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Conjunctiva by Mind Map: Conjunctiva

1. Degenerative disorders (due to alteration of collagen structure )

1.1. Pterygium

1.1.1. vascularised , encroatch onto cornea

1.1.2. Treatment: steroids (if inflamed) , surgical excision (if affect vision) but may recur

1.2. Pinguecula

1.2.1. Small benign elevated yellowish paralimbal Lesions and never impinge on the cornea

2. Conjunctivitis

2.1. Bacterial

2.1.1. Clinical pic:redness,irritation,purulent discharge

2.1.2. Diagnosis: clinical diagnosis (unless not resolve by treatment we need swab )

2.1.3. Treatment:self limited in 10-14 days!or antibiotic

2.2. Neonatal conjunctivitis (very serious)

2.2.1. Chlamydia infection(M.C) Inclusion keratoconjunctivitis Chronic red eye, Mucopurulent discharge,Hyperemia, Follicular reaction on the tarsal conjunctiva, Micropannus Diagnosis :Immunoflourescence to detect chlamydial antigens+ Inclusion body identification by Giemsa stain Treatment: azithromycin , erythromycin Trachoma Complications: Keratitis and Trichiasis, Recurrent subconjuctival fibrosis (due to re-infection) ,Corneal scaring (blindness) Treatment: Tetracycline , erythromycin

2.2.2. Clinical pic:Itching, Conjunctival injection and swelling ,Lacrimation,rhinitis

2.3. Neisseria gonorrhea (most serious)

2.4. Viral(M.C adenovirus)

2.4.1. Clinical pic:watery discharge,increased lacrimation,lid edema, conjunctival follicles .

2.4.2. Treatment : usually self-limited Good hygiene ( separate towels ), Symptomatic treatment for irritation. AB if bacterial conjuctivitis is over. Topical steroid may used if cornea involvement

2.5. Allergic

2.5.1. Treatment : Antihistamines ,Mast cell stabilizers (Na chrmolin, nedochromil, lodoxamide) ,Topical steroids , Mucolytics (to dissolve corneal plaques

3. Cornea

3.1. Herpes simplex Keratitis (The M.C cause of infectious blindness in the world)

3.1.1. asymptomatic or with : ➢Fever ➢Vesicular lid lesion ➢Follicular conjunctivitis ➢Preauricular lymphadenopathy

3.1.2. Antivirals: Vidarabine., Trifl uorothymidine, Aciclovir., Ganciclovir. (Topical steroids must not be given to patients with a dendritic ulcer

3.2. Herpes zoster ophthalmicus

3.2.1. Pain and vesicles in the distribution of the ophthalmic nerve. ,Ocular problems if nasociliary branch of the nerve is involved.

3.2.2. Oral antiviral treatment for post infective neuralgia . Antibacterials to prevent secondary infection

3.3. Bacterial keratitis (most common form of keratitis)

3.3.1. Pain ,Purulent discharge ,Ciliary injection ,Visual loss ,Hypopyon, White corneal opacity

3.3.2. Gram staining and culture + topical antibiotics ,Dual therapy to cover most bacteria (cefuroxime + gentamicin ) , Monotherapy ( ciprofloxacin ) , Tissue adhesives and corneal graft for perforated cornea