micro-eye infections
Terms
undefined, object
copy deck
-
What is a hordeolum?
What organism is it usually caused by? -
Sty, or infection of eyelid glands (zeis, moll, meibomian)
Staph aureus - What is a Chalazion?
-
cronic granulomatous infection of meibomian gland.
Etiology unknown. - What is marginal blepharitis characterized by.
- bilateral inflammation of lid margins, scales.
- What are the two types of marginal blepharitis?
-
1. Staphylococcal blepharitis
2. Sebrrheic blepharitis - Describe Staphylococcal Blepharitis
-
ulcerative
dry scales, red lids
caused by staph aureus
predisposes pt to chalazions & hordeola
treat w/ topical AB - Describe Seborrheic Blepharitis
-
no ulceration
greasy scales
not microbial
complication of seborrheic dermatitis - describe meibomiantis
- bilateral chronic inflammation of meibomian glands
- what is dacryocysitis
- Infection of lacrimal sac. Most often unilateral and always secondary to obstruction of the naso-lacrimal duct
- Pathogenesis of dacryocystitis
- Tear fluid collects in the lacrimal sac because of the obstruction and bacteria from the conjunctival surface that have washed into the sac find a stagnant pool of fluid in which they may multiply.
-
Chronic adult dacryocystitis:
What is the organism and treatment? -
Etiology is usually Streptococcus pneumoniae, or occasionally Candida albicans
Control - relieve obstruction of the nasolacrimal duct usually via surgical means - Acute adult dacryocystitis: What is the organism?
- Staphylococcus aureus
- Infantile dacryocystitis: What a major cause and the organism?
-
Often due to failure to canalize of a nasolacrimal duct.
Etiology Haemophilus influenzae -
Canaliculitis
Organisms -
Actinomyces israelii, Candida albicans, or Aspergillus species
Occurs exclusively in adults. - Dacryoadenitis
-
rare acute inflammation of the lacrimal gland.
Occasional complication of mumps, measles, or influenza in children or in adults in association with gonococcal conjunctivitis.
May occur as a retrograde infection from a bacterial conjunctivitis -
Orbital Cellulitis
Is it serious?
What is the portal of entry?
What are the organisms?
Sequelae if not treated -
YES
Microorganisms have direct portal of entry through the sinuses
Organisms are:
Pneumococci, streptococci, staphylococci.
Haemophilus influenzae b in unvaccinatedchildren under three.
Fungi - in the immunocompromised.
Sequelae is meningitis, or brain abscess - conjunctiva
- thin transparent mucous membrane that covers the posterior surface of the lids and the anterior surface of the sclera, continuous with skin at lid margin and with corneal epithelium at the limbus.
- patient may report the following symptoms with conjunctivitis
-
1.Foreign body sensation – feel like they have something in eye
2. Scratching or burning sensation
3. Sensation of fullness around the eyes
4. Itching (usually means allergic)
5. If cornea involved, photophobia and pain - patient with conjunctivitis may show the following signs
-
1. Hyperemia (redness)
2. Tearing
3. Exudation
4. Edema sometimes
5. Papillary hypertrophy sometimes
6. Follicles sometimes - what are the three stains done when conjunctivitis is suspected and what are they for?
-
1)Gram stain to identify bacterial type.(G+,G-)
2)Giemsa stain to identify human cell type.(poly, lymphocytes, etc)
3)Wet mount for fungi. - EXPECTED RESULTS FROM STAINS OF CONJUNCTIVAL SCRAPING: Normal eye
- epithelial cells and occasional goblet cells
- EXPECTED RESULTS FROM STAINS OF CONJUNCTIVAL SCRAPING: Acute bacterial infection
- large numbers of neutrophils, with bacteria inside or outside the cells.
- EXPECTED RESULTS FROM STAINS OF CONJUNCTIVAL SCRAPING: Viral conjunctivitis
- lymphocytes and monocytes are predominant. In herpes simplex infections, multinucleated epithelial cells may be seen. Intranuclear inclusion bodies in epithelial cells reflect DNA viruses
- EXPECTED RESULTS FROM STAINS OF CONJUNCTIVAL SCRAPING: Chlamydial infections
- basophilic intracytoplasmic inclusion bodies seen in epithelial cells
- EXPECTED RESULTS FROM STAINS OF CONJUNCTIVAL SCRAPING: Allergic conjunctivitis
- eosinophils.
-
Acute catarrhal conjunctivitis (Mucopurulent conjunctivitis) (pinkeye)
is caused by what in adults, children, newborns -
Streptococcus pneumoniae (most common in adults & children)
Haemophilus (frequent cause in children).
Staphylococcus aureus (most common cause in the newborn; fairly rare otherwise) - Acute Purulent Conjunctivitis
-
Serious
Needs immediate treatment
Caused by Neisseria gonherrea & meningitis
Produce toxic products that can result in perforation of cornea and toxic iritis - Chronic Bacterial Conjunctivitis is most frequently caused by
-
Staphylococcus aureus
Moraxella lacunata - Chlamydial Conjunctivitis (trachoma) is caused by what organism?
- Chlamydia trachomatis antigenic types A-C
- Chlamydial Conjunctivitis (trachoma) complications are due to ______.
- scarring -- most common cause of blindness in developing countries
-
Inclusion Conjunctivitis (Inclusion Blennorrhea) is caused by what organism?
In what ways? -
Chlamydia trachomatis antigenic types D through K.
genital to eye contact (via fomites), inadequately chlorinated swimming pools, in newborns via birth - Viral Conjunctivitis
- very common, may be part of a systemic infection or may be limited to epithelium of cornea and conjunctiva. Discharge usually watery rather than purulent. E.g. chicken pox & shingles
- Epidemic Keratoconjunctivitis (EKC)
- viral conjunctivitis that can cause pseudomembranes
- Herpes simplex virus (HSV) Conjunctivitis
- viral conjuntivitis that can also cause pseudomembranes
- Allergic Conjunctivitis
- Immediate hypersensitivity reactions - characterized by itching
- Ophthalmia neonatorum
-
a conjunctival infection that follows contamination of the baby's eyes during its passage through the mother's cervix and vagina.
topical erythromycin is used - Keratitis
- Inflammation of the cornea
- Signs and Symptoms of Keratitis
-
Pain and photophobia
Blurred vision and/or iridescent vision (halos)
No discharge, since there are no blood vessels or mucous glands, but there will usually be tearing.
Circumcorneal vascular congestion (ciliary or limbal flush)
If corneal inflammation is severe, toxins produced by infectious agents may diffuse into the anterior chamber, and leukocytes may settle there, resulting in hypopyon.
Abnormal light reflex (reflection of light from cornea) - Predisposing factors which may lead to corneal ulcers.
-
Dry eye syndrome (caused by deficiency of mucin or total ocular secretions).
Exposure of cornea from inability to close the lids.
Trauma to the cornea.
Inappropriate use of glucocorticoids.
Preexisting infection of the eye.
Inappropriate use of contact lenses, especially extended wear. -
Acute Serpiginous Ulcer (Pneumococcal Ulcer) is caused by what organism?
Where is it prominant?
What is it's prognosis? -
Streptococcus pneumoniae
developing countries
developes rapidly, if untreated eye will be lost -
Necrotizing keratitis (Pseudomonas ulcer) is caused by what organism?
Where is it prominant?
What is it's prognosis? -
Pseudomonas Aruganosa
Common in US
Occurs following minor injury & contaminated lens solution or make up, cornea may perforate and eye may be lost in 48 hours or less - Herpes simplex keratitis (dendritic keratitis)
- viral corneal ulcer -- Caused usually by Herpes simplex virus type 1, but occasionally by type 2 --Self-limited and usually produces minimal scarring unless corticosteroids are used, or unless the cornea or patient is otherwise immunocompromised