Tropical eye disease

Question 1

Features of xerophthalmia and keratomalacia

Answer 1

indicate vit D deficiency: diet, alcohol abuse, steatorrhoea (low ADEK)

Question 2

Signs of xerophtlamia and keratomalacia (6)

Answer 2

night blindness
tunnel vision
decreased acuity
dry conjunctivae
bitot's spots: small foamy plaques
if severe can>corneal ulceration>perforation>extrusion of intra-ocular contents

Question 3

Ix for xerophthalmia and keratomalacia (3)

Answer 3

visual fields
dark-adapted electroretinography
plasma vit-A

Question 4

Rx of xerophthalmia and keratomalacia

Answer 4

vit A

Question 5

Trachoma features (2)

Answer 5

caused by chlamydia trachomatis

spread by flies

Question 6

Staging of trachoma (4)

Answer 6

1: follicles on upper lid give fine granulomatous appearance
2: intense erythema
3: follicles rupture>replaced by scar tissue
4: scar tissue distorts lids>entropion>lash scratches cornea>ulceration.

Question 7

Rx and prevention (3)

Answer 7

azithromycin/tetracycline eye drops
lid surgery
prevent w. clean water, facial hygiene and azithromycin.

Question 8

Onchocerciasis features (3)

Answer 8

caused by onchocerca volvulus (nematode)
transmitted by black flies
bite>nodule>invasion of conjunctiva, ciliary body, iris, retina>inflammation>fibrosis>corneal opacities

Question 9

Dx of onchocerciasis (2)

Answer 9

skin nip tests and triple antigen serology/PCR

Question 10

Rx of onchocerciasis

Answer 10

Ivermectin