1. Conjunctiva

2. Baby picture of the day!

4. Papillae vs. Follicles Papillae Follicles
Think “pABillae” = Allergic & Bacterial
Red dots of varying size (red due to central vessel)
Non-specific
Chlamydia, toxic, viral
Avascular/white nodules, filled with lymphocytes

5. Cysts
Benign
Fluid-filled

6. Concretions Deposits of mucous secretions
Sometimes foreign body sensation

7. Nevi
Benign proliferation of melanocytes

8. Primary Acquired Melanosis (PAM) Conjunctival Melanosis
Unilateral acquired pigmentation
Flat, indistinct margins
Progression from PAM
Proliferation of melanocytes
Metastasize to the liver

9. Conjunctival Intraepithelial Neoplasia (CIN)
Conjunctival Squamous Cell Carcinoma
#1 conjunctival malignancy
Unilateral pre-malignant
Elevated, gelatinous mass with neovascularization
Progression from CIN
Malignant

10. Bacterial Conjunctivitis
Simple
Gonococcal
Children
H. influenzae or Staph
Acute redness, discharge
Neisseria gonorrhea
HYPERACUTE onset
Severe purulent discharge

11. Adenoviral Conjunctivitis
Acute non-specific conjunctivitis
Most common
Red eye, follicles, tearing
All 3 of these are very contagious!
Pharyngo- conjunctival Fever (PCF)
“Swimming pool conjunctivitis”
Pharyngitis
Acute follicular conjunctivitis
Fever
Epidemic Keratoconjunctivitis (EKC)
Most serious
Pain, corneal involvement

12. Molluscum Contagiosum
Associated with poor hygiene, children
DNA pox virus
Infectious
Dome-shaped, umbilicated, waxy nodules
Chronic follicular conjunctivitis

13. Allergy Allergic conjunctivitis Vernal Keratoconjunctivitis (VKC)
Atopic Keratoconjunctivitis (AKC)
Giant Papillary Conjunctivitis (GPC)

14. Allergic Conjunctivitis
Seasonal allergic conjunctivitis
Perennial allergic conjunctivitis
Type 1 hypersensitivity
History of allergy
Ex: pollen allergy
Type 1 hypersensitivity
History of allergy
Ex: dust allergy

15. Vernal Keratoconjunctivitis (VKC)
Rare
Boys <10yo
Family history of atopy
Itching
Papillae on superior lid
Shield ulcer

16. Atopic Keratoconjunctivitis (AKC)
Young adults
History of atopy
Not seasonal
Dennie’s lines (atopy)
Inferior papillae

17. Giant Papillary Conjunctivitis
Associated with silicone hydrogel (SiHy) contact lens wear, mechanical trauma
Non-infectious, immune, inflammatory response
Itching, discharge, decreased wearing time
Papillae of superior lid

18. Chlamydia/Trachoma Chlamydia Chlamydia is the most common STD!
Acute follicular conjunctivitis, becomes chronic
Inferior follicles
Usually unilateral
Most common cause of ophthalmia neonatorum

19. Chlamydia/Trachoma Trachoma
Leading cause of preventable blindness worldwide
Follicular conjunctivitis
Bilateral
Late-stage: Arlt Lines, tarsal conjunctival scarring, trichiasis

20. Phthiriasis Palpebrarum (Pediculosis Ciliaris)
Pubic lice on eyelashes
Sleeves at base of lashes
Itching
Follicular conjunctivitis, bruises from bites

21. Subconjunctival Hemorrhage
Causes: valsalva (coughing), medications (blood thinners), hypertension, clotting disorders

22. Pingueculum Associated with UV exposure & chronic dryness
Abnormal growth of conjunctiva

23. Pterygium Associated with UV exposure & chronic dryness
Abnormal growth of the conjunctiva onto the cornea, destroys Bowman’s membrane
Stocker’s line = iron deposit along leading edge of pterygium
Blocks vision & causes irregular astigmatism