, pigment in the angle, glaucoma
when guttata is advanced what is it known as?
Fuch’s dystrophy
what is guttata?
depression of endothelium from loss of cells because the corneal endothelial pump is compromised
how is guttata best viewed?
by specular reflection
angle estimation is a comparison of the:
depth (width) of the anterior chamber with the thickness (width) of the cornea through which the beam travels
