Ophthalmology Conditions and Treatments

Vitreous Wick Syndrome

• Damages vitreous attachments to the corneal endothelium, potentially causing angle closure.

Post Embryotoxon

• Recognize in all Iridocorneal Dysgenesis cases (Axenfeld-Rieger Syndrome, Peters Anomaly).
• Often shows a prominent Schwalbe's line or ring at the limbus.

Actinic Keratosis

• Precancerous lesion; 10% progress to squamous cell carcinoma (especially with multiple lesions).
• Management involves photodocumentation, six-month follow-ups, and biopsy if indicated.

Cataracts Due to Antipsychotic Drugs

• Anterior polar or capsular opacities.
  • Anterior Polar: often presents as a PPM (posterior polar opacity).
  • Anterior Capsular: shows a granular, dirty area affecting distance vision.
• Anterior Pigmented Opacities: a separate type of opacity.

Poliosis

• Premature localized discoloration of eyelashes and eyebrows.
• Associated with Vogt-Koyanagi-Harada Syndrome.

Molluscum Contagiosum Treatment

• Typically self-resolves, but treatment may be needed for transmission or symptom reduction.
  • Adults: Podophyllotoxin cream
  • Children: Oral cimetidine

Papilloma Types

• Verrucae (warts):
  • Viral (HPV 6 & 11), causing various presentations (planar, vulgaris, pedunculated, cutaneous horn).
  • Vulgaris type has higher malignant potential.
• Squamous Cell Papilloma (skin tag):
  • Most common benign lesion, non-viral, and non-malignant.

Carcinoma Differentiations

• Differentiate sebaceous, squamous, and basal cell carcinomas in images.
• Differentiate anterior cortical and anterior subcapsular cataracts in images.

Glaucoma Flecken

• Complicated cataract caused by glaucoma.
• Characterized by central and anterior subcapsular opacities as a consequence of acute angle-closure glaucoma.

Traumatic Cataracts

• Rosette cataract: a floral pattern opacity in the anterior cortex/capsule, which may progress to a total traumatic cataract.
• Total traumatic cataract: severe lens capsule damage; lens nucleus may be displaced or lost.

Peter's Anomaly

• Primarily an autosomal recessive condition.
• Results from a chromosomal defect.
• Peters 1 involves the iris, and Peters 2 involves the lens.
• May involve a corneal plana, cataracts from lens adhesions, aniridia (absence of part of iris), persistent fetal vasculature (PFV), and glaucoma (open-angle or closed-angle, likely from synechia formation).

Milia

• Entrapped keratin in the epidermis (similar to acne but rounded and white).
• Possible causes include trauma, medication, skin conditions, laser treatments, and corticosteroids.
• May be associated with Lupus or Pseudoxanthoma elasticum.
• Management varies with age: children typically don't need treatment, while adults may require incision, expression, and antibiotic ointment.

Rieger Anomaly Complications

• Axenfeld-Rieger Syndrome and Axenfeld Syndrome have various ocular (Iris Hypoplasia, Pupil Defects, Peripheral Anterior Synechiae (PAS), Iris Ectropion, Glaucoma) and potentially systemic features (Facial, dental, hearing, cardiac issues, Hypothyroidism, Maxilla malformation).
• Management prioritizes glaucoma treatment.

Hydrodissection vs. Hydrodelineation

• Hydrodissection: saline injection separates the lens capsule from the cortex.
• Hydrodelineation: saline injection separates the epi-nucleus from the central nucleus.

Endophthalmitis

• Bacterial Endophthalmitis:
  • Usually within 2 weeks of surgery.
  • Symptoms include reduced vision, redness, and pain.
  • Treatment: AC Paracentesis, Vitreous Tap, Intravitreal antibiotics (Vancomycin + Amikacin), Vitrectomy, fortified topical/oral antibiotics, topical/oral steroids.
• Fungal Endophthalmitis:
  • Usually after 6 weeks from surgery.
  • Treatment: AC Paracentesis, Vitreous TAP, antifungal treatment, frequent monitoring (critical 48-hour period).

Morgagnian vs. Hypermature Cataract

• Morgagnian: a type of hypermature cataract where the cortex and nucleus separate, and the nucleus displaces.
• Hypermature: liquefied with breaks.

Corneal Plana

• Two types: mild (38-40 D) and advanced (23-38 D).
• Associated with myopia, narrow anterior chamber, angle-closure glaucoma, iris transillumination, and systemic scleroderma.
• Management (limited success): keratectomy or corneal transplant.

Post-Cataract Surgery Corneal Edema

• Causes within first two weeks: wound leak verified by Seidel test; require cycloplegia and patching.
• Chronic edema: sign of corneal decompensation in intermediate or late-stage.

Cataract Grading

• Provides a numerical description with associated VA based on opacity degree and location (nuclear, cortical, subcapsular).

Ectropion Uveae

• Displaced pigment epithelium of the iris (often associated with Rieger Anomaly).

Amelanotic Nevi (Lid)

• Different types exist that need differentiation.

Poliosis Associated Conditions

• Vogt-Koyanagi-Harada Syndrome, Tuberous Sclerosis, Waardenburg Syndrome, Piebaldism.

Chloasma (Melasma)

• Tan or dark skin patches, possibly hormone-related.
• UV light exposure can contribute to its development and is more common in women.
  • Treatment: Hydroquinone, tretinoin, corticosteroids; triple therapy; dermabrasion.

Vitiligo

• Autoimmune disorder causing skin depigmentation.
• Topical corticosteroids, psoralen/PUVA (UVA), and surgical skin grafting are used as treatment.

Secondary Cataracts from Systemic Diseases

• Numerous systemic conditions cause cataracts, including atopic dermatitis (anterior subcapsular plaque), myotonic dystrophy (Christmas tree or posterior subcapsular), diabetes (snowflake), Wilson's disease (sunflower), galactosemia (oil droplet), and drug-induced opacities (phenthiazines, hypertension medications, steroids, miotics).
• Complicated cataracts show anterior capsular and cortical opacities (uveitis), or the dense, irregular posterior subcapsular opacity (chronic anterior uveitis, high myopia).

This quiz explores various ophthalmological conditions including Vitreous Wick Syndrome, Post Embryotoxon, Actinic Keratosis, and others. It covers their characteristics, associations, and treatment options. Test your knowledge on important eye health topics!