Give an example of a gram positive cocci?
Give an example of a gram negative cocci?
Give an example of a gram negative bacilli?
Give an example of a gram negative cocci-bacilli?
What is infection of the conjunctiva called?
What is infection of the cornea called?
What is infection of the entire globe called?
What is infection of the skin around the eye called?
What is bacterial conjunctivitis?
This is an acute infection of the conjunctiva of the eye, caused by bacteria. Causes a red and inflamed eye
What are the causative organisms in bacterial conjunctivitis of neonates?
What should be done in neonatal bacterial conjunctivitis?
What are the causative organisms in bacterial conjunctivitis of all ages?
Which of the causative organisms in bacterial conjunctivitis of all ages is most common in children?
Treatment for bacterial conjunctivitis?
Swab Chloramphenicol - Drops/Ointment
When should you not give Chloramphenicol?
- History of aplastic anaemia
What would you consider if symptoms weren't resolving on Chloramphenicol and were instead getting worse?
Possible Chloramphenicol Allergy?
Describe viral conjunctivitis?
Red eye caused by virus (normally adenovirus) Leads to red, itchy, inflamed eye that may tear up Self limiting Contagious
Describe causes of viral conjunctivitis?
Describe presentation of herpes simplex? Common in?
Red, itchy, inflamed eye Often eyelid skin is involved and covered in vesicular lesions Common in children and infants
Describe presentation of herpes zoster?
Presents as fever, malaise, severe pain and lesions along the ophthalmic division of the trigeminal nerve. May also have ocular discharge and conjunctivitis.
Young, sexually active adult with bilateral conjunctivitis You should consider..?
What is Chlamydia Conjunctivitis?
This is conjunctivitis caused by chlamydia trachomatis Often unresponsive to treatment Presents with a red eye Common in young, sexually active adult Requires contact tracing
Symptoms of chlamydia conjunctivitis?
Chronic Conjunctivitis Purulent Discharge May have vaginitis or urethritis
What is Hypopyon?
This is inflammatory cells in the anterior chamber Appears as yellowish exudate
Describe bacterial keratitis? Associated with?
This is bacterial infection of the cornea Requires hospital admission for daily review and hourly eye drops Often associated with other corneal pathology or contact lens wearing
Describe herpes keratitis?
Herpes infection of the cornea Often presents with a dendritic ulcer Very painful
Treatment of herpes keratitis? Cautious about?
Aciclovir (Anti-viral) Never give steroids alone to herpes keratitis - increase virus growth leading to corneal melting and perforation
Describe adenovirus keratitis? Treatment?
Usually bilateral Follows upper respiratory tract infection Can damage vision and become chronic May give topical antibiotics to prevent secondary infection and steroids to speed up recovery
Describe fungal keratitis?
Common in those with contact lenses Caused by pseudomonas aeruginosa or acanthamoeba Takes a long time to heal Usually history of trauma by vegetation
Very painful especially when moving the eye Can cause pyrexia Associated with paranasal sinusitis Sight threatening
Radiography in someone with cellulitis?
CT scan for intra-orbital abscess
Describe treatment in orbital cellulitis?
Broad spectrum antibiotics Abscess drainage Monitor Closely
Name some organisms in orbital cellulitis?
Staphylococci Streptococci Coliforms Haemophilus Influenzae
What is endophthalmitis? Causes?
Infection affecting the entire globe (inside the eye) Very painful with decreasing vision Red eye Sight threatening Post-surgery or endogenous Most commonly conjunctival commissars - staph epidermis
Treatment for endophthalmitis?
Intravitreal antibiotics - Amikacin - Vancomycin Topical antibiotics
What is chorioretinitis? Causative organisms?
This is the inflammation of the choroid and the retina CMV - Cytomegalovirus (In immunosuppressed eg: Aids) Toxoplasma Gondii Toxocara Canis (Worm)
Describe CMV Chorioretinitis?
Only occurs in immunosuppressed people e.g.: those with aids Can cause hemorrhagic retina
Describe toxoplasma gondii chorioretinitis?
This causes a mild, flu like illness Rarely causes any further problem In immunocompetent patients, it enters latent phase Very common
Describe toxocara Canis chorioretinits?
This is roundworm Found in cats and dogs - can't replicate in humans Can get into eyes and form granulomas Self limiting
Describe 5 samples/microbiology tests done for diagnosis of eye infection
Cultures - Bacterial/Viral Eye Scrapes - Bacterial Keratitis Aqueous/Vitrous - Endophthalmitis Serology - Toxoplasma/Toxocara Microscopy - Acanthamoeba
Describe Chloramphenicol? Side effects?
Most commonly used topical antibiotic Ointment or drops Broad spectrum antibiotic Bactericidal and bacteriostatic Allergy Irrevesible aplastic anaemia (rare) Grey Baby Syndrome
anti-viral Inhibits viral DNA synthesis Used for dendritic ulcers of the cornea
Should you use steroid drops in viral diseases?
NO Causes multiplication of virus
What bacteria does Chloramphenicol not treat?
Describe Fusidic acid?
Another antibiotic Used against staph aureus
Another antibiotic Treats most gram negative bacteria Can treat pseudomonas
Three treatments for bacterial conjunctivitis?
Chloramphenicol Fusidic Aci Gentamicin
Treatment for chlamydial conjunctivitis?
Treatment for bacterial keratitis?
Ofloxacin (A quinolone) Gentamicin + Cefuroxime