Eye Care - Conjunctivitis Flashcards
what is a think, translucent, relatively elastic tissue layer that lines the inside of the eyelids and the anterior aspect of the globe?
conjunctiva
what is a general term that refers to any inflammatory condition of the membrane that lines the inside of the eyelids and covers the exposed surface of the sclera?
conjunctivitis
what are 3 types of bacterial conjunctivitis?
hyperacute, acute, and chronic
what are common causes of bacterial conjunctivitis in neonates?
Chlamydia trachomatis, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Neisseria gonorrhoeae, Neisseria meningitidis
what are common causes of bacterial conjunctivitis in children?
H. influenzae, S. pneumoniae, S. aureus
what are common causes of bacterial conjunctivitis in adult?
S. aureus, coagulase-negative Staphylococcus organisms, H. influenzae, S. pneumoniae, N. gonorrhoeae, N. meningitidis, C. trachomatis
what are the common cause of viral conjunctivitis?
Adenovirus
Herpes simplex virus
Human papillomavirus
what are other Common causes of conjunctivitis (not bacterial or viral)
immunologic,
chemical or irritative,
associated with dermatologic conditions (ocular rosacea, psoriasis, stevens-johnson syndrome),
associated with systemic disease (thyroid disease, kawasaki disease), lacrimal system infections (canaliculitis, dacryocystitis)
what is the most common causative organism of acute bacterial conjunctivitis ?
Staphylococcus aureus;
but Streptococcus pneumoniae and H. influenzae are also common especially in kids
what are nonpharmacologic measure for acute bacterial conjunctivitis?
prevent contamination - hand-wash, avoid direct hand-to-eye contact, separate towel use;
soak with a warm compress;
irrigate with sterile saline or a commercial eye wash product;
no contact lens wear - seek medical advice;
if you use eye drops for other indication (e.g. glaucoma or dry eye), replace the eye drop bottles
when do you recommend polysporin eye drop?
mild cases of bacterial conjunctivitis in adults - continue treatment for 2 days after symptoms have resolved;
if not better in 2 days, refer or AB Rx
what is empiric tx with broad spectrum AB drops for acute bacterial conjunctivitis?
trimethoprim/polymyxin B;
erythromycin ophthalmic ointment;
fusidic acid ophthalmic drops
according to bugs and drugs - what is adult ophthalmic for acute bacterial conjunctivitis?
polysporin qid 7-10 days OR
tobramycin 0.3% qid 7-10 days
according to bugs and drugs - what is infant/kids ophthalmic for acute bacterial conjunctivitis?
bacitricin-polymyxin B qid 7-10 days OR
erythromycin 0.5% qid 7-10 days
if patient wears contact lens, what is Rx for acute bacterial conjunctivitis? why?
cipro 0.3% or tobramycin 0.3% -
need pseudomonas coverage
what is side effect of tobramycin eye drop for prolonged use (>7 days) ?
toxicity to the corneal epithelium
what is characterized by a copious, yellow-green purulent discharge, redness, irritation and tenderness to palpation, a severe, sight-threatening ocular infection caused by Neisseria gonorrhoeae or Neisseria meningitidis?
hyperacute bacterial conjunctivitis
what is chronic bacterial conjunctivitis?
if symptoms lasts 4 weeks or longer;
often associated with blepharitis, and is sometimes found in conjunction with facial seborrhea, acne rosacea, nasolacrimal duct obstruction or chronic dacryocystitis
what is the common cause of chronic bacterial conjunctivitis?
S. aureus and Moraxella lacunata;
In sexually active adults, chronic bacterial conjunctivitis can be a manifestation of a sexually transmitted infection involving Chlamydia trachomatis
what is nonpharmacologic therapy for chronic bact conjunc?
eyelid hygiene, warm compress as daily routine;
no contaminated facial-care products and makeup
what are RX for chronic bacterial conjunc?
topical AB during periods of exacerbation;
doxycycline or erythromycin oral - if associated with meibomian gland dysfunction or severe acne rosacea;
topical metronidazole for acne rosacea may also ameliorate associated conjunctivitis
what are usual symptom of viral conjunctivitis?
red eye, watery discharge, conjunctival swelling, foreign body sensation and mild photophobia;
may be tenderness around the preauricular node;
Occasionally, patients may have subconjunctival hemorrhage
The most common causative organism of viral conjunctivitis is ?
adenovirus
what is treatment for viral conjunctivitis?
supportive - cold compresses, avoid direct contact with others for at least 10 days after the onset,
handwashing with soap and water (not sanitizer), separate towel, kids kept out of school until no ocular discharge (approx 1 week)
