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Head and Neck Microbiology > Eye Infections > Flashcards

Eye Infections Flashcards

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1
Q

Eye examination?
What it examines?

A

Inverted ophthalmoscope and slit lamp
- Visual acuity and intraocular pressure
> Starts with the lids and adnexae, and ending with the funduscopic
examination.

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2
Q

What is microbial conjuctivitis?

A

Inflammation of the thin lining of the inner eyelid and front of the eyeball
- dilation of the conjunctival blood vessels

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3
Q

Epidemiology of microboial conjunctivitis?

A

Affects males and females of all ages but mostly children
- Viral cases are more common in adults
> mostly adenovirus

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4
Q

Risk factors for microbial conjuctivitis?

A
  1. contact lens wear
  2. contaminated ocular medications
  3. exposure to an infected person
  4. vaginal versus cesarean delivery
  5. visits to camps
  6. swimming
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5
Q

Signs and symptoms of microbial conjuctivitis?

A
  1. Itching
  2. Light sensitivity
  3. Pink color
  4. Swelling
  5. Preauricular lymphadenopathy
  6. Secretions
  7. Discharge
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6
Q

Diagnosis of microbial conjunctivitis?

A

Laboratory diagnosis not needed
- Conjunctival scraping

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7