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What are the layers of the conjunctiva and cells?
- epithelium- no keratinised, goblet, langerhands, melanocytes
- stroma- bv, loose connective tissue, lymphocytes, lymphatic vessels, immune cells
What is a pseudomembrane?
coagulated exudate/fibrin adherent to inflamed conjunctival epithelium
What are follicles?
- discrete, yellowish, slightly elevated lesions
- avascular- vessels may encircle
What are papillae
- palpebral and limbal bulbar conjunctiva
- mosaic like pattern of elevated red dots
- macro<1mm, giant>1mm
- non specific inflammatory response
What is a symblepharon?
fusion of palpebral and bulbar conjunctiva
What is keratinisation?
epithelial cells become keratinised
What is a pinguecula?
- yellow lesion on bulbar
- adjacent to limbus mostly nasal, bilateral
- due to UV
- inflammation- pingueculitis- steroids
What is pterygium?
- whitish triangular, fibrovascular subepithelial ingrowth od degenerative bulbar conj tissue
- adjacent to limbus, apex growing toward and onto corne
Sx of pterygium?
- nasal- light focusing on here due to UV exposure
- sx: redness, irritation, grittiness, inflammation, astigmatism
tx of pterygium and grading?
- 1: <2mm on cornea- asympt/inflamm
- 2: 4mm, tear film disturbances
- 3: >4 invasion
- tx: singalsses, tear supps, steroid/non antiinflams
What are concretions?
- common lesions
- elderly/chronic meibomian gland disease
- sx: small, multiple chalky deposits
- inferior tarsal and fornices
What is conjunctivchalasis?
- extra fold of conj between globe and lower lid
- normal aging change- post lid margin disease
What are retention cysts?
- common lesions
- thin walled lesion containig clear fluid
- mayb clusters
- 1-2 decade
- compound: at junction+ stroma
- junctional: at junction of epi and subepit
- subepithelial: beneath epithelium
sx and tx of naevus?
unilateral, solitary, slightly elevated, pigmented lesion
What is a conjunctival papilloma?
- sx: pedunculated lesions in children, juxtalimbal, fornix, caruncle
- proliferation of keratinised, stratifeid squamous epi containig goblet cells
- tx: resolve, large- excision
What is an epibulbar dermoid?
- choristoma- normal tissue in wrong placesub/cutaneous tissue
- childhood, juxtalimbal
What is an epithelial melanosis?
- Primary: early life then stabilises
- area of flat, patchy pigmentation scattered about conjunctiva
- secondary: mascara deposits, pigment clumps
areas of flat patchy pigmentation
- arise from intraepi neoplasia
- late in life, juxtalimbal, fleshy avascular mass
- may become vascualr-> extend onto cornea
- vascular, slow growing
- lower fornix, re/brown
- proliferation of vascular endo cells, leukocytes
- salmon coloured
- b cell lymphomas arise from MALT
- vit a deficiency- debris dpostisted from keratin secretions
- appears foam grey spots
- silver containing medications
- slate grey discolouration of mucous membranes