Conjunctival disorders

Question 1

Phlyctenule

Answer 1

• type IV reaction to Staph, coccidioidomycosis, Candida, HSV, LGV, TB
• round, elevated, focal, sterile inflammation on bulbar conj, limbus or cornea
• overlying epi breaks down (stains with fl)
• may have corneal neovascularization
• Tx: topical steroids and abx

Question 2

DDx conjunctivitis with preauricular LN

Answer 2

EKC, HSV, gonococcus, chlamydia, parinaud’s oculoglandular syndrome, Newcastle’s disease

Question 3

DDx acute follicular conjunctivitis

Answer 3

EKC, chlamydia, HSV, medicamentosa, viral lid infections, Newcastle’s disease, acute hemorrhagic conj

Question 4

DDx chornic follicular conjunctivitis

Answer 4

Chlamydia, medicamentosa, viral lid lesion, HSV, psittacosis, Lyme, Parinaud’s oculoglandular syndrome, chronic fiber granuloma (nylon in fornix), atopic, molluscum, trachoma

Question 5

Newcastle’s disease

Answer 5

Unilateral follicular conj, pneumonitis, preauricular LAD

• poultry handlers
• self-limited, lasts 1 week

Question 6

Herbert’s pits

Answer 6

cicatrized limbal follicles in trachoma

Question 7

Parinaud’s oculoglandular syndrome

Answer 7

Monocular granulomatous conjunctivitis

• necrosis and ulceration of follicles
• fever, malaise, LAD

Question 8

Most common malignant epithelial tumor of conjunctiva

Answer 8

squamous cell carcinoma

Question 9

Indication for biopsy of PAM

Answer 9

nodular thickening

Question 10

Worst location for conjunctival melanoma for prognosis

Answer 10

Caruncle, fornices, palpebral (better overall prognosis than cutaneous melanoma)