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Questions and Answers
What value in the Schirmer 1 test indicates an abnormal measurement for dry eye symptoms?
What value in the Schirmer 1 test indicates an abnormal measurement for dry eye symptoms?
- 10 mm (correct)
- 18 mm
- 12 mm
- 15 mm
Which condition can the Schirmer 1 test help diagnose in a patient experiencing dryness of the eyes?
Which condition can the Schirmer 1 test help diagnose in a patient experiencing dryness of the eyes?
- Glaucoma
- Keratoconjunctivitis sicca (correct)
- Blepharitis
- Allergic conjunctivitis
Why is the Schirmer 1 test performed without anesthetic?
Why is the Schirmer 1 test performed without anesthetic?
- To prevent interference with reflexes
- To measure reflex tearing accurately (correct)
- To eliminate discomfort caused by drying
- To improve patient comfort
Which of the following is a potential limitation of the Schirmer 1 test?
Which of the following is a potential limitation of the Schirmer 1 test?
What duration is typically used for the Schirmer 1 test to determine tear production?
What duration is typically used for the Schirmer 1 test to determine tear production?
What is the primary characteristic of entropion?
What is the primary characteristic of entropion?
Which condition can cause entropion to develop?
Which condition can cause entropion to develop?
What condition is characterized by eyelashes turning inward and rubbing against the cornea?
What condition is characterized by eyelashes turning inward and rubbing against the cornea?
What aspect of entropion could potentially lead to complications?
What aspect of entropion could potentially lead to complications?
Which of the following is least likely to be associated with entropion?
Which of the following is least likely to be associated with entropion?
Which of the following best explains the secondary cause of trichiasis?
Which of the following best explains the secondary cause of trichiasis?
What is a common treatment option for entropion?
What is a common treatment option for entropion?
What is a common consequence of untreated trichiasis?
What is a common consequence of untreated trichiasis?
Which symptom is NOT associated with trichiasis?
Which symptom is NOT associated with trichiasis?
In which population is trichiasis due to entropion most likely to occur?
In which population is trichiasis due to entropion most likely to occur?
What is the appearance of concretions in the ocular adnexa?
What is the appearance of concretions in the ocular adnexa?
In which demographic are concretions most commonly found?
In which demographic are concretions most commonly found?
What is a major contributing factor to the formation of concretions?
What is a major contributing factor to the formation of concretions?
Which of the following is NOT a characteristic of concretions?
Which of the following is NOT a characteristic of concretions?
What color variations can concretions display?
What color variations can concretions display?
What characterizes distichiasis?
What characterizes distichiasis?
Which condition occurs when eyelashes grow inward from their normal position without entropion?
Which condition occurs when eyelashes grow inward from their normal position without entropion?
What is a common cause of madarosis?
What is a common cause of madarosis?
Which condition is NOT classified as having inward-growing lashes?
Which condition is NOT classified as having inward-growing lashes?
What is a potential cause of trichiasis?
What is a potential cause of trichiasis?
What is primarily affected in meibomian gland dysfunction?
What is primarily affected in meibomian gland dysfunction?
Which symptom is most commonly associated with meibomian gland dysfunction?
Which symptom is most commonly associated with meibomian gland dysfunction?
Meibomian gland dysfunction is also known as which of the following?
Meibomian gland dysfunction is also known as which of the following?
What is a potential consequence of untreated meibomian gland dysfunction?
What is a potential consequence of untreated meibomian gland dysfunction?
What type of glands are primarily dysfunctional in meibomian gland dysfunction?
What type of glands are primarily dysfunctional in meibomian gland dysfunction?
What abnormal eyelash condition is characterized by eyelashes growing from the meibomian glands?
What abnormal eyelash condition is characterized by eyelashes growing from the meibomian glands?
Which condition is characterized by the inward turning of eyelashes, causing irritation to the eye?
Which condition is characterized by the inward turning of eyelashes, causing irritation to the eye?
Which of the following conditions could cause a sensation of a foreign body in the eye due to eyelash misalignment?
Which of the following conditions could cause a sensation of a foreign body in the eye due to eyelash misalignment?
In what condition might a patient notice excessive tearing and irritation due to abnormal eyelash growth?
In what condition might a patient notice excessive tearing and irritation due to abnormal eyelash growth?
Which condition is associated with the loss of eyelashes, potentially impacting eye comfort?
Which condition is associated with the loss of eyelashes, potentially impacting eye comfort?
What defines symblepharon in relation to ocular anatomy?
What defines symblepharon in relation to ocular anatomy?
Which eyelids are primarily affected by symblepharon?
Which eyelids are primarily affected by symblepharon?
In the context of symblepharon, what does 'partial adhesion' imply?
In the context of symblepharon, what does 'partial adhesion' imply?
What are potential causes of symblepharon?
