Conjunctival and Corneal disorders

conjunctivitis

What is inflammation of the mucous membrane and can be caused by allergies, bacteria, or viral issues and is transmitted by direct contact?

allergic conjunctivitis

What presents with Itching, tearing, redness, stringy discharge, occasional photophobia and vision loss and has a large "cobblestone" papillae appearance in the upper tarsal conjunctiva?

allergic conjunctivitis

•Mast cell stabilizers and antihistamines

•Short term use of vasoconstrictors

What is the tx for mild allergic conjunctivitis?

topical steroids and refer!!

What is tx for acute exacerbations or severe allergic conjunctivitis?

S. aureus

What bacteria MC causes conjunctivitis?

bacterial conjunctivitis

What presents with:

-Purulent discharge, lid crusting

•Fluorescein stain to evaluate for keratitis and abrasions

typically self limited

- gonococcal= EMERGENT tx

- topical abx- erythromycin

- COVER PSA IN CONTACT WEARERS: CIPRO

What is the tx for bacterial conjunctivitis

bacterial conjunctivitis

adenovirus

What is the MC cause of viral conjunctivitis?

viral conjunctivitis

viral conjunctivitis

What presents with:

•Clear watery discharge

•Associated with URI

•Ipsilateral preauricular lymphadenopathy

supporative- compresses artificial tears, antihistamines, hygiene

What is the tx for viral conjunctivitis?

topical ganciclovir and or systemic acyclovir

What is the tx for HSV conjunctivitis?

neonatal conjunctivitis

What affects newborns after birth and is caused by bacteria, viral, or chemical?

erythromycin ointment

What is tx for neonatal conjunctivitis?

cataracts

What are opacities of the crystalline lens and is the leading cause of blindness?

cataracts

What clinical findings are these correlated with:

•Blurring of vision

•Glare in bright light or when driving at night

•Development of nearsightedness

•Monocular double vision

•Seen early through a dilated pupil with an ophthalmoscope or slit lamp

•As matures the fundus reflection is absent and the pupil is white

surgery if interfere with daily living

What is the tx for cataracts?

cataract

corneal abrasion

What is a common eye injuries that frequently result from eye trauma, foreign bodies, and improper contact lens use and pts present with eye pain and foreign body sensation?

fluorescein stain

- should have round, reactive pupil, and normal visual acuity

What is the dx for corneal abrasion?

corneal abrasion

What are these clinical findings associated with:

- severe pain and photophobia and visual acuity is recorded

bacitracin-polymyxin ointment or drops

- FQ topical abx in contact lens wearers!

What is the tx for corneal abrasion?

corneal ulcer

What is a defect in the surface epithelium of the cornea that involves the underlying stroma?

common in contact lens wearers and presents as: eye pain, blurry vision, and photophobia

REFER

What should you do for a pt with acute painful red eye and corneal abnormality??

infectious keratitis

What is a corneal infection and inflammation

staphylococci

What is the MC pathogen of bacterial keratitis?

fluorescien stain- corneal ulceration with underlying opacity

What is the dx for bacterial keratitis?

topical FQs!

What is the tx for bacterial keratitis?

bacterial keratitis

herpes simplex keratitis

What is an infection that can manifest the lid, conjunctival or corneal ulceration and has dendritic branching?

herpes simplex keratitis

fluorescein stain

What is the dx for herpes simplex keratitis?

topical and or oral antiviral!

What is the tx for herpes simplex kertitis?

herpes zoster opthalmicus

What involes the trigeminal nerve branch that presents with malaise, fever, headache, and periorbital burning and itching (prodromal phase)- and a rash that travels the tip of the nose?

herpes zoster opthalmicus

high dose oral acyclovir

- REFER URGENTLY

What is tx for herpes zoster ophthalmicus

fungal keratitis

What is a corneal injury involving plant material or in an agricultural setting- hypopyon may be present

- can have feathery edges and multiple satellite lesions

fungal keratitis

diagnosis delayed and tx difficult

- natamycin

What is tx for fungal keratitis?

amoebic keratitis

acanthoameoba

What is the MC cause of ameobic keratitis?

amoebic keratitis

What presents with severe pain and

- •Perineural and ring infiltrates in the corneal stroma

confocal microscopy and giemsa staining of cornea

- culture

What is the dx for ameobic keratitis?

immediate topical biguanide and long term tx

- refer

What is the tx for ameobic keratitis?

pterygium

pterygium

What is a slow growing thickening of the bulbar conjunctiva due to prolonged sun, sand, wind, and dust exposure?

rarely needed- artificial tears or surgical removal if severe

What is tx for pterygium

pinguecula

What is a slow growing thickening of the bulbar conjunctiva that does NOT grow over the cornea?

artificial tears

What is the tx for pineguecula?

pinguecula