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63 Cards in this Set
- Front
- Back
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Blepharitits
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Inflamation of the eyelid
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Blepharitits
Infectious causes |
1)Staph Aureus
2)Bacteria 3)HSV 4)Varicella-Zoster Virus |
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Blepharitits
Nonifnectious causes |
1)Lice
2)Skin conditions 3)Allergies 4)Environmental Conditions 5)Systemic illness |
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Blepharititis
Symptoms |
Gritty or Burning sensation
1)Red ichy swollen eyelid 2)Excessive tearing 3)Crusty eyelashes 4)Loss of eyelashes 5)Dry Eyes |
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Blepharitits
Treatment |
1)Warm compress cleansing
2)Limit makeup and contacts 3)Antibiotics |
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Orbital cellulitis
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Acute infection of tissues surrounding the eye
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Orbital cellulitis
Causes |
1)Spread of another infection...Emergency
2)H. Influenza (6-7yo) 3)S.aureus, S. pneumonie, S. Pyogenes 4)Fungal infection in immunodeficiency host-Mucor or aspergillus 5)Trauma 6)Septicemia |
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Orbital cellulitis
Symptoms |
1)Painful swelling of eyelid
2)Eyeball appears normal, may bulge 3)Painful/restricted globe movement 4)Fever(102 or higher) |
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Orbital cellulitis
Complications |
1)Menigitis,
2)Brain abscess 3)Blindness |
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Orbital cellulitis
Treatment |
1)IV antibiotics or antifungals
2)Surgery for drainage or debridment |
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Viral conjunctivitis
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1)More common than Bacterial
2)Self Limited 2-4 weeks 3)Hand to eye transmission 4)Hand washing important in prevention |
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Follicular Conjunctivitis
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Infection without ocular complications
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Follicular Conjunctivitis
Causes |
1)Adenovirus-most common(20-40yo)
2)Primary HSV (cesarean to avoid neonatal conjunctivitis) 3)Varicella-Zoster infection |
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Pharyngoconjuntival Fever (PCF)
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1)Adenovirus serotype 3 and 7
2)SX:Fever, Sore throat, Headache, Malaise 3)Usually bilateral, onset in one eye 1-3days before the other |
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Epidemic keratoconjunctivitis (EKC)
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1)Adenovirus 8,19,37
2)Corneal ulcer 10-14 days 3)Contaminated diagnostic instruments 4)may persist for months or resolve spontaneously |
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Acute epidemic hemorrhagic conjunctivitis
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Subconjunctival hemmorage prominent
Usually self limiting |
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Acute epidemic hemorrhagic conjunctivitis
Epidemiology |
Age: 10- 14
Associated with crowding and poor hygiene Southwest US |
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Acute epidemic hemorrhagic conjunctivitis
Causitive agents |
Adenovirus A24
Enterovirus 70 Adenovirus serotype 11(less common) |
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Bacterial Conjunctivitis
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Mucopurulent discharge
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Bacterial Conjunctivitis
Causitive agents |
S. Aureus-adults
S.Pneumo, H.Flu - Children/epidemics N.gonorrhoeae-sexually active, preauricular adenopathy |
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Bacterial Conjunctivitis
Treatment |
Topical antibiotics for S. Aureus
All others self limited |
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Bacterial Conjunctivitis
Complications |
Pain
Visual impairment Photophobia |
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Inclusion conjunctivitis
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Inclusion bodies in infected cells
affect any age |
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Adult Inclusion conjunctivitis
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1)Chlamydia trachomatis Serotypes D-K
2)Little or no discharge 3)Numerous papillae on conjuntival membrane. 4)Corneal scarring if not treated |
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Adult Inclusion conjunctivitis
Epidemiology |
Age 15-35
sexually transmitted contact with infected fluids |
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Trachoma
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Keratocunjunctivitis (inc. cornea)
Leading cause of preventable blindness Chlamydia Trachomatis |
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Trachoma
Clinical course |
1)Acute inflammatory conjunctivitis
2)Folicles develop on elids 3)Necrosis of follicles 4)Resolution-scarring/inversion of eyelids and lashes 5)Repeat infections needed for blindness-constant abrasion |
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Trachoma
Epidemiology |
Poverty and unsanitary conditions
Middle East, SE asia, Africa Southwest US Probability and Severity associated with Family |
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Trachoma
Transmission |
Called Disease de Creche(children and caretakers)
Mechanical vectors( Flies) Infected fomites (towels) Handwashing and clean water reduce transmission |
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Diagnosis of Trachoma and Inclusion conjunctivitis (IC)
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Clinical Findings (WHO scale)
Conjunctival Scrapings -Geimsa for Inclusion Bodies -Inclusion not common in adults ELISA and PCR not common |
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Treatment of Trachoma and IC
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S:Surgery
A:Antibiotics tetracycline ointment and oral azithromycin F:Facial cleanliness (education) E:Environmental Changes ie: clean water |
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Conjunctivitis of newborn
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With in the first 28 days of birth
inoculation in Birth canal |
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Conjunctivitis of newborn
Neisseria gonorrheae |
50% of all infants born to mothers with gonorrhea
Onset 2-5 days Bilateral Rapidly destructive TX: Systemic antibiotic |
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Conjunctivitis of newborn
Chlamydia trachomatis |
most common
1/3 conjunctivitis 15%pneumonia Onset 5-10 days Unilateral-no follicle |
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Conjunctivitis of newborn
Treatment |
Prophylactic: 1% silver nitrate, erythromycin/tetracyline eyedrops
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Conjunctivitis of newborn
Diagnosis |
High index of suspicion
Screen pregnant women and treat before delivery |
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Keratitis
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Unilateral
Moderate to severe pain 1 Photophobia 2 Decreased/Impaired vision from corneal scarring 3 Associated with immunosupressant therapy for Eye |
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Viral keratitis
HSV |
1 Adults
2 Leading cause of infectious blindness 3 Characterized by latent infections recurrence in immunosupression |
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HSV Stromal Keratitis
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1 More serious
2 Nonnecrotizing: Immune Stromal keratitis 3 Necrotizing: Viral replication in stromal kerocytes-severe tissue damage due to immune response |
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Epithelial HSV Keratitis
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1 More Common
2 Dendritic figures on corneal surface 3 Irritation and tearing 4 Dendridic ulcers evident on corneal epithelium |
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Varicella Zoster Virus Recrudescence
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Complication of shingles
Shingles outbreaks have sharp lines of demarcation |
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Adenovirus keratitis
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Punctiform lesions in the cornea
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Viral Keratitis
Diagnosis |
1 Clinical Features
2 Gram or geimsa stain 3 HSV=multinucleated giant cells 4 Flourescent Antibody |
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Viral Keratitis
Treatment |
Acyclovir for HSV or VZV
Treat within 3 days of appearance of lesion |
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Bacterial Keratitis
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S. Pneumo
Psuedomonas Aeruginosa Neisseria Species Listeria species |
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Strep Pneumo Keratitis
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1 Only true bacterial corneal pathogen
2 Others need overwhelming inoculum or immunodeficient cornea 3 Corneal ulcers in less developed countries |
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Pseudomonas aeruginosa Keratitis
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1 Most common in developed countries
2 Associated with Soft contact lenses 3 Leukocytes in the anterior chamber (hypopyon) 4 Corneal Ulceration |
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Bacterial Keratitis
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Central Corneal ulcer not due to HSV is an emergency
Rare unless cornea is breached Surgery(drying), or Abrasions |
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Fungal Keratitis
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Immunocompromised patients
Topical use of corticosteroids may have severe consequences |
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Fungal Keratitis
Organisms |
Aspergillus sp
Candida sp Fusarium solani |
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Acanthamoeba Keratitis
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Free living amoeba
Water, soil, Air, Sewage systems often misdiagnosed- when keratitis does not respond to therapy |
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River blindness
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Onchocerca volvus
second leading cause of infectious blindness |
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African eye worm
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1 Loa Loa
2 Migrate through subconjuntival tissue 3 Painful when moving around eyeball 4 Surgical removal 5 Does not affect vision |
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Retinitis
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unilateral, progresses to bilateral
visual field loss is first complaint |
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CMV retinitis
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1 Immunocomprimised hosts
2 Most frequent in AIDS 3 Untreated results in Blindness 4 Damage to retina is permanent 5 Retinal detatchment 1/3 |
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CMV retinitis
Diagnosis |
Patches of red, and white on retina
No inflamation in vitreous humor |
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CMV retinitis
Treatment |
1 Intravitreal injections of antivirals
2 Gangcyclovir implant 3 Surgery to reattach retina 4 Laser photocoagulation (small detachment) |
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HSV and VZV retinitis
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1 Immunodeficient and AIDS
2 Poor prognosis for sight preservation |
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OHS (ocular histoplasmosis syndrome)
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Rare, onset of symptoms may take years
Resembles Macular degeneration Histo spots- tiny scars Fragile abnormal blood vessels |
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Endopthamitis
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Infection that involves several tissue layers and aqueous/vitreous humors
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Endopthamitis
Complication of intraocular surgery |
Normal flora
S. Epidermidis Staph or strep |
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Endopthamitis
Post traumatic |
Penetrating eye injuries
Bacteria (Staph, Strep, Bacillus) Fungi |
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Endopthamitis
Endogenous |
1 Blood borne infection invades
2 Fungi >50% of cases C. Albicans, then aspergillus 3 Bacteria: S. Aureus, Staph/Strep 4 IV drug users B. Cereus |
