Lacrimal system 1
Lacrimal system 2
Conjunctivitis 1
Conjunctivitis 2
Other external diseases
100
Where is the nasolacrimal duct opening located?
Under the inferior turbinate
100
Identify condition + how to treat
Complete punctual atresia
CDCR (conjunctivodacryocystorhinostomy)
100
How do newborns acquire infectious neonatal conjunctivitis
Through direct contact during passage through the birth canal (infections can ascend to the uterus so babies delivered by C section can still get infected)
100
Name the most common cause of preventable blindness in the world
Trachoma (C. trachomatis serotypes A-C)
100
What is the best test that correlates with dry eye disease severity in children
Fluorescein staining
200
What is the prevalence of congenital NLDO?
5% of newborns affected
20% in Down syndrome
200
Diagnose + Treat
Congenital lacrimal fistula
Observe. If discharge present (distal NLDO can probe), can suture close if persists despite patent NLD
200
Describe the differences between Chlamydia and N. Gonorrhea ophthalmia neonatorum? (time to sx, ocular signs, systemic complications and treatment)
Chlamydia: inclusion conjunctivitis, onset 1 week, minimal/moderate filmy discharge, mild swelling, hyperemia, papillary reaction (follicular in adults), risk of pneumonitis/ OM, Tx= oral erythromycin x 14 days or Azithromycin x 3 days.
Gonorrhea: GNID, 3-4 days, copious discharge potentially corneal ulceration and perforation, risk of sepsis/ meningitis/ arthritis. Tx= systemic ceftriaxone and topical saline irrigation + top Abx if cornea involved.
200
What should you suspect in a child with inclusion conjunctivitis
Sexual abuse (cause with Chlamydia serotypes D-K)
200
What is a special consideration in children with dry eye syndrome
Vitamin A deficiency
300
At what age should you probe if NLDO does not resolve spontaneously?
BONUS +100: what is the success rate of the initial probing if done at appropriate time?
12 months (90% of patients improved within 9-12 months)
80% or more
300
In this condition, which structure prevents decompression of the lacrimal sac
Valve of Rosenmuller.
300
List the 4 most common causes of bacterial conjunctivitis in school-aged children
Strep pneumo, Haemophilus sp., S. Aureus, Moraxella
300
How does molluscum contagiosum cause conjunctivitis? What kind of conjunctivitis
Lesion next to eyelid directly release viral particles resulting in follicular conjunctivitis
300
Type of hypersensitivity reaction for seasonal AK, perennial AK and the difference between them
Seasonal: type 1 to seasonal allergens in spring/ fall
Perennial: type 1 to ubiquitous household allergens (year long)
400
List all the structures your probe passes through when probing NLD
punctum, canaliculus, common canaliculus, valve of rosenmuller, lacrimal sac, nasolacrimal duct, valve of hasner
400
NLD probing alone is curative in what % of patient with Dacryocystocele
25%
Rest needs probing in combo w nasal endoscopy (BILATERAL) and intranasal cyst removal
400
What is Parinaud oculoglandular syndrome and name 3 organisms that can cause it
Unilateral granulomatous conjunctivitis associated with preauricular and submandibular lymphadenopathy.
Bartonella henselae (most common), Mycobacterium tuberculosis or leprae, Francisella Tularensis, Yersenia, Syphilis, Chlamydia.
400
How are conjunctival papillomas managed
observation, if too big and irritation oral CIMETIDINE
400
Name this and where do you typically see those
Limbal form of VKC (thickening and opacification of limbus) Horner trantas dots- raised whitish center filled with eosinophils and epithelial cells
500
What does DCR stand for and what does it entail?
Dacryocystorhinostomy- new opening created between lacrimal sac and nasal cavity
500
Differential diagnosis of dacryocystocele (name all 3)
Hemangioma (vascular appearance), Dermoid cyst, Encephalocele (later 2 are ABOVE medial canthal tendon)
500
Name the 4 types of adenoviral diseases
Double points if you can name ALL serotypes
- epidemic keratoconjunctivitis (serotypes 8,19,37, subgroupD)
- pharygoconjunctival fever (3,7)
- Acute hemorrhagic conjunctivitis (11,21)
- Acute follicular conjunctivitis (1,2,3,4,7,10)
500
Describe the typical course of EKC (with durations)
Acute follicular conjunctivitis followed by diffuse superficial keratitis, followed by focal epithelial lesions. After 11-15 days sub epithelial opacities begin. epithelial component fades by day 30 but subepi opacities can remain for up to 2 years.
500
Most common cause of SJS/TEN in children
Medications: anticonvulsants and sulfonamides
Infections: Mycoplasma or herpes simplex