Clinical picture of bacterial keratitis:Syptoms:4p+referred sypmtoms

pain
blurring of vision
photophobia
blepharospasm
signs:- Alarm
L-loss of luster
R-red eye
M-miosis
ttt of corneal ulcer
hospitalization
swab
2A
atropine&antibiotics

darkglasses
analgesics
hotfoments
bandges


resistance

4D
wrong
Diagnosis or
Drug
or
Dose
or
DM
..
: resistance
6C
reCulture
subConjunctival antibiotics
Chemical cautery by carbolic acid
Corneal graft
Conjunctival flap
therapeutic Contact lesn

complication
glucoma and hypotony

BB&DIAMOX

DECMATOCELE OR PERFORATION

 BCG
Bandges
Contact lens& cyanoacrylate glue
Graft
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complications of blebharitis
The vicious circle of 3Es
Eczema
Ectropion
Epiphora
ulcerative 3 Infections
Infection of conjunctiva ___>conjunctivitis
Infection of cornea ----->recurrent corneal ulcers
Infection of the whole lid ----> styes and internal hordeola
: Poliosis and madarosis
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congenital anomalies of lid
APCDE
Akylobleharon
Ptosis
coloboma
Dystichiasis
Epicanthus

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Causes of lagophthalmos
2P...2S....D
Paresis of oporbicularis muscle
Protrusion of the globe
Severe ectropion of upper or lower
Symblepharon
Deficient lid tissue
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otic neuritis
ORG

organization dukn
O= optic neuritis
damages
R = red
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complications of chronic dacryocystitis
RAB
R-recurrent conjunctivitis
R-risk for post operative endophthalmitis
R- risk for pneumcoccal corneal ulcer
A- acute dacryocystitis
B- bacteremia
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contraindications of DCR
TAB

T-tumors of sac
T- TB
A-atrophic nasal mucosa
B-peristitis &bone abnormalities
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sings of acute iridocyclitis:TELICOM+flare and cells
T-tenderness of ciliary body
E-exudation into the vitrious
L-lenticular precipitate
C-circumcorneal ciliary injection and keratic precipitates
M-muddy iris and miosis of pupil
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protection functions of conjunctiva
PEN AFLLC

P= phagocytosis
E= exofoliation
N= normal flora
A=
F= flushing
L= lysozymes
L= lymphoid tissue
C= cool temp
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comment signs of cojunctivitis :
1-lid
2- type of discharge
3- conjunctiva
-hypraemia

-follicles
-papillae
-pseudomembrane
- subconjunctival hge
4-lymphadenopathy
5- corneal complications
present or absent
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management of corneal ulcer
Diagnosis
suspect:From history
Verify:Flourescine stain
Reach an aitiological diagnosis:swab n culture
Treatment
Treat cause:Antmicrobial for infective, steroids for
hypersensitivity
Relief pain ain killers, cycloplegics, hot foment, dark glasses
promote haealing: Vitamins, patching, therapeutic CL
control predisposing factor
Treat complications : specially glaucoma
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clinical picture of primary Buphthalmos
symptoms 3BL:
b...........big eye
p...........photophobia
b............blue sclera
L............lacrimation
signs comment on.... ISAL+2C:

I...............IOP
S...........stretched sclera
A............ant. chamber
L............large globe
C............cornea

C...........cupping of optic disc

mangement..............GTT

G.............ICC
I............IOP<30mmhg
C...........clear cornea
C...........corneal diameter<13mm

T.............trabeculotomy
T..............subscleral trabeculectomy
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aetiology of congenital cataract : 3(HM)
heriditary
hypoxia
hypoclacemia
malnutrition
maternal infection
metabolic disorders
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ocular causes of complicated cataract : My (CAR)2
myopia
central perforated corneal ulcer
chronic ant. uveitis
acute angle closure glaucoma
absolute glaucoma
retinits pigmentosa
retinal detachment

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primary angle closure glucoma
acute phase
clinical picture
signs:comment on PAVCLE+F
P............PUPIL...semidilated,sluggishly reactive to light
A...........ANT.Chamber...shallow
V...........very poor visual acuity
C...........corneal edema,cillary congestion
L..............lens edema
E.............stony hard eye
+
F..............fundus examination show.....pulsation of central
retinal artery,venous congestion,papilledema
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__
Trachoma

toxin
and
epithulim

conjunctiva
1- epithulim swell


goblet cells

epithulim

PTD and PTC

2- limbus

epithulim

bowman membrane

epithulim necrosis

blood vessels

and nicknamed by TRACHOMATUS PANNUS


localized causing herbert rossetes

3- substansia propria
da doooooooor el toxin
irritate lymphoid--------> hyperplasia----->follicles----->
ulcerate----> fibrosis

--------------------------------el cornea

epithulim

------> ulcer -----> scar

----------------------------------------complications


fibrosis

toxins

toxins ---------> amyloid degeneration- muller ms paralysis

fibrosis -------> as trichiasis - entropian - close opening
of glands causing drynes--> scars--> opacities + dacro
adeniitis
......etc

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Signs of absolute glaucoma

... ..
CACATII DS
C.... Complicated cataract
A.... Areas of iris atrophy

C.... Congesestion of main ciliary veins

A.... Artophy of ciliary body and hypotony
T.... Total disc cupping
I.... Insensive cornea
I.... Irrevesible loss of vision
D... Degenerative pannus in the cornea
S...Staphylomata .
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Third cranial nerve palsy

4F...4P ....L
F..... Failure of adduction paralysis of medial rectus muscle
F..... Failure of accomodation ciliray muscle paralysis
F....Failure of elevation paralysis of so.rectus and inf.oblique
F....Fixed pupil not reactive
P......Ptosis..complete paralysis of leavator muscle
P.......... Proptosis ... slight
P....Paralytic squint... divergent and downwards
B.... binocular diplopia
L.....Limitation of depression due to paralysis of inf .rectus