Upload
dominic-mckenzie
View
230
Download
0
Tags:
Embed Size (px)
Citation preview
Conjunctiva
Baby picture of the day!
Papillae vs. Follicles
Papillae Think “pABillae” = Allergic &
Bacterial
Red dots of varying size (red due to central vessel)
Non-specific
Follicles Chlamydia, toxic, viral
Avascular/white nodules, filled with lymphocytes
Cysts
Benign
Fluid-filled
Concretions
Deposits of mucous secretions
Sometimes foreign body sensation
Nevi
Benign proliferation of melanocytes
Primary Acquired Melanosis (PAM)
Unilateral acquired pigmentation
Flat, indistinct margins
Conjunctival Melanosis Progression from PAM
Proliferation of melanocytes
Metastasize to the liver
Conjunctival Intraepithelial Neoplasia (CIN)
#1 conjunctival malignancy
Unilateral pre-malignant
Elevated, gelatinous mass with neovascularization
Conjunctival Squamous Cell Carcinoma
Progression from CIN
Malignant
Bacterial Conjunctivitis
Simple Children
H. influenzae or Staph
Acute redness, discharge
Gonococcal Neisseria gonorrhea
HYPERACUTE onset
Severe purulent discharge
Adenoviral Conjunctivitis
Acute non-specific conjunctivitis
Most common
Red eye, follicles, tearing
All 3 of these are very contagious!
Pharyngo-conjunctival Fever (PCF)
“Swimming pool conjunctivitis”
Pharyngitis
Acute follicular conjunctivitis
Fever
Epidemic Keratoconjunctivitis (EKC)
Most serious
Pain, corneal involvement
Molluscum Contagiosum
Associated with poor hygiene, children
DNA pox virus
Infectious
Dome-shaped, umbilicated, waxy nodules
Chronic follicular conjunctivitis
Allergy
Allergic conjunctivitis
Vernal Keratoconjunctivitis (VKC)
Atopic Keratoconjunctivitis (AKC)
Giant Papillary Conjunctivitis (GPC)
Allergic ConjunctivitisSeasonal allergic
conjunctivitis Type 1 hypersensitivity
History of allergy
Ex: pollen allergy
Perennial allergic conjunctivitis
Type 1 hypersensitivity
History of allergy
Ex: dust allergy
Vernal Keratoconjunctivitis (VKC)
Rare
Boys <10yo
Family history of atopy
Itching
Papillae on superior lid
Shield ulcer
Atopic Keratoconjunctivitis (AKC)
Young adults
History of atopy
Not seasonal
Dennie’s lines (atopy)
Inferior papillae
Giant Papillary Conjunctivitis
Associated with silicone hydrogel (SiHy) contact lens wear, mechanical trauma
Non-infectious, immune, inflammatory response
Itching, discharge, decreased wearing time
Papillae of superior lid
Chlamydia/Trachoma
Chlamydia Chlamydia is the most
common STD!
Acute follicular conjunctivitis, becomes chronic
Inferior follicles
Usually unilateral
Most common cause of ophthalmia neonatorum
Chlamydia/Trachoma
Trachoma Leading cause of
preventable blindness worldwide
Follicular conjunctivitis
Bilateral
Late-stage: Arlt Lines, tarsal conjunctival scarring, trichiasis
Phthiriasis Palpebrarum (Pediculosis Ciliaris)
Pubic lice on eyelashes
Sleeves at base of lashes
Itching
Follicular conjunctivitis, bruises from bites
Subconjunctival Hemorrhage
Causes: valsalva (coughing), medications (blood thinners), hypertension, clotting disorders
Pingueculum
Associated with UV exposure & chronic dryness
Abnormal growth of conjunctiva
Pterygium
Associated with UV exposure & chronic dryness
Abnormal growth of the conjunctiva onto the cornea, destroys Bowman’s membrane
Stocker’s line = iron deposit along leading edge of pterygium
Blocks vision & causes irregular astigmatism