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56 Cards in this Set

  • Front
  • Back
staph aureus
bleph
ulcer
blurred margins
perforation in 7 days
strep pneumo
acute bact conj
marginal infiltrates to ulcers
central snakelike ulcer that has hypopyon
moraxella lacunata
angular blepharoconj
with or without hypopyon
neisseria gonorrhea
lusterless cornea
34 hour progression to ulceration, perforation, or panophthalmitis
haemophilus influ
in fall
petechial hemorrhages
progression to preseptal cellulitis or metastatic meningitis
atopic keratitis
anterior subcap cataract
marginal infiltrates/ulcers
differentiate from herpes
hypersensitivity rxn
oval and linear infiltrates separated from limbus by interval of clear cornea
pain
photophobia
dellen
corneal thinning d/t dehydration
epithelial defect and ulcers
pathogens can access stroma
inflammatory response to stromal infiltration
promotion of ulceration
bacterial corneal ulcer pathogens
staph aureus, strp pneumo, moraxella, pseudomas
s/s bacterial corn ulcer
overlying epithelial defect
infiltrate extends beyond border of defect
hypopyon
staph ulcer
mucopurulent discharge
strep ulcer
serpiginous nature with undermined borders
moraxella ulcer
alcoholics and institutionalized pts
psudomonas ulcers
EW SCL pts
greenish mucopurulent discharge--GREEN GOO!
endothelial plaque
progress rapidly (perforate w/in 24 hours)
tx of bacterial ulcer
fortified tobra q1h alternated with fortified cefazolin q1h OR
ciprofloxacin 2gtt q15min x 6 hours, 2gtt q 30 min rest of day, 2gtt q1h on 2nd day, 2gtt q4h on days 3-14. continue past day 14 if reepithelialization hasn't occurred.
4 main forms of hsv keratitis
1. epithelial
2. disciform
3. necrotizing interstitial keratitis
4. indolent
punctate epithelial keratitis from HSV
precursor to dendritic or ameboid. may not progress
dendritic epithelial HSV
arborized ulcer
true terminal end bulbs
raised edges
ameboid epithelial HSV
large amoeba0-shaped ulcer with dendritic edge of elevated mounds
disciform (stromal) HSV
stromal edema with intact overlying epithelium
necrotizing interstitial keratitis (stromal)
multiple/diffuse stromal infiltrates often with neo
bacterial superinfection must be r/o
indolent (neurotrophic) ulceration HSV
sterile ulcer with smooth margins over area of stromal dixease persisting depspite antiviral therapy
hallmark sign of HSV keratitis
cornal hypoesthesia
mngmt of HSF ocular dz
debridement, topical antiviral
cycloyplegic, etc
mngmt of HSV epithelial keratitis
mechanical debridement, topical antiviral (viroptic q2h while awake for no longer than 21 days)
varicella zoster keratitis types
spk, pseudodendrites, immune stromal keratitis, neurotrophic keratitis
pseudodendrite zoster keratitis
periph cornea elevated
medusa-like lesions that stain vividly with rose bengal
chornic epi keratitis: corneal mucous plaque keratitis: accompanied by ciliary & tarsal conj injetion, mild anterior uveitis, fine keratic precipitattes, and corneal hypoesthesia
mngmt of herp zoster ophthal
oral acyclovir within 72 hrs
fungal corneal ulcer causative agents
FACC: Fusarium, Aspergillus, Candida, Cephalosporium
filamentous fungal infection fungal ulcer
fusarium, aspergillus
yeast infection fungal ulcer
candida
fungal ulcers
satellite lesions
immune ring
protozoan corneal ulcers agents
acanthamoeba
s/s acanthamoeba keratitis
severe ocular pain disproportionate to clinical signs
upper lid edema
stromal infiltrate in shape of ring
mngmt acanthamoeba keratitis
hosp admission?
cornal transplant often required eventually
interstitial keratitis
most commonly associated with syphilis
binocular: congenital
monocular: acquired
s/s old and acute
old: deep corneal haze, stromal thinning, ghost vessels
new: pain, conj injection, ant uveitis
stromal edema 2nd to:
endothelial dysfunction
apithelial dysfunction (less common)
signs: folds in descemet's membrane
epithelial edema
more effect on comfort and vision than stromal edema
may be 2nd to endothelial dysfunction or increased IOP
reducted by hyperosmotics
signs: microcystic edema, bullous keratopathy
verticillata
Fabry's disease, differentiate from drugs like miodarone, plaquenil, indomethacin, etc
fabry's dz lens findings
granular ant capsular cat with radial pattern
unusual post subcap cat with spoke-like deposits of granular material radiating from central part of post cortex
marginal corneal melting/ulceration
collagen vascular dx like RA SLE, sjogren's
mgmt of marg corneal ulceration/melting
bandage SCL-best
ocular lubrication
caution with steroids
r/o underlying dz
alkaptonuria
missign enzyme: homogentisic acid oxidase
ochronosis: pigmentation of cartilage and other connective tissues
ocular ochronosis: patches or particles of pigment in sclera conj andlimbic cornea
sclerosis of cardiac valves
degen. arthritis
Wilson's dz
copper
liver, kidney, brain
descemet's membrane of periph. cornea leading to kayser-fleischer ring
mngmt of wilson's dz
d-penicillamine (cuprimine): mobilizes copper from tissues
leprosy cornea
thick, prominent corneal nerves with beading
when does epithelial regen begin and do peripheral or central defects heal faster?
w/in one hour
peripheral heal faster b/c closer to limbal vascular supply
scar with Bowman's
no scar if Bowman's is intact
when to resume CL wear after corneal abrasion?
no sooner than 2 days after resolution
corneal laceration
r/o foreign body
r/o thickness laceration: ant chamber flattening, prolapse of IO contents, seidel's sign
burns: better prognosis with white or red conj?
red: the whiter the worse the prognosis
radiation burns: UV radiation
wavelength?
rarely results in ant segment damage b/c of imediagte discomfort caused by heat
lag of 6 hrs b/w exposure and s/s
shorter the wavelength, greater the tendency for keratoconj.
severe keratoconj may result in mucin deficiency
thermal burns
debride, remove FB, cycloplege, abx, patch, reexamine in 24 hrs
can result in: ant uveitis, corneal scars, corneal pannus, 2ndary infection, cictricial conj changes, cictricial dermal changes, ocular penetration
chemical burns
copius irrigation
may result in: ant uveitis, ischemic necrosis of conj, corneal scrring and pannus, etc etc