Cataracts and Conjunctivitis (Chapters 55 & 57)

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Questions and Answers

Which of the following is a symptom of corneal surface defects?

Sudden onset of severe eye pain in the affected eye

Blurred vision

Redness

All of the above (correct)

What is the most common cause of corneal surface defects?

Infections

Direct trauma from foreign objects (correct)

Allergies

Contact lens wear

What is the typical treatment for a corneal surface defect?

Antibiotic ointment and supportive care (correct)

Immediate surgery

Antihistamines

Oral corticosteroids

What does RSVP stand for in the context of corneal surface defects?

Redness, Sensitivity to light, Vision changes, Pain (D) Signup and view all the answers

What is the recommended treatment for a chemical eye injury?

Immediately irrigate the eyes (D) Signup and view all the answers

What is a common symptom of dry eye syndrome?

Foreign body sensation (C) Signup and view all the answers

What is the main factor contributing to dry eye syndrome?

Abnormalities in the tear film (B) Signup and view all the answers

Which of the following activities can worsen symptoms of dry eye syndrome?

Reading or computer use (B) Signup and view all the answers

What are the two basic tests that help distinguish aqueous-deficient from evaporative dry eye?

Schirmer test and tear breakup time (B) Signup and view all the answers

Which of the following conditions is NOT listed as a symptom of pinguecula or pterygium?

Glaucoma (D) Signup and view all the answers

What is the recommended treatment for advanced stages of pterygium when decreased vision is present?

Surgical removal. (C) Signup and view all the answers

In the context of dry eye syndrome, what does the term "aqueous deficient" refer to?

Insufficient tear production. (A) Signup and view all the answers

What is a key management strategy for dry eye syndrome recommended in the provided content?

Avoiding environments with low humidity. (B) Signup and view all the answers

In the context of conjunctivitis, which of the following symptoms are typically associated with a bacterial infection?

Thick, purulent discharge, often making the eyes sticky or glued shut, particularly in the morning (C) Signup and view all the answers

Which of the following is NOT a typical finding during a physical examination of a patient with cataracts?

Inflammation of the conjunctiva, causing redness and irritation (A) Signup and view all the answers

What is the primary treatment for cataracts?

Surgical cataract extraction (C) Signup and view all the answers

Which type of conjunctivitis is most commonly associated with a recent upper respiratory infection (URI)?

Viral conjunctivitis (B) Signup and view all the answers

What is the recommended duration of topical antibiotic treatment for bacterial conjunctivitis?

1 week (C) Signup and view all the answers

Which of the following interventions is NOT typically recommended for managing acute allergic conjunctivitis?

Topical antibiotics (D) Signup and view all the answers

In the context of conjunctivitis, what is the primary recommendation for patients with viral conjunctivitis?

Rest and supportive care with artificial tears and cool compresses (C) Signup and view all the answers

What is the leading cause of blindness worldwide?

Cataracts (A) Signup and view all the answers

What is a common characteristic of cataracts?

Progressive loss of visual acuity (C) Signup and view all the answers

Which diagnostic tool is essential for assessing cataracts?

Fundoscopic exam (A) Signup and view all the answers

What is a typical feature of viral conjunctivitis?

Excessive watery discharge (A) Signup and view all the answers

Which treatment is recommended for bacterial conjunctivitis?

Topical antibiotics as needed (D) Signup and view all the answers

In the management of allergic conjunctivitis, what is the first step?

Avoidance of triggers (B) Signup and view all the answers

What is a distinguishing sign of a traumatic cataract?

Hazy optic nerve visualization (A) Signup and view all the answers

Which of the following is NOT a feature of allergic conjunctivitis?

Thick, sticky discharge (D) Signup and view all the answers

What is a common cause of noninfectious conjunctivitis?

Allergy (A) Signup and view all the answers

What happens if conjunctivitis is caused by a virus?

Contagious until all symptoms resolve (A) Signup and view all the answers

Which of the following can lead to cataracts in rare instances?

Trauma (D) Signup and view all the answers

What is a common consequence of prolonged contact lens use?

Corneal epithelial breaks (D) Signup and view all the answers

How can the pain from a corneal surface defect typically be alleviated?

By using topical anesthetic eye drops (D) Signup and view all the answers

Which symptom is NOT associated with dry eye syndrome?

Tearing only when outdoors (D) Signup and view all the answers

What should be checked when a chemical eye injury is suspected?

pH level of the eyes (B) Signup and view all the answers

What sensation might a person with a corneal surface defect experience?

A sensation of foreign body in the eye (D) Signup and view all the answers

Which of the following is NOT a typical management strategy for corneal surface defects?

Surgical intervention (A) Signup and view all the answers

What indicates a need for ophthalmologic referral in a patient with corneal surface defects?

Presence of RSVP symptoms (A) Signup and view all the answers

What activity is likely to worsen symptoms of dry eye syndrome?

Reading or computer use (D) Signup and view all the answers

What symptom is typically relieved by blinking in patients with dry eye syndrome?

Burning sensation (D) Signup and view all the answers

What might indicate a severe issue with corneal surface injury?

Persistent light sensitivity (B) Signup and view all the answers

What primary symptom is associated with pterygium in advanced stages of the condition?

Decreased vision (D) Signup and view all the answers

Which serologic evaluations are recommended if autoimmune conditions are suspected in dry eye syndrome?

SS-A (anti-Ro) and SS-B (anti-La) (A) Signup and view all the answers

Which environmental factors should individuals with dry eye syndrome avoid?

Low-humidity environments (D) Signup and view all the answers

What is a common treatment strategy for managing mild dry eye symptoms?

Preservative-free artificial tear drops (C) Signup and view all the answers

What is the characteristic appearance of a pinguecula?

Benign yellow-white nodule (A) Signup and view all the answers

Which treatment is generally NOT recommended for managing pterygium?

Long-term topical antibiotic use (D) Signup and view all the answers

Which of the following tests assesses tear production in dry eye syndrome?

Schirmer test (C) Signup and view all the answers

What is a recommended action for individuals experiencing dry eye symptoms while using a computer?

Take breaks without interruptions (D) Signup and view all the answers

What is the typical location of a pinguecula on the conjunctiva?

Nasal side of the cornea (C) Signup and view all the answers

What additional management recommendation is given for patients with dry eye syndrome?

Review systemic medications (C) Signup and view all the answers

Study Notes

Cataracts (Chapter 55)

Opacification of the eye's crystalline lens
Leading cause of blindness globally
Non-painful, progressive vision loss
Frequent changes in eyeglass prescriptions
Physical exam involves a full ophthalmologic evaluation
Typically does not cause conjunctival injection, corneal opacification, or pain (except in rare instances of trauma or hypermature cataracts)
Hazy vision of the optic nerve and retina due to lens opacity
Poor or absent response to the red light reflex
Diagnostics include fundoscopic and dilated retinal exams
Treatment is surgical cataract extraction

Conjunctivitis (Chapter 57)

Inflammation of the conjunctiva (transparent mucosal tissue lining the eye and inner eyelid surface)
Infectious Conjunctivitis
- Bacterial: Thick, purulent discharge, eyes are sticky/glued shut, symptoms worse in the morning
- 70% of cases—recent URI or exposure to sick contacts (likely adenoviral)
- Acute onset, red eye, excessive watery discharge, usually starts in one eye, then the other a few days later
- Viral: Artificial tears and cool compresses; contagious while tearing
- Management:
  - Bacterial: Use discretion in topical antibiotics (trimethoprim-polymyxin B or fluoroquinolone drops, 4 times a day for 1 week); high-risk patients should always receive antibiotics
  - Acute allergic: Avoidance of triggers, oral antihistamines, preservative-free artificial tears, cool compresses, and removal of contact lenses. Severe cases may also require addition of antihistamines and vasoconstrictors, mast cell stabilizers.

Corneal Surface Defects and Ocular Surface Foreign Bodies (Chapter 58)

Corneal surface defect: Interruption of the corneal epithelium
Causes: Direct trauma from foreign objects (fingers, branches, makeup applicators)
Risk factors: Prolonged lens use (contact lens wearers)
Symptoms: Sudden onset of severe eye pain, pain typically resolves after topical anesthetic drop, foreign body sensation, blurred vision, redness, tearing, light sensitivity, eyelid swelling, blepharospasm
Physical exam: Thorough eye exam - visual acuity, pupil, light response, eye pressure, cornea check for foreign bodies. Topical fluorescein dye.
Management: Supportive care in most cases, ophthalmic antibiotic ointment (e.g., erythromycin or polymyxin B/bacitracin) for pain/comfort, oral analgesics, artificial tears, If visible foreign object removal, referral to ophthalmologist for other cases, immediate irrigation of chemical exposure, check pH (7-7.5)
- If symptoms warrant ophthalmologic referral (RSVP - Redness, Sensitivity to light, Vision changes, or Pain)

Dry Eye Syndrome (Chapter 59)

Multifactorial disorder characterized by abnormalities in tear film stability, hyperosmolarity, and ocular surface inflammation
Symptoms: Dryness, foreign body sensation, burning/stinging pain, itching, ocular fatigue, redness, light sensitivity, transient blurred vision relieved by blinking, symptoms worsened by activities requiring concentration, excessive tearing, intolerance to contact lenses.
Diagnostics: Schirmer test and tear breakup time to differentiate aqueous-deficient from evaporative dry eye. Autoimmune testing (SS-A, SS-B, rheumatoid factor, antinuclear antibodies) if autoimmune suspected
Management: Stepwise management based on disease severity. Avoid windy/smoky environments, low humidity, limit uninterrupted computer work, review systemic medications, make dietary recommendations, artificial tears, high-viscosity gels, ointments

Pingueculae and Pterygia (Chapter 62)

Pinguecula: Benign, yellow-white nodule on the bulbar conjunctiva, often located nasally to the cornea
Pterygium: Benign growth of fibrovascular conjunctiva extending onto the cornea's surface.
Symptoms: Dryness, irritation, foreign body sensation, itching, redness, cosmetic concerns. Advanced cases may cause persistent vision decrease
Diagnostics : Slit-lamp exam
Management: Symptom management (preservative-free artificial tear drops, UV protection), lower potency topical steroid drops (4-7 day course)

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Explore the key concepts of Cataracts and Conjunctivitis with a focus on their causes, symptoms, and treatments. Understand the importance of timely diagnosis and the intricacies of eye examinations. This quiz covers critical information necessary for understanding these common eye conditions.