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)


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


SymblepharonY


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 spotY

Foamy surface with chalky avascular appearance


Conjunctiva navusY


Conj. cystY


Conj. follicles


Conj. papillae

Giant (cobblestone) papillae

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


Conj. ScarringY


Corneal pannusY

Herbert pits


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


Subconjunctival hemorrhage


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 SyndromeZ
  • 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)