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Sydney Child Health Program > 3.3.2 Eye - Conjunctivitis/Infalammatory Periocular Probs > Flashcards

3.3.2 Eye - Conjunctivitis/Infalammatory Periocular Probs Flashcards

1
Q

Conjunctivitis presents?

A

Redness of eye
Watery eye
Discharge

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2
Q

How to classify conjunctivitis?

A 
Infective
Allergic
Chemical
Special: neonatal
Associated with systemic disease
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3
Q

Hx of conjunctivitis?

A

One or both eyes?
Discharge?
Systemic illness?

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4
Q

If eye is itchy in conjunctivitis, most likely to be?

A

Allergic

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5
Q

Examination of conjunctivitis?

A 
Test vision
Look at conjunctiva
Look at cornea - flurocine
Skin rashes
Lymphadenopathy
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6
Q

When do you need to investigate conjunctivitis?

A

Neonate
Chronic/recurrent
Suspected HSV 1/2
Atypical reaction

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7
Q

Neonatal conjunctivitis, what bacteria on day 1?

A

Gonococcal

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8
Q

Neonatal conjunctivitis wat bacteria on day 7-14?

A

Herpes simplex

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9
Q

Neonatal conjunctivitis what bacteria on day 8-12?

A

Chlamydia

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10
Q

Neonatal conjunctivitis what bacteria on day 4-6?

A

Strep/staph/haemopilus

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11
Q

Management of Neonatal conjunctivitis?

A

Investigate:
Swab: M/C/S
Chlamydia culture/PCR
HSV PCR

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12
Q

Neonatal conjunctivitis, how to treat chlamydia?

A

Erythromycin 5mg/kg/day

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13
Q

Neonatal conjunctivitis how to treat gonococcus?

A

Penicillin

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14
Q

Neonatal conjunctivitis don’t forget to treat?

A

The parents

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15
Q

Bacterial conjunctivitis treat with

A

Topical chloramphenicol/tobramycin
Drops every 2-4 hours
Infectious

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16
Q

Should you use steroid eye drops in children?

A

Nope, seldom used in kids

17
Q

If cornea involved in conjunctivitis what is it called?

A

Keratitis

18
Q

How to manage HSV conjunctivitis?

A

Examine cornea with fluroscein

HSV 1 and 2 PCR

19
Q

How to treat HSV conjunctivitis?

A
  • Acyclovir/famvir systemic: reduced rate of recurrence
  • Topical acyclovir ointment
  • If immunocompromised: IV
20
Q

How to manage allergic conjunctivitis?

A 
Avoid agent
Cool compress
Tears for 4-8 times per day - wash
Antihistamine
Corticosteroids if severe
21
Q

What is vernal keratoconjuntivitis?

A 
Males
Spring/autumn
Tarsal conjunctiva (upper lid)
Get conjunctival papillae
Scratches cornea
Photophobia
22
Q

How to manage vernal keratoconjunctivitis?

A

Cool compress
Topical eye drops: antihistamine/lubricants
-use STEROIDS (FML/Maxidex) short term.
Dexamethasone drops. 4 times a days for 4 days, 3 times a day for 4 days, 2 times a day for 4 days, then once a day for 4 days.

23
Q

Complication of verbal keratoconjunctivitis?

A

Shield ulcer:
Needs to be scraped
Chloramphenicol
F/U in 1-3/7

24
Q

Acids damage what in eye?

A

Surfaces

25
Q

Alkali damage what in eye?

A

Penetrate and damage cornea

26
Q

Management of chemical conjunctivitis?

A

Tap water rinse

  • GP
  • local anaesthetic drop
  • Irrigate for 30 minutes with normal saline
  • remove particles
  • chloramphenicol
  • REFER to ED
27
Q

What is Stevens-Johnson syndrome?

A

Usually caused by medication or infection

Shedding of top layer of skin widespread, bulbous blisters around mouth, nose, eyes, genitals

28
Q

What is presentable cellulitis?

A

Usually unilateral
Associated with systemic illness, insect bite, periocular infection

Hospital
IV Abx
Image if no better in 48 hours

29
Q

How does a child with orbital cellulitis present?

A

Unwell, fevers miserable
Limited eye movement
Proptosis

30
Q

Where does the eye drain into?

A

Cavernous sinuses: ethmoid

31
Q

Orbital cellulitis management?

A 
Emergency, refer
Admit to hospital
Needs IV Abx
Imaging
Drain abscess
32
Q

How to treat chalazion or Meibomian cyst?

A

Heat compress
Abx
Incise and curette under GA

33
Q

How to differentiate preseptal from orbital cellulitis?

A

Orbital:

  • proptosis,
  • movement restriction
  • unwell child

Sydney Child Health Program (113 decks)

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