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Ophthalmology Conjuctiva 4b672951

'Herbert's pits' are seen in

A
Trachoma
B
Viral keratitis
C
Vernal conjunctivitis
D
Any of above
High-Yield Explanation
Ans. a (Trachoma) (Ref Khurana pg 91; Ophthalmology by Basak 4th/142; Parson 19th / Page 184)Herbert pits are the oval or circular pitted scars, left after healing of Herbert follicles in the limbal area, seen in the patients with trachoma.The signs of Trachoma are:A. Conjunctival:# Congestion of Upper Fornix and upper tarsal conjunctiva# Follicles on the upper Tarsal Conjunctiva; Bulbar Conjunctiva# Follicles contain multinucleated Giant Cells called as Leber's Cells# Velvety papillary Hyperplasia# Herbert's Pits (pathognomonic) - Follicles on the limbus# Arlt's Line is linear scar in sulcus subtarsalis due to Conjunctival Scarring# Concretions due to accum of dead epithe cells and mucus in glands of HenleB. Corneal signs:# Superficial keratitis# Herbert follicles (in limbal area)# Pannus - Is fine subepithelial neovascularisation seen at the upper limbus- Progressive Pannus - Infiltration ahead of vascularisation- Regressive Pannus - Vessels extend a short area beyond infiltration (Pannus Sicca)# Corneal ulcer# Herbert's Pits# Corneal opacity (end result).Additional Educational Points# International trachoma Initiative sponsors a programme called SAFE to control Trachoma0- Surgery,- Antibiotics,- Face wash &- Environmental change# Vernal keratoconjunctivitis is characterized by:- Called as Spring Catarrh0- Bilateral- Exogenous Allergen- Itching- Ropy Discharge0- Cobblestone Papillary hypertrophy,- Bulbar Conjunctiva has Horner Trantas Spots- Punctate epitheliapathy is earliest finding.- Maxwell Lyon sign is also seen.- Cornea has Pseudogerantoxon with Cupid Bow outline# Pterygium has Stocker's line which is due to deposition of IRON.0

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