What are potential causes of symblepharon?
How might a clinician diagnose symblepharon?
How might a clinician diagnose symblepharon?
What is the approximate length of a phthiriasis organism?
What is the approximate length of a phthiriasis organism?
Where are phthiriasis organisms typically observed during a slit lamp exam?
Where are phthiriasis organisms typically observed during a slit lamp exam?
What shape is the body of phthiriasis described as?
What shape is the body of phthiriasis described as?
In which anatomical location can phthiriasis be found?
In which anatomical location can phthiriasis be found?
Which of the following is NOT a characteristic of phthiriasis?
Which of the following is NOT a characteristic of phthiriasis?
Which treatment is used for corneal pseudodendrites or superficial punctate keratitis (SPK) in herpes zoster ophthalmicus?
Which treatment is used for corneal pseudodendrites or superficial punctate keratitis (SPK) in herpes zoster ophthalmicus?
What is the most appropriate management for postherpetic neuralgia related to herpes zoster?
What is the most appropriate management for postherpetic neuralgia related to herpes zoster?
In cases of increased intraocular pressure (IOP) associated with uveitis, what is a recommended course of action?
In cases of increased intraocular pressure (IOP) associated with uveitis, what is a recommended course of action?
What is the recommended follow-up interval for patients with ocular involvement after an acute herpes zoster episode?
What is the recommended follow-up interval for patients with ocular involvement after an acute herpes zoster episode?
Which treatment is indicated for stromal keratitis in herpes zoster?
Which treatment is indicated for stromal keratitis in herpes zoster?
Which medication is often used for the management of uveitis in herpes zoster?
Which medication is often used for the management of uveitis in herpes zoster?
What should be done if corneal ulceration occurs in neurotrophic keratitis?
What should be done if corneal ulceration occurs in neurotrophic keratitis?
Which of the following is a recommended initial treatment for conjunctivitis in the context of herpes zoster ophthalmicus?
Which of the following is a recommended initial treatment for conjunctivitis in the context of herpes zoster ophthalmicus?
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Study Notes
Entropion
- Inward turning of the eyelid towards the globe.
Trichiasis
- Resultant trichiasis occurs when eyelashes turned inward and rub against the cornea, secondary to entropion of the upper and lower lids.
Schirmer 1 Test
- A measurement below 10 mm in 5 minutes is considered abnormal.
Concretions
- Small, chalky, white/yellow inferior sub-conjunctival palpebral deposits.
- Often seen in elderly patients or those with chronic meibomian gland dysfunction.
Distichiasis
- A condition where eyelashes grow inward toward the globe from a position posterior to the normal row of lashes.
- Typically, these lashes emanate from the meibomian gland orifices.
- May be congenital or acquired secondary to chronic eyelid inflammatory conditions, surgery, or when an eyelid tumor is present.
Trichiasis
- Occurs when eyelashes originating from a normal position grow inward toward the globe.
- No entropion of the eyelid margin is present.
- Can occur after eyelid trauma, surgery, chronic blepharoconjunctivitis, cicatricial pemphigoid, trachoma, or may be idiopathic.
Madarosis
- A loss of lashes, usually due to a congenital condition or an infectious condition.
- Trichotillomania occurs secondary to a compulsive urge to pull out one's own hair and/or eyelashes.
Meibomian Gland Dysfunction (MGD)
- Frothy tear film associated with MGD, also known as posterior blepharitis.
- Caused by a dysfunction of the sebaceous glands.
Symblepharon
- A partial or complete adhesion between the palpebral conjunctiva of the eyelid to the bulbar conjunctiva of the globe.
Phthriasis (Crab Lice)
- Measures about 2mm long with a broad, flat body.
- Typically observed on slit lamp exam clinging to the base of the eyelash or buried within the eyelid margin.
Herpes Zoster Ophthalmicus
- Ocular involvement may include:
- Conjunctivitis: treated with cool compresses and erythromycin or broad-spectrum antibiotic.
- Corneal pseudodendrites or SPK: lubrication with preservative-free artificial tears and ointment.
- Stromal keratitis: topical steroids starting at QID and slowly tapering over months.
- Uveitis: topical steroid and cycloplegic.
- Neurotrophic keratitis: treated with erythromycin ointment and cultures to rule-out bacterial infection.
- Retinitis/choroiditis/optic neuritis/cranial nerve palsies: IV acyclovir and prednisolone.
- Increased IOP: may be steroid response or secondary to inflammation, treated with topical aqueous suppressants.
- Postherpetic neuralgia: treated with amitriptyline, capsaicin, or oral gabapentin.
Follow-Up
- Patients with ocular involvement: examined every 1-7 days, depending on the severity of the presentation.
- Patients without ocular involvement: followed every 1-4 weeks.
- After the acute episode resolves, checked every 3-6 months.
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