Micro Winter 1 Eye Infections

Front 1

what are the 2 main broad cetegories of eye infections

Back 1

1. External- eyelids, conjunctive, cornea, sclera

2. internal: retina, (protected by the cornea nad sclera

Front 2

what is blephritis?

what are the bacteria and virus that causes it

Back 2

eyelid infection

Caused By:
staph a
Molluscum contagiousum
Hsv
Varicella

Front 3

whats the curious thing about the eye and infection

Back 3

the eye is good at fighting them.

when you have an infection its bc there is a large innoculum OR there was an injury

Front 4

what is orbital cellulitis

Back 4

inflammation of the tisue SURROUNDING the eye (edema of eyelids, restricted eye movement)

S aureus
H influenza
**USUALLY A MANIFESTATION OF ANOTHER INFECTION

Front 5

what it it called when the eyelid is infection. what is the common pathogen

Back 5

blepharitis

S aeurus
MCV (molluscum contagiosum)
HSV
Varicella

Front 6

is vision restricted in orbital cellulitis
what about conjunvtivitis

Back 6

orbital: restricted vision

conjunctivitis: vision is ok bc you blink away the crud

Front 7

when we have orbital cellulitis what are we thinking

Back 7

its the manifestation of another infection, there is something else going on

**traima
**septic
**sinus infection

Front 8

if you have itching burning and discharge what disease

what about eyelid edema and globe restriction

Back 8

conjunctivitis, vascular system is under attack! lots of red eyes, thick discharge. no pain and no vision impairment

orbital cellulitis

Front 9

tell me what conjunctivitis looks like

Back 9

itch, burn, discharge
red
vision ok
no pain

**usually UL but spreads easily
**caused by allergy, dust, chemical

Front 10

what causes conjunctivitis

Back 10

1. infection
2. allergy
3. inflammation after chemical
4. decreased tear production (keratoconjunctivitis)

Front 11

how can you tell when conjunctivitis is bacterial. what bacteria is it likely to be

Back 11

its NASTY!

staph- adults
strep pneumonia/h influenza- kids, pink eye

**treat with topical AB if s aureus, others are self limited

Front 12

whats inclusive conjunctivitis

Back 12

any disease caused by Chlamydia trachomatis

**can be in any age group. seen in low SES, poor hand washing

Front 13

do you get corneal scarring with inclusive conjunctivitis

Back 13

nope. its caused by chlamydia trachomatis and we get mild discormort with little discharge and lots of papillae on lower conjunctival membrane

**we get problems with repeat infections
**leading cause of PREVENTABLE blindness

Front 14

in what disease is there little discharge and only mild discomfort but LOTS of papillae on lower conjunctival membrane

Back 14

inclusive conjunctivitis, caused by C trachomatis

**trachoma means roughness

Front 15

what is the leading cause of preventable blindness in the world

Back 15

Chlamydia trachoma

**inclusive conjunctivitis

**need repeat infections bc trachoma is a progression that leads to blindness

Front 16

what is the progression of trachoma seen in Inclusive Conjunctivitis

Back 16

trachoma means rough

1. inflammatory conjunctivitis
2. lymohoid follicles form on the conjunctiva of upper lid
3. slow progression to necrosis
4. scarring, inversion of eyelashes

**common cause of preventable blindness
**repeat infection (poor sanitation, handwashing)
**constant abrasion of cornea by inverted lashes
**common to have 2 bacterial infections
**dry eye is common

Front 17

what disease can progress to superior limbic pannus and fibrovascular membrane from CT that leads to complete blindness

Back 17

trachoma

**Inclusive conjunctivitis caused by C trachomatis

**preventable cause of blindness

Front 18

what population gets trachoma

Back 18

poverty, low SES
unsanitary conditions that lead to repeat infections

**common to be seen in family units. if one person has it its likely other family members do also

Front 19

what is transmission of trachoma

Back 19

person to person, cleanliness
also mechanical vector --> FLY, dirty towel

Front 20

what is the dx for trachoma

Back 20

inclusion body in kids. (not common to see them in adults)

**stain C trachomatis with iodine (other chlamydia spp wont stain)

Front 21

what is the tx for Inclusion conjunctivitis

Back 21

erythromycin, tetracycline

WASH HANDS nad prevent reinfection

Front 22

what is opthalmia neonatorum

Back 22

conjunctivitis of the newborn (less than a month old)

**colonized as babe passes through birth canal
*prophylaxis against it bc it can be bad for the immature immune system (chlamydia)
also caused by goniorrhea

Front 23

why do babes get silver nitrate drops

Back 23

prophylaxis against conjunctivitis of the newborn caused by chlamydia or gonorrhea

Front 24

what do we do when a mom has gonorrhea and passes it to her baby

Back 24

conjunctivitis of the newborn, typically seen in 2-5 days

1/2 of babes will be affected

SYSTEMIC AB, topical wont be enough

Front 25

whats the dif in conjunctivitis of the newborn caused by gonorrhea and chlamydia

Back 25

1. gonorrhea- 2-5 days is apparent. needs systemic AB. BL

2. 5-10 days after delivery. can be eye or lung disease. UL. NO follicle formation is evident as in adult inclusice conjunctivitis

Front 26

what type of eye disease is dx when there is a HIGH index of suspicion

Back 26

conjunctivitis of newborn!

tx with erythromycin (NOT tetracycline)

Front 27

what is more common bacterial or viral conjunctivitis

Back 27

viral. hand to eye transmission is common.

**remember bacterial is NASTY!!!

Front 28

what is follicular conjunctivitis? what causes it

Back 28

viral infection w/or w/o ocular complications

caused by:
1. adeno- common contamination in Dr office eye drops
2. HSV, Varicella

Front 29

what is the common culprit in eye drops in Dr Office

Back 29

Adenovirus conjunctivitis/ Pharyngeal Conjunctival fever

**also associated with inadequatly chlorinated pools

**get VIRAL follicular conjunctivitis

Front 30

tell me about epidemic keratoconjunctivitis (EKC)

Back 30

viral conjunctivitis
Shipyard eye
adenovirus

caused by DUST/PARTICLES

Front 31

what is shipyards eye

Back 31

epidemic heratoconjunctivitis

**its a viral (adeno) conjunctivitis. linked to partcles/dust in the eye

**see it light up like dots

Front 32

wht is acute hemorrhagic conjunctivitis

Back 32

acute subconjunctival hemmorage

**associated with coxsackie, enterovirus 70, adenovirus

**poor hygeine and crowds

Front 33

what is keratitis

Back 33

UL bacterial incection of cornea

**pseudomonas (green)
**seen with soft contact use
PAIN

Front 34

what is assicated with soft contact use

Back 34

pheudomonas aeruginosa keratitis

**green and gross. infectino of CORNEA- scarring is common (unlike trachoma)

Front 35

in what disease is Corneal scarring from infection is a major cause of reduced vision and blindness

Back 35

keratitis- corneal infection


**associated with use of immunosuppression drugs

Front 36

what dose HSV in teh eye cause

Back 36

viral keratitis (corneal infectino)

Seen more in adults (uncommon in kids, unlike chlamydia and gonorrhea which can be common in kids IF YOU SUSPECT it)

**LEADING CAUSE of INFECTIOUS blindness in developed countries

**latent infection in trigeminal nerve

Front 37

when might you see eye HSV

where in the eye is it

Back 37

reactivation (recrudesence) by immune suppression- stress, sunlight, fever

can be in the stroma or epithelium

Epithelium- see lightning bolts in the eye "dendritic figures", more common

Stroma- necrotizing, non-necrotizing

Front 38

what are hte clinical manifestations of HSV Keratitis

Back 38

recall it can be stroma (more serious, necrotizing or not) or epithelium (more common, lightning bolts)

**ulcers
**irritation, tearing
**no pain
**no photophobia

Front 39

what does VZV recrudesence look like in the eye

Back 39

varicella zooster

**complication of shingles.
**trigeminal ganlion is involved and can involve the eye

**viral keratitis

**wont cross midline

Front 40

how are viral keratitis dx and tx (HSV, VZV)

Back 40

Dx:
clinical findings- corneal scrapings
HSV- epithelial lightning bolts, multinucleated giant cells

Tx:
acyclovir
treat shingles ASAP

Front 41

Punctiform lesions in the cornea are characteristic of what disease

Back 41

adenovirus keratitis (corneal infectino)

Front 42

what is the only true bacterial corneal pathogen

Back 42

strep pneumoniae

**all other bacteria/fungi need an HUGE innoculum or trauma

Front 43

pseudomonas is associated with what? what is seen with keratitis

Back 43

soft contacts use. this bug can live in the disinfectant

**keratitis- collection of leukocyted in anterior chamber & corneal ulceration

Front 44

other than P aeruiginosa what other bacteria can cause keratitis

Back 44

neisseria
listria

Front 45

using glucosteroids in the eye can cause what

Back 45

FUNGAL keratitis

aspergillus, candidia, fusarium

Front 46

what do we do if there is a corneal ulcer that is likely NOT caused by HSV

Back 46

EMERGENCY!!

Front 47

is retinitis UL or BL?

what clues us in to a retinal infection

Back 47

UL then progresses to BL bc of viremia

**loss of visual field/visual acuity

Front 48

what eye infection is common in AIDS pts

Back 48

retinitis caused by CMV

**not suppressed with acyclovir as are other HSV

**also VZV and HSV

Front 49

how is retinitis Dx

Back 49

red hemmorages and whide edema/necrosis patches on opthalmic exam

Front 50

CMV that causes retinitis is tx how

Back 50

NOT acyclovir as are other HSV tx

Ganciclovir, foscarnet. bet we still get 50% reactivation

Front 51

what is the outcome of HSV/VZV for AIDS pts

Back 51

prbly loose sight

**healthy ppl also prbly will loose sight but they are less likely to get it in the first place

Front 52

what is Endophthalmitis? when does it happen

Back 52

infection of several tissue layers of the eye (present in humor(s))

1. complictino of cataracts surgery
2. post traumatic
3. Endogenous- blood infection, metastatic infectino (candida) R eye more common. Bacillus cereus in IV users
4. uncontrollded infectinos of cornea or orbital cellulitis

Front 53

what is bacillus cereus associated with

Back 53

IV drug use get endogenous cause of endophthalmitis

**other causes are cataracts, injury or uncontrolled infection