Tuesday, 6 December 2016

Trachoma/Rough Eye/Egyptian Ophthalmia - Clinical Features

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Trachoma/Rough Eye/Egyptian Ophthalmia  - Clinical Features


Conjunctival signs

A. large fornicial follicles                               B. Superior tarsal follicles
  • Congestion of upper tarsal and forniceal conjunctiva.
  • Conjunctival follicles - boiled sago grain like follicles.
  • characteristic feature is necrosis n leber cells(large multinucleated cells)(d/f follicular conjunctivitis).
  • Conjunctival follicle in trachoma in children shows Lymphocyte.
  • Commonly present on upper tarsal and forniceal conjunctiva.
  • Follicles on bulbar conjunctiva is pathognomonic.
  • Papillary hyperplasia(velvety appearance to tarsal conjunctiva).
  • Conjunctival scarring/Arlt’s line - linear scar in the sulcus subtarsalis.
  • Concretion - d/t dead epithelial cells,mucus in Glands of Henle.

Corneal Signs

C.peripheral corneal infiltrates                         D.superior pannus

  • Superficial keratitis.
  • Herbert follicles in limbal area.
  • Herbert pits - healed herbert follicles.
  • Pannus - infiltration with vascularization.
  • Cicatricial pannus in trachoma known as Pannus ciccus.
  • Corneal ulcer
  • Corneal opacity
            

Complications

  • Lids - entropion,tylosis,ptosis,madarosis,ankyloblepharon.
  • Conjunctival - pseudocyst,xerosis,symblepharon.
  • Corneal - ectasia,xerosis.
  • Blindness
  • Chronic dacryocystitis,chronic dacryoadenitis.
Actual cause of blindness is
corneal opacity and scarring,secondary to eyelid scarring.



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