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36 Cards in this Set
- Front
- Back
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Keratitis |
Inflammation of the cornea
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Infectious causes of Keratitis |
Bacteria Viruses Fungi Amoebas |
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Non infectious causes of Keratitis |
Ectropian Dry eyes Other inflammatory conditions |
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S/S of Keratitis |
Blurred vision Photophobia Periocular pain FB sensation Circumcorneal injection |
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Bacterial Keratitis Precipitating RF |
Contact lens wear Refractive corneal surgery Corneal trauma Prolonged use of topical steroids |
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Common Pathogens of Bacterial Keratitis |
Pseudomonas Pneumococcus Staph Haemophilus |
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TX of Bacterial Keratitis |
Intensive topical antibiotic drops
Ciprofloxacin drops hourly for couple of days then less
do NOT use topical corticosteroid drops
URGENT REFERRAL if no improve in 24 hrs |
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Most common Organisms of Bacterial Conjunctivitis |
s.aureus s.pneumo haemophilus sp gonorrhea |
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S/S Bacterial Conjunctivitis |
Conjunctival injection and general discomfort
Mucopurulent discharge - continues throughout the day |
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Bacterial Conjunctivitis TX |
Topical antibiotic drops (fluoroquinolones)
If gonorrhea --- URGENT REFERRAL |
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Most common etiologic agent in Viral Conjunctivitis |
Adenovirus
Often follows a URI |
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S/S Viral Conjunctivitis |
Conjunctival injection Watery discharge General discomfort Palpebral follicles
Often unilateral then bilateral
Preauricular adenopathy possible |
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TX of Viral Conjunctivitis |
Cold compresses Artificial tears Vasoconstrictor drops
HIGHLY CONTAGIOUS |
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Epidemic keratoconjunctivitis |
Severe viral conjunctivitis
Inflammation of cornea in addition to conjunctiva
Usual viral symptoms plus FB sensation and corneal infiltrates
TX: EMERGENT REFERRAL TO SPECIALIST |
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Allergic Conjunctivitis |
Seasonal Hx of allergy Pruritisine Bilateral involvement Corneal injection -- stringy discharge |
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TX of Allergic Conjunctivitis |
Topical vasoconstrictor/antihistamine combination |
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Soft Contact Lens Wearers |
At an increased risk for pseudomonal keratitis |
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Episcleritis |
Focal inflammation of the deep subconjunctival tissue |
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Scleritis |
Focal or diffuse inflammation of the sclera |
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Episcleritis/Scleritis S/S |
Eye pain -- worse with scleritis Focal or diffuse bulbar conjunctival and episcleral injection
May also have uveitis Associated with autoimmune or viral condition |
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Episcleritis Details |
Mostly idiopathic Acute onset redness Pain - dull ache No discharge or corneal involvement Vision is normal
REFER for confirmation - tx is conservative |
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Scleritis Details |
More gradual onset Severe pain - may radiate to temple or jaw Photophobia Tearing Vision normal or mildly decreased
REFER URGENTLY - NSAIDSs |
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Uveitis |
any inflammatory condition involving the uveal tracts (iris, ciliary body, choroid) |
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Causes of Anterior Uveitis |
Autoimmune disorders Infectoins Trauma Sarcoidosis |
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S/S Anterior Uveitis |
Redness, photophobia and pain w/ eye movement
vision is normal or decreased
onset may be acute or insidious
Unilateral or bilateral
cicumcorneal injection |
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Preseptal Cellulitis |
Involves lid structures alone
Periorbital inflammation and swelling
Does NOT affect eye movement |
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Postseptal Orbital Cellulitis |
Bacterial infection of periocular tissue
Posterior to the orbital septum Rare in adults, more common in children Most commonly associated with sinus infex |
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S/S Orbital Cellulitis |
Conjunctival injection Periocular pain, fever, swelling of lids and periorbital tissue Tenderness of lids and globe Proptosis Typically unilateral |
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Diagnostic studies of Orbital Cellulitis |
CT or MRI
TX: Broad-spectrum IV antibiotics |
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Endophthalmitis |
Intraocular infection
Eye pain Generalized conjunctival inflammation Reduced vision Hypopyon
EMERGENT REFERRAL - vision threatening |
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Hypopyon |
Build up of white fluid in the ey |
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herpes Zoster Ophthalmicus |
Prodome: fatigue, malaise, +/- fever
Ocular manifestations preceded by pain, tingling and appearance of vesicles
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When is ocular involvement more likely in herpes zoster ophthalmicus? |
When nasociliary branch of nerve is involved
Hutchinson's sign (keratitis, iritis, secondary glaucoma) |
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Herpes Zoster Ophthalmicus TX |
Antivirals within 3 days |
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Horner's SYndrome |
Oculosympathetic paresis
Ptosis Miosis anhydrosis |
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Thyroid Eye Disease |
Associated with both hyper and hypothyroid states, often Hashimoto's thyroiditis
Gritty sensation, tearing, periorbital swelling, focal conjunctival irritation
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