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What 2 histological layers exist in the bulbar conjunctiva?
- Stratified epithelium
What is the purpose of the plica semilunaris?
Provides slack in conjunctiva for lateral movement
What are the peripheral arcades in the conjunctiva?
Blood supply to the palpebral conjunctiva and fornix
What arteries supply to the bulbar conjunctiva?
Anterior ciliary arteries
What lymph node does the lateral conjunctiva drain into?
Parotid / preauricular
What lymph node does the medial conjunctiva drain into?
What innervates the bulbar conjunctiva?
What innervates the palpebral conjunctiva?
What is the thinnest area of sclera?
0.30 mm (under recti tendons)
What is the weakest area of the sclera?
What is the thickest part of the sclera?
1.0 mm at the posterior pole
what is the nerve supply to the sclera?
What are the 3 layers of the sclera?
- Lamina fusca
In what layer of the sclera does iritis and ciliary flush occur?
In what layer of the sclera does melanosis occur?
What systemic diseases cause blue sclera?
- Osteogenesis imperfecta (brittle bone syndrome)
- Ehler's Danlos syndrome
Where are the palisades of vogt located?
At the limbus
What is the purpose of the palisades of vogt?
Site of corneal stem cells destined to become basal cells
What layer in the drainage angle does descemet's layer become?
What is a premalignant sign for conjunctival melanoma?
Primary acquired melanosis
What are key points of primary acquired melanosis?
- Common in elderly white patients
- Premalignant sign of conjunctival melanoma
What is a premalignant sign of SCC in the conjunctiva?
Conjunctival intraepithelial neoplasia (CIN)
What are follicles associated with?
- Toxic conjunctivitis
- Viral infection
What layer of the cornea do pterygium destroy?
What is stocker's line?
Iron deposit found around pterygium
What bacterial conjunctivitis is more common in children?
what bacterial conjunctivitis is more common in adults?
what are typical S&S of bacterial conjunctivitis?
- Acute onset of redness
- FB sensation
- Eyelids stuck together upon awakening
- Mod-severe discharge
- Clear cornea
- No lymphadenopathy
What gram stain is a gonococcal infection?
What does chlamydial conjunctivitis cause?
- Inclusion conjunctivitis
- Chronic follicular conjunctivitis
- Preauricular lymphadenopathy
- Stringy mucous discharge
What organisms cause conjunctivitis with membranes?
- corynebacterium diphtheriae
- Strep hemolyticus
- Strep pneumonia
How many days after birth does neonatorum gonorrhoeae first present?
How many days after birth does neonatorum chlamydial conjunctivitis first present?
What corneal sign does adenoviral conjunctivitis cause?
Subepithelial infiltrates (SEIs)
What is the pathophysiology of adenoviral conjunctivitis?
- upper respiratory tract infection
- Pharyngoconjunctivitis fever
What is molluscum contagiosum?
- Chronic follicular conjunctivitis
- Dome-shaped waxy nodule on lid or lid margin
What is the pathophysiology of molluscum contagiosum?
What is found in VKC?
- Intense itching
- Stringy mucopurulent discharge
- Bilateral prominent papillae
- Shield ulcer
What is the demographic of patient that typically has VKC?
Male children and young adults
What are Trantas dots?
Papillae at the limbus found in VKC
What are cobblestone papillae?
Papillae on the upper palpebral conjunctiva found in VKC
What is found in AKC?
- Bilateral itching
- Watery discharge
- Scaly thickened, swollen eyelids
- Dennie's lines
- Inferior papillae
What is the leading cause of preventable blindness worldwide?
What are arlt lines?
Scarring of superior tarsal conjunctiva found in trachoma conjunctivitis
What are Herbert pits?
Depressions of limbal conjunctiva after limbal follicles in trachoma conjunctivitis
What conjunctivitis causes velvety superior tarsal conjunctivitis?
Superior limbic keratoconjunctivitis (SLK)
What is the demographic most commonly associated with superior limbic keratoconjunctivitis?
What is parinaud's oculoglandular syndrome?
- Cat-scratch fever
- Unilateral granulomatous palpebral conjunctivitis
- Visibly swollen lymphadenopathy
What are the pathophysiologies of parinaud's oculoglandular syndrome?
- Cat-scratch fever
- Tularemia(rabbit fever)
What are S&S of episcleritis?
- Acute unilateral red eye
- Mild pain
- Sectoral injection
- Can be simple of nodular
- Blanches with phenyl 10%
What is the pathophysiology of episcleritis?
- Collagen vascular diseases
- Acne rosacea
What is the demographic most common with episcleritis?
Young adults 20-40s
What is the typical demographic found in scleritis?
What is the most common type of scleritis?
What is the most dangerous type of scleritis?
Necrotizing with inflammation
What is scleromalacia perforans?
- Necrotizing scleritis without inflammation found in Chronic RA
- Causes blue hue of sclera
What are examples of granulomatous uveitis?
- Koeppe nodules
- Busacca's nodules
What causes acute non-granulomatous uveitis?
- Reiter's syndrome
- Behcet's disease
- Lyme disease
- Glaucomatocyclitic crisis
What causes chronic granulomatous uveitis?
What are key findings in ocular syphilis?
- Maculopapular rash on palms and soles
- Interstitial keratitis
What causes chronic non-granulomatous uveitis?
- Fuch's heterochromic iridocyclitis
What causes posterior uveitis?
- Pars planitis
What is the most common cause of posterior uveitis in the USA?
What are S&S of toxoplasmosis?
- Unifocal yellow-white lesion obscured by overlying vitritis
- Headlights in the fog
What causes toxoplasmosis?
- Parasite in undercooked meat
- Toxoplasmas gondii
What is the triad associated with histoplasmosis
- Peripapillary atrophy
- Multifocal "punched out" yellow-white lesions
- Maculopathy (CMNV)
- Ohio-Mississippi river valley
Where are cotton-bal opacities and candle-wax droppings seen?
What causes snow-banking?
Who has- CMV?
AIDS pts with less than 50