Drainage system (infections) Flashcards
1
Q
What are the two causes of epiphora
A
Hypersecretion: Paradoxical watering, due to dry eye or ocular surface disease
Defective drainage: comprimised drainage system. Tends to be exacerbated by cold windy environments
2
Q
What Bacteria is most likely to cause canaliculitis
A
actinomyces israelii, gram positive bacteria
3
Q
DDx’s of canaliculitis
A
- Orbital or preseptal cellulitis
- Dacrocystitis
- PANDO or SANDO (punctal stenosis)
- Bacterial conjunctivitis
- Hordeolum, chalazion
- Ectropion
4
Q
Risk factors of canaliculitis
A
- Obstructions of the canaliculus
- Punctal plug
- Foreign body in the canaliculus
5
Q
What is a normal tear meniscus height?
A
0.2mm-0.4mm, above 0.6mm can indicate a blocked drainage system
6
Q
Management of canaliculitis
A
- topical antibiotic, fluoroquinolone, 4 times a day daily for 10 days
- if no success canaliculotomy
7
Q
Bacteria most likely to cause dacrocystitis?
A
staphylococcal or streptococcal.
8
Q
Treatment of acute dacrocystitis?
A
- Children older than 5 and <40kg: amoxicillin twice daily
- Adults: Cephalexin q6h
- Alternative: amoxicillin every 8 hours
Incision and irrigation may be considered, (increased risk of fistula)
9
Q
Treatment of chronic dacrocystitis?
A
dacryocystochinostomy.
