CONJUNCTIVITIS Flashcards
Conjunctivitis
Inflammation of the conjunctiva
Classification of conjunctivitis
Hypercute, acute or chronic
Infectious or Noninfectious
Three main regions of the conjunctiva
Palpebral conjunctiva
Bulbar or Ocular conjunctiva
Conjunctival fornix
Parts of the palpebral conjunctiva
Marginal
Tarsal
Orbital
Part of the conjunctiva that lines the eyelids
Palpebral conjunctiva
Part of the conjunctiva that covers the eyeball over the anterior sclera
Bulbar conjunctiva
Parts of the bulbar conjunctiva
Scleral
Limbal
Divisions of the conjunctival fornices
Superior
Inferior
Lateral
Medial
Location of the conjunctival fornices
Junctions between the palpebral and bulbar conjunctivas
Role of conjunctiva
Secretes mucous to lubricate the eyes and keep it moist
Prevent entry of microbes into the eye
Highest rate of diagnosis of conjunctivitis occurs in………………, with highest incidence between ………………………
Children less that 7 years,
0-4 years
Second peak distribution of conjunctivitis
22 years in women
28 years in men
Most frequent cause of conjunctivitis
Allergic conjunctivitis
Two main divisions of conjunctivitis
Infectious
Non-infectious
Causes of non-infectious conjunctivitis
Allergic
Toxic
Secondary to systemic causes
Systemic causes of non-infectious conjunctivitis
Immune-mediated diseases
Neoplastic processes
Causes of Toxic Non-infectious conjunctivitis
Idoxuridine
Brimonidine
Apraclonidine
Dipivefrin
Contact lens solution
An immune mediated disease that causes conjunctivitis
Sarcoidosis
Infectious causes of conjunctivitis
Virus
Bacteria
Rickettsia
Fungus
Parasites
Viral causes of conjunctivitis
Adenoviruses
Herpes simplex virus
Bacterial causes of conjunctivitis
Staphylococcus spp.
Strep. pneumonae
H. influenzae
Moraxella catarrhalis
Virual conjunctiva is more prevalent during…………..
Summer
Most commonest causes of infectious conjunctivitis in adults
Virus followed by Bacteria
Bacterial conjunctivitis is observed more frequently from………….
December to April
commonest cause of bacterial conjunctivitis
Staphylococcus species followed by S. pneumoniae
Allergic conjunctivitis occurs moslty in…
Spring and Summer
Difference between seasonal and perennial allergic conjunctivitis
Perennial allergic conjunctivitis involves infiltration of eosinophils, neutrophils and T cells but
Seasonal involves only eosinophils and neutrophils.
Pollen is to seasonal allergic conjunctivitis as house dust mite is to
Perennial allergic conjunctivitis
Atopic or allergic conditions that predispose to allergic conjunctivitis
Eczema
Asthma
Urticaria
Rhinitis
Symptoms of viral conjunctivitis
Red eye
Unilateral thin watery discharge
Pain
Vesicular eyelid discharge
Photophobia
Subconjunctival hemorrhage
Risk factors of viral conjunctivitis
Direct contact with:
Contaminated fingers
Contaminated medical instruments
Contaminated swimming pool water
Personal items from an infected person
Risk factors for bacterial conjunctivitis
Contact with contaminated fingers, fomites or oculo-genital contact with someone infected
Compromised tear production or drainage
Disruption of the natural epithelial barrier
Abnormality of adnexal structures
Trauma
Immunosuppressed status
Incubation period for viral conjunctivitis
5-14 days
Risk factors for allergic conjunctivitis
History of current or previous non-ocular allergic or atopic conditions
When is eyelid cultures and cytology done for conjunctivitis
Recurrent conjunctivitis
Rapid antigen testing is used to test for…..
Adenoviruses
Fluoroquinolones used in bacterial conjunctivitis
Ciprofloxacin
Levofloxacin
Moxifloxacin
Gatifloxacin
Treatment for hyperacute conjunctivitis without corneal ulceration secondary toN. gonorrhoeae
1 g IM ceftriaxone single dose
Signs and symtopms of bacterial conjunctivitis
Hyperemia
Photophobia
Unilateral or bilateral
Purulent discharge
Eyelids may be shut in the morning and dificult to open
Treatment of hyperacute conjunctivitis with corneal ulceration secondary toN. gonorrhoeae in patients allergic to penicillins
2g IM Spectinomycin
or
Oral fluoroquinolone for 5 days
Ciprofloxacin 500mg
Ofloxacin 400mg BD
Immune cells and their associated infections
Lymphocytes– Viral
Eosinophils- Allergic
Neutrophils— Bacterial
Antibioitcs used in bacterial conjunctivitis
Fluoroquinolones
Aminoglycosides
Bacitracin-Polymyxin B
Erythromycin
Ceftriaxone
Complication of adenovirus conjunctivitis
Pharyngoconjunctival fever
Epidemic keratoconjunctivitis.
Management of concurrent chlamydial infection in bacterial conjunctivitis
Azithromycin 1g
Doxycycline 100mg BD for 7 days
Tetracycline 250mg QID for 7 days
Erythromycin 500mg QID for 7 days
Allergic conjunctivitis
Bilateral
Itching
Maybe seasonal
Tearing
Mild eye swelling
Watery discharge
Feeling of grittiness on the eye
Frequency of application for fluoroquinolones and aminoglycosides in bacterial conjunctivitis
4-6 hourly for 5-7 days
Aminoglycosides used in bacterial conjunctivitis
Tobramycin
Gentamycin
These antibiotics have a higher incidence of toxicity to the corneal epithelium
Tobramycin
Gentamycin
Treatment of hyperacute conjunctivitis with corneal ulceration secondary to N. gonorrhae
Admit to hospital
1g IV Ceftriaxone 12 hourly for 3 days
Drugs for allergic conjunctivitis
Topical antihistamines
Topical mast cell stabilizers
Topical steroids
Immunosuppresants
Management of Viral conjunctivitis
Acyclovir
Ganciclovir
Topical antihistamines used in allergic conjunctivitis
Azelastine
Epinastine
Ketotifen
Olopatadine
………………. via parenteral and oral routes has been shown to be effective in seasonal and perennial allergic conjunctivitis
Immunotherapy
When are oral antihistamines used to manage allergic conjunctivitis
Oral antihistamines are added in moderate to severe allergic conjunctivitis
Topical mast cell stabilizers used in allergic conjunctivitis
Lodoxamide
Sodium cromoglycate
Ketotifen
Olopatadine
Topical steroids used in allergic conjunctivitis
Fluorometholone
Prednisolone
Immunosuppressants used in allergic conjunctivitis
Cyclosporine
