Ophthalmology Quiz: Acanthamoeba and Glaucoma

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Questions and Answers

What is the hallmark symptom of acanthamoeba infection in contact lens wearers?

Mild discomfort

Intense photophobia

Severe burning sensation

Very severe relentless pain (correct)

Which treatment is commonly used for acanthamoeba infection?

Oral antibiotics

Topical steroids

Propamidine isethionate drops (correct)

Surgical intervention only

What is a common feature of episcleritis?

Associated with bacterial infection

Presence of discharge

Severe vision impairment

Tenderness over inflamed area (correct)

Which condition is characterized by a violaceous hue of the sclera?

Scleritis Signup and view all the answers

What can be a trigger for photophthalmia?

Intense light of short wavelength Signup and view all the answers

What is NOT a symptom of photophthalmia?

Localized inflammation Signup and view all the answers

In what scenario is penetrating keratoplasty frequently required?

In non-responsive acanthamoeba infections Signup and view all the answers

Which of the following may indicate an underlying systemic disease in episcleritis?

Recurrent episodes Signup and view all the answers

What is the primary mechanism behind acute angle closure glaucoma?

Iris bombe Signup and view all the answers

Which of the following is a predisposing factor for angle closure glaucoma?

Having a small hypermetropic eye Signup and view all the answers

What symptoms are commonly associated with acute angle closure glaucoma?

Acute pain and headache Signup and view all the answers

What is considered a precipitating factor for acute angle closure?

Moderate pupillary dilation Signup and view all the answers

In the early stages of acute angle closure glaucoma, what condition can make the situation reversible with medical treatment?

Simple apposition of the iris Signup and view all the answers

What clinical sign indicates a marked increase in intraocular pressure during acute angle closure?

Semi-dilated irreactive pupil Signup and view all the answers

Which of the following symptoms can occur due to reflex vagal stimulation in acute angle closure glaucoma?

Severe nausea and vomiting Signup and view all the answers

What is a characteristic finding in the eye when evaluating for acute angle closure glaucoma?

Severe corneal haze and edema Signup and view all the answers

What characterizes Vernal Keratoconjunctivitis (VKC) in terms of symptom onset?

Symptoms have a clear seasonal exacerbation, particularly in spring. Signup and view all the answers

Which of the following symptoms is NOT typically associated with VKC?

Excessive tearing Signup and view all the answers

What kind of appearance does the limbus have in patients with limbal VKC?

A thickened, fleshy appearance Signup and view all the answers

Which treatment is considered the mainstay for managing VKC?

Topical antihistamines and mast cell stabilizers Signup and view all the answers

What is a potential complication of long-term use of topical steroids in VKC treatment?

Steroid-induced glaucoma Signup and view all the answers

What is the typical shape of a dendritic ulcer?

Linear branching with knobbed ends Signup and view all the answers

Which symptom signifies corneal involvement in VKC?

Blurred vision Signup and view all the answers

In the context of Trachomatous conjunctivitis, what is the primary public health concern?

It is a leading cause of preventable blindness. Signup and view all the answers

What type of corneal sensation alteration is associated with dendritic ulcers?

Decreased sensitivity Signup and view all the answers

Who is primarily affected by Trachomatous conjunctivitis in endemic regions?

Rural children Signup and view all the answers

Which treatment is recommended for dendritic ulcers upon epithelial healing?

Discontinue topical acyclovir gradually Signup and view all the answers

What does Hutchinson's rule signify in herpes zoster ophthalmicus?

Ocular involvement is likely with nasal lesions Signup and view all the answers

Which of the following accurately describes the clinical phases of herpes zoster ophthalmicus?

Phases can be acute, chronic, or relapsing Signup and view all the answers

What kind of virus is responsible for herpes zoster ophthalmicus?

Varicella-zoster virus Signup and view all the answers

Which symptom is NOT commonly associated with herpes zoster ophthalmicus?

Bilateral vesicular lesions Signup and view all the answers

What happens to the lesions in herpes zoster over time?

They form crusting ulcers after vesicles burst Signup and view all the answers

What is the causative organism of Trachoma?

Chlamydia trachomatis Signup and view all the answers

Which of the following phases of Trachoma may coexist in the same patient?

Active and cicatricial Signup and view all the answers

What symptom is least likely to be associated with severe scarring in Trachoma?

Chronic discharge Signup and view all the answers

Which of the following WHO classifications represents the initial stage of Trachoma infection?

Trachomatous follicles TF Signup and view all the answers

What complication can result from trichiasis in Trachoma?

Corneal opacity Signup and view all the answers

What is the primary symptom of the chronic stage of Trachoma?

Chronic discharge Signup and view all the answers

Which of the following treatments is effective against Trachoma?

Tetracycline Signup and view all the answers

What leads to the condition known as Herbert's Pits in Trachoma?

Resolved limbal follicles Signup and view all the answers

What is the typical presentation of a corneal ulcer in relation to the pannus?

Superficial, linear, horizontal ulcers at the lower edge of the pannus Signup and view all the answers

Which complication is specifically caused by local scarring around the lid margin?

Trichiasis Signup and view all the answers

What is one of the primary goals of the SAFE strategy developed by WHO for trachoma?

To improve environmental conditions and sanitation Signup and view all the answers

What type of surgery is indicated for complications such as trichiasis and entropion?

Surgery for trichiasis and entropion Signup and view all the answers

What symptom may indicate progressive pterygium requiring surgical excision?

Visual disturbance due to astigmatism Signup and view all the answers

Which category of drugs is frequently used to manage corneal ulcers medically?

Local sulfonamide or broad-spectrum antibiotic eye drops Signup and view all the answers

In what climate is pterygium most likely to occur?

Hot climates with excessive UV exposure Signup and view all the answers

Toxic conjunctivitis is commonly mistaken for which type of ocular condition?

Allergic ocular disease Signup and view all the answers

Study Notes

Red Eye - Chapter 4

A red eye is a troubling symptom, potentially indicating acute or chronic conjunctivitis
Injection is the dilation and engorgement of blood vessels in the conjunctiva, sclera, or episclera
Conjunctival injection is associated with conjunctival pathology (e.g., conjunctivitis).
Ciliary injection is a more serious sign, indicating inflammation of the cornea, iris, or ciliary body.
Acute red eye can range from easily treatable conditions (like subconjunctival hemorrhage) to serious underlying conditions needing referral.
Conjunctivitis is inflammation of the bulbar and/or palpebral conjunctiva, often caused by bacteria, viruses, or chlamydia, or allergies (e.g., vernal keratoconjunctivitis).
Key symptoms of conjunctivitis are inflammation and discharge.
Classifying Conjunctivitis discharge can aid in diagnosis:
- Purulent/mucopurulent: indicates bacterial/chlamydial infection.
- Mucoid: suggestive of allergic disease or dry eye.
- Watery: likely viral conjunctivitis.
Acute bacterial conjunctivitis is caused by gram-positive (Staphylococci, Streptococcus pneumoniae, viridans) and gram-negative (Hemophilus influenzae, Neisseria gonorrhoeae, Pseudomonas aeruginosa, Moraxella) bacteria.
Standard infection control measures are crucial when dealing with bacterial conjunctivitis due to its contagious nature.
Treatment usually involves antibiotic eye drops or ointments.
Systemic antibiotics are considered only exceptionally in cases like gonorrhea or chlamydia.
Neonatal conjunctivitis (ophthalmia neonatorum) should be addressed urgently.
Acute viral conjunctivitis is typically caused by adenoviruses. Other common viral causes include herpes simplex and herpes zoster, or acute viral illnesses.

Clinical Picture and Symptoms

Symptoms of acute conjunctivitis can include lid edema, hyperemia, mucopurulent or purulent discharge, foreign body sensation, and possible complications.
Spontaneous recovery is often seen within 1-2 weeks without treatment, this recovery time is shorter with treatment.
Possible complications of acute bacterial conjunctivitis include chronic bacterial conjunctivitis (if untreated) and development of secondary keratitis with corneal ulceration.
Viral conjunctivitis is often self-limiting.
Acute allergic conjunctivitis involves an allergic reaction to exogenous antigens.
Symptoms can include itching, redness, lid puffiness, and conjunctival edema.

Acute Non-Infective Conjunctivitis

Allergic conjunctivitis is categorized as an eye inflammation due to allergic reaction to various agents (pollen, dust, mites, or medications.)

Management, Prevention, and Treatment of Different Types

Prevention and management of conjunctivitis involve measures to prevent infection spread.
Mild cases often resolve without treatment, but proper diagnosis is crucial.
Systemic antibiotic use is limited to severe or complicated infections.
Topical antibiotics are used frequently for local treatment.
Antiviral and topical corticosteroid use can address viral and severe/allergic infections.
General measures like avoiding touching the eyes or proper hygiene should be observed.

Corneal Ulcer and Keratitis

Corneal ulceration involves loss of epithelium, and can range from simple abrasions to more severe ulcers involving deeper corneal layers.
Bacterial keratitis includes infections from gram-positive and gram-negative organisms.
The causative bacterial organisms of corneal ulceration vary widely.
Infection control is critical, and appropriate antibiotic treatment is often necessary.

Phlyctenular keratoconjunctivitis is a hypersensitivity reaction in children/young adults involving the cornea and conjunctiva.
Herpes simplex keratitis (HSV) is a common viral infection.
A corneal ulcer may be infectious or non-infectious.
Herpes zoster ophthalmicus results from reactivation of the varicella-zoster virus in the ophthalmic branch of the trigeminal nerve.
Protozoal keratitis (Acanthamoeba) is a significant, serious cause of corneal damage, usually from exposure to contaminated water sources (e.g., swimming pools).
Treatment involves vigorous topical and/or systemic anti-parasitic treatment.
Acute angle closure glaucoma and cavernous sinus thrombosis are severe conditions requiring immediate medical attention.
Symptoms include severe headache, pain, nausea, vomiting and various visual disturbances.
Diagnostic investigations like MRI/MRV are necessary to confirm diagnosis.
Treatment of infectious conditions and acute angle closure glaucoma must be managed aggressively.

Other Relevant Conditions

Endophthalmitis is intraocular inflammation requiring urgent treatment due to potential vision loss.
Orbital cellulitis involves inflammation of the soft tissues in the posterior orbit, commonly due to sinus infections.
Cavernous sinus thrombosis is a rare but serious condition in which blood clots form within the cavernous sinus, frequently due to infection.
Subconjunctival hemorrage is the collection of blood between the conjunctiva and sclera.
Keratoconjunctivitis sicca (dry eye) is characterized by tear deficiency.
Vernal keratoconjunctivitis (VKC) is a chronic inflammatory condition of the conjunctiva.
Toxic conjunctivitis is caused by contact with an irritating agent.
Episcleritis relates to inflammation of the episclera often sectoral and usually not threatening to vision.
Scleritis is inflammation of the sclera, often accompanied by pain and may indication systemic disease.
Photophthalmia: inflammation of cornea and conjunctiva due to exposure to intense light.

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Description

Test your knowledge on key symptoms and treatments related to acanthamoeba infections, episcleritis, and acute angle closure glaucoma. This quiz further explores the underlying mechanisms and symptoms associated with these ocular conditions, providing insight into clinical features and management options.