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Disease of Conjunctiva & Sclera

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1- Bulbar Conjunctiva: (Covers the sclera) 2- Palpebral Conjunctiva: (Lines the inner surface of the eyelids) 3- Conjunctival Fornix: (The junction/fold between the bulbar and palpebral conjunctiva)

Conj. follicles

Conj. papillae

Giant (cobblestone) papillae Diagnosis: Giant palpebral conjunctivitis What is the cause: Wearing contact lens, - Chronic allergy

Conj. Scarring Y

Subconjunctival hemorrhage

Young male after gym training discovered redness in eye.

Causes:

  • Truama,
  • Spontaneously (rupture due severe cough, constipation, lifting heavy objects)
  • Systemic Hypertension
  • Coagulation diseases

Treament:

  • No specific treatment only assurance to patient, leave the hemorrhage would resolve its own in two weeks
  • ask for medical assessment for hypertension, liver diseases

its never IOP doesnt lead to it

Symblepharon Y

Pinguecula

Cause: Hyaline degeneration of conjunctiva

Sign: Yellowish, grayish elevation near limbus never crosses cornea, usually triangular shape

Risk Factors:

  • Exposure to sun rays, hot weather

Treatment:

  • Assurance
  • Lubricants
  • Decrease exposure to sun rays with sunglasses

Pterygium (wing)

Cause: Fibrovascular growth of conjunctiva, triangular shape near limbus, and creeps may crosses cornea

Risk Factors:

  • workers, farmers

Treatment:

  • Assurance
  • Lubricants
  • Decrease exposure to sun rays with sunglasses
  • If it crosses to the cornea, Surgical removal is indicated (cosmetic and effects vision by covering pupil or compression may result in astigmatism)

Pterygium (recurrent)

Bitot’s spot Y

Foamy surface with chalky avascular appearance

Conjunctiva navus Y

Conj. cyst Y

Conjunctivitis

  • Viral; LN
  • Allergic; Itching

Neonatal Conjunctivitis

Cause:

  • Neisseria gonorrhea
  • Chlamydia

Treatment:

  • Before starting, child’s conjunctiva swab, mother’s cervical, and vaginal
  • Eye lid hygiene
  • Topical & Systemic antibiotics

Scleritis. Y

Episcleritis. Y

Y

#Y

Iritis

Uveitis

  • Inflammation of the uveal tissue (iris, ciliary body, or choroid), retina, blood vessels, optic disc, and vitreous can be involved.

Etiology; Bilateral

  • Idiopathic 90%
  • Inflammatory diseases
    • HLA B27, Ankylosing spondylitis, IBD; UC, Reiter’s syndrome, Psoriatic arthritis
    • Sarcoidosis, Behcet’s, Vogt-Koyanagi-Harada Syndrome Z
  • Infectious
    • Herpes virus
    • Toxoplasmosis
    • Tuberculosis
    • Syphilis

Management

  • Identify possible cause
  • Topical steroid; muscle relaxant
  • Topical cycloplegic; ciliary spasm
  • Systemic immunosuppressive medication
    • Steroid
    • Cyclosporine
    • Methotrexate
    • Azathioprine
    • Cyclophosphamide
  • Immunomodulating agents ±
    • Infliximab (Anti-TNF)

Graph View

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