INFECTIOUS EYE DISORDERS Flashcards
(31 cards)
What are the etiologies of bacterial conjunctivitis ?
– Staphylococcus aureus
– Streptococcus pneumonia
– Haemophilus influenza
– Moraxella catarrhalis
– Chlamydia trachomatis
– Neisseria gonorrhoea
What is the onset pattern of bacterial conjunctivitis ?
acute and chronic suggests Chlamydia
What is the Hx of BC ?
Unilateral thick purulent discharge becoming bilateral, sticky and matted eyelashes in the morning.
What are the PE findings in bacterial conjuntivitis ?
– Unilateral mucopurulent discharge
– Papillary folliculitis on palpebral conjunctiva
– Bulbar conjunctivae intensely hyperaemic and
oedematous
– Moderate eyelid oedema
What is the Tx of bacterial conjuntivitis ?
- Self care and Abx only after 3 days, if the symptoms doesn’t resolve.
The Abx are:
*Cloramphenicol 0.5% drops, 2 drops every
6 hours
*Chloramphenicol 1% ointment, apply once
every 6 hours
*Fusidic acid 1% drops, 1 drop every 12
hours. - Treatment should continue until 48
hours after symptom resolution
what is the most common cause of follicular conjunctivitis?
Chalmydial with an incubation period of 7-14 days.
What are the two types of chlamydial conjunctivitis ?
- Trachoma- The most common cause of blindness worldwide.
- Inclusion conjunctivitis – congenital and STI.
What is the main Hx feature of chlamydial conjunctivitis ?
– Mild symptoms from weeks to months
– May have been recently treated for
bacterial conjunctivitis.
what are the PE findings in chlamydial conjunctivitis ?
– Mucus discharge
– Conjunctival hyperaemia and
chemosis
– Folliculitis (cobblestoning) on
conjunctiva and semilunar folds
What is the Dx work-up in chlamydial conjunctivitis ?
NAAT of Conjunctival scrapings.
What is the Tx of chlamydial conjunctivitis ?
– Doxycycline 100 mg BID for 7 days (avoid in pregnancy)
OR
– Azithromycin 1 g stat followed by 500 mg daily for 2 days
What is the presentation and risk of Goncoccal conjunctivitis ?
It presents with rapidly progressive conjunctivitis with Profuse mucopurulent discharge. It Can penetrate through cornea and cause corneal perforation within 48 hours, Endophthalmitis, Meningitis, and septicaemia. NAAT for Gonorrhoea is the Dx test of choice.
What is the Tx of Goncoccal conjunctivitis ?
– Ceftriaxone 1 gm IM injection single dose
OR…
– Ciprofloxacin 500 mg BID for 1 day OR…
– Azithromycin 2 g once
What is the most common cause of viral conjuntivitis ?
Adenovirus
What is the incubation period and symptomatology of viral conjuntivitis ?
The incubation period is 5-12 days and the eye symptoms frequently precede symptoms of a common cold.
What are the PE findings in viral conjuntivitis ?
– Conjunctival hyperaemia
– Enlarge follicles on palpebral conjunctiva
– Preauricular lymph node swelling
– Symptoms are self-limited, often resolving within
3-4 days
What is the Tx of viral conjunctivitis ?
– Supportive measures, no antiviral options exist
– Cool compress to the affected eye
– Temporarily d/c contact lens use
What is the pattern of corneal involvement in herpetic keratitis ?
– Initial infection involves superficial layer of cornea
– Reactivation involves deeper layers of the cornea leading to vision loss/blindness
What is the Hx of herpetic keratitis ?
– Unilateral
– Red, painful eye
– Decreased sensation (reactivated disease)
What are the PE findings in HSV keratitis ?
– Dendritic ulcer
– Corneal scaring (reactivated disease)
– Decreased corneal reflex (reactivated disease)
What is the Tx of HSV keratitis ?
– Oral acyclovir (5 times a day) or valacyclovir (3
times a day) for two weeks.
OR
Topical acyclovir 3% ophthalmic ointment applied 5
times daily until 3 days after clearing of corneal
lesions.
What is the presentation of periorbital or preseptal orbital cellulitis ?
It occurs due to Local spread of adjacent
sinusitis or dacryocystitis or following local trauma. It is limited to lid swelling, erythema; fever; and
eye pain. The Tx is amoxiclav 625 mg every 8
hours for 7-14 days.
What is the presentation of post septal orbital cellulitis ?
It occurs in children due to extension of bacterial rhinosinusitis. They present with lid swelling, erythema; fever; and eye pain. The dangerous presentations are pain with eye movement, proptosis, opthalmoplegia with diplopia. The Dx is clinical, but CT head maybe needed to see the extension of the infection.
What is the Tx of post septal orbital cellulitis ?
– IV Vancomycin + IV Ceftriaxone or IV Cefotaxime
– Switch to oral therapy when fever abates and eyelid swelling subsides
