Epidemic Keratoconjunctivitis (aka Pink Eye)
Signs: 1. follicles 2. preauricular node 3.pseudomembrane 4. SEIs
Treatment: AT, antihistamine, topical/ oral steroid, BCL
Limbal Dermoid
Systemic Association- Goldenhar Syndrome
Features: Malformation of 1st and 2nd Brachial clefts; auricular apendages, skeletal anomalies, eyelid coloboma, Duane's syndrome
Corneal Abrasion
Vertical= Foreign Body Under Eyelid!
Optic Neuritis
Symptoms: 1. Pain with eye movements 2. Color desaturation 3. Pulfrich Effect 4. Worse with heat
Signs: APD, VF defect, Enhancement of ON on MRI
Look for UBOs, demyelination in brain/ spine
LP: Oligoclonal bands, MBP in CSF, lyme, bartonella, ANA
Treatment: ONTT (IV steroid) CHAMPS (Avonex for at risk pts)
Optic Nerve Hypoplasia
"Double Ring Sign"
Systemic Association: Septo-Optic Dysplasia "DeMorsier Syndrome"
Absent Septum Pellucidum, agenesis corpus callosum, pituitary abnormalities
Growth Hormone is most common deficiency
Hyphema
"8 Ball"
Bartonella Neuroretinitis "Cat Scratch Disease"
Symptoms: flu like illness, anorexia, HA, nausea/emesis
Signs: pustule at inoculation site, LAD, conjunctivitis, disc edema, macular star, +titers
Tx: Azithromycin
Pigmentary Retinopathy
Syndromic Association: Hearing Loss
Usher Syndrome: Hearing loss + Retinitis Pigmentosa
Ruptured Globe
Signs: Peaked Pupil, Hypotony, asymmetric AC depth, 360 chemosis, iris prolapse
CMV Retinitis
Patient Population: AIDS with CD4 <50
Signs: Start peripherally, move posterior
Tx:IV Foscarnet/ gancyclovir vs intravitreal
Morning Glory Disc
Syndromic Asociation: Moya Moya Disease "Puff of Smoke"
Canalicular Tear
Candida Vitritis/ Endophthalmitis
Organism: Candida Albicans
Signs: "string of pearls" + positive diagnostic vitrectomy
Patient Population: GI surgery, neutropenia, hyperalimentation, transplant
Tx:Intravitreal Amphotericin B or voriconizole + dex along with IV
Peripapillary Lacunae/ ON abnormalities
Syndromic Association: Aicardi Syndrome
X Linked, but lethal in males, Seizures/ Infantile Spasm, absent corpus callosum, vertebral anomalies
Iridodialysis
Symptoms: Photophobia, monocular diplopia
Tx:Mydriasis, McCannell Suture