• def.- small amount of blood layered between the conjunctiva and schlera
• prognosis
  • looks frightening, but not serious
  • common with ASA or warfarin use, strain during bowel movt, lifting
  • resolves over time

• def.- inflam. of conjunctiva
• types
  • acute vs. chronic
  • bacterial vs. viral (infectious)
  • allergic vs. toxin (non infectious)

• aka pink eye
• symptoms
  • redness
  • watery discharge
  • foreign body sensation
  • blurry vision
• cause- adenovirus
• prognosis
  • highly contagious
  • can be severe with conjunctival membranes or corneal sub-epithelial infiltrates
• treatment- treat symptoms, wash hands

• symptoms
  • mucous discharge
  • redness
  • discomfort
• causative agent
  • Staph
  • Pneumococcus
  • Moraxella
  • Haemophilus
  • N. gonorrhea
  • Chlamydia
• treatment
  • start with antibiotic drops (systemic in some cases)
  • culture if not responding to emperic treatment

• cause- severe inflam. disease
  • ocular cicatricial pemphigoid
  • Stevens Johnson
• pathology- cause tissue to adhere abnormally
• treatment- depend on etiology and severity

• def.- purulent, mucoid, mucopurulent discharge in the first month of life
• causes
  • silver nitrate
  • N gonorrhea (2-3 dys)
  • Chylamydia (one wk)
  • HSV
• treatment
  • treat cause
  • systemic antibiotics or retrovirals
  • treat mother and her sexual partners

• inflamation of epischlera
• cause- idiopathic
• symptoms- redness, discomfort (moderate)
• treatment- time, NSAIDS

• def.- inflam. of schlera (deeper)
• symptoms
  • severe pain often with mild touch or eye movements
  • redness
• treatment
  • systemic steroids or immunosuppressants
  • require work up for rheumatological disease, TB, syphilis (systemic disease)

• cause
  • actinic changes
  • can be temporal or nasal
• symptoms- can be elevated leading to redness and dry eye
• treatment
  • no surgery needed
  • artificial tears

• cause
  • actinic changes
  • triangular ingrowth of fibrovascular tissue
• progression- can grow over visual axis or cause significant astigmatism
• treatment
  • surgery
    • excision with conjunctival autograft or amniotic membrane (high recurrence without autograft or amniotic membrane)

• appearance- elevated, nodular
• treatment
  • complete excision with cryotherapy at margins to eradicate any residual neoplastic cells

• def.- superficial epithelial defect usually secondary to trauma
• symptoms
  • extremely painful
  • redness
  • tearing
  • decreased vision
• treatment
  • topical antibiotics
  • cycloplegia
  • pain management
  • NO STEROIDS, TETRACAINE

• anesthetic prevent would healing
• can lead to chronic ulceration and scarring

• major risk factor- contact lens wear too long
• def.- infection of corneal tissue
• cause
  • most often bacterial
  • can be fungal, parasitic, viral, or sterile

History is important

• depends on size, location, etiology of ulcer
• tailor treatment based on results of treatment and results of any cultures
• if small- treat with fourth generation FQ
• large central- culture and treat with fortified topical antibiotics

• pathology
  • can be primary or recurrent
  • latent in trigeminal ganglion
• symptoms
  • fever
  • stress
  • illness
  • immunocompromised
• treatment- oral antivirals w/ or w/o topical antivirals, could require steroids
• usually HSV-1 more than HSV-2

• def.- shingles affecting CN V1 (but can cause wide spectrum of diseases in the eye)
• at risk pop:
  • immunosuppressed
• treatment
  • oral antivirals
  • NO EFFECTIVE TOPICAL
  • may require steroids
  • treat pain

• purpose- correction of myopia, astigmatism, and hyperopia
• types
  • LASIK
  • PRK

• use microkeratome or femtosecond laser to create flap in the cornea (hinge usually superior)
• flap lifted and laser done within the stroma of cornea

• remove epithelium with brush, blade, or concentrated alcolol
• laser ablation after epithelial removal
• bandage soft contact lens placed while epithelium healing

• advantage- faster visual recovery
• disadv.
  • risk flap dislocation, flap striae, epithelial ingrowth
  • risk corneal ectasia (higher than PRK)
  • risk dry eye (higher than PRK)

• advantage- greater safety margin
• disadvantages
  • pain
  • risk of corneal haze
  • risk of cornea ectasia (LOWER than LASIK)
  • risk of dry eye (LOWER than LASIK)