Conjunctivitis Flashcards
Causes of Hyperacute Bacterial Conjunctivitis
Neisseria
Causes of Acute Bacterial Conjunctivitis
Staph aureus
Strep pneumo
Haemophilus influenzae
Spreading Bacterial Conjunctivitis
direct contact
Cause of Chronic Bacterial Conjunctivitis
Chlamydia- main
Staph aureus and Moraxella lacunata
General Symptoms of Bacterial Conjunctivitis
redness/ inflammation
bilateral
discharge- eyelashes sticky/ lids glued shut
gritty/ burn
General Signs of Bacterial Conjunctivitis
diffuse bulbar conjunctival injection
mucopurulent discharge
quiet anterior chamber, normal pupils and VAs
Papillae
small red bumps, more on upper lid
indicative of allergic or bacterial conjunctivitis
Follicles
type of lymphatic rxn
larger, clear, more gelatinous
indicative of viral and Chlamydial conjunctivitis
Reasons to stain for suspected bacterial conjunctivitis
hyperacute
chronic/ nonresponding
neonates
Staining Neisseria gonorrheae
chocolate agar
Thayer- Martin
Treating Mild Cases of Bacterial Conjunctivitis
topical antibiotics
qid x 1 week
Specific Meds for Mild Bacterial Conjunctivitis
Polymixin B/ Trimethoprim
Erythromycin
Tobramycin
Sulfacetamide
Treating Moderate/ Severe Bacterial Conjunctivitis
fluoroquinolones
bid or tid
Specific Meds for Moderate Bacterial Conjunctivitis
Ciprofloxacin, Ofloxacin (2nd gen)
Levofloxacin (3rd)
Moxifloxacin, Gatifloxacin, Besifloxacin (4th)
Treating Hyperacute Infections
swabs/ scrapes- gram stain
consult genitourinary or infectious disease specialist
Systemic Meds
Chlamydia trachomatis causes…
adult inclusion conjunctivitis
neonatal conjunctivitis
trachoma
Adult Inclusion Conjunctivitis
sexually transmitted with self inoculation
Diagnosing Adult Inclusion Conjunctivitis
follicular reaction
tender preauricular lymph nodes
Managing Adult Inclusion
refer to genitourinary specialist
Azithromycin
Trachoma
in underdeveloped areas, associated with bad hygiene (flies)
Progression of Trachoma
recurrent infection - hypersensitivity rxn - conj scarring -
dry eye and entropian, trichiasis, corneal opacification - blindness
Management for Trachoma
Surgery for entropian
Antibiotics
Facial hygiene
Environmental improvements
Arlt’s Line
line of conjunctival scarring seen in trachoma
Neonatal Conjunctivitis
any conjunctival infection in the first month of life
often acquired during birth
Prophylaxis for Neonatal Conjunctivitis
povidone- iodine
silver nitrate
Epidemic Keratoconjunctivitis
EKC
pink eye
very contagious
Pharyngoconjunctival Fever
PCF
follicular reaction
fever
kids
very contagious
Adenovirus
most likely cause of viral conjunctivitis
nonspecific acute follicular
EKC and PCF
HSV
usually primary infection
associated with skin vesicles
HZV
usually secondary infection
associated with ophthalmic shingles- one sided face rash
Enterovirus
causes acute hemorrhagic conjunctivitis
Molluscum Contagiosum
can shed if close to eye and cause viral conjunctivitis
Differentiating Viral Conjunctivitis
point of care testing for adenovirus
Giemsa stain
PCR
Inclusion Bodies in Giemsa Staining
chlamydia
AdenoPlus
point of care testing to confirm adenovirus
2 lines- infection
Managing Viral Conjunctivitis
decrease transmission- D/C contacts, dont touch eye, dont share towels, wash hands
Artificial tears and cold compress
Treatment for Viral Conjunctivitis
Povidone - iodine for EKC
steroids to help with inflammation, not shortening infection
remove pseudomembranes
Betadine
stings like hell
for more severe viral conjunctivitis
move around on eye and rinse out after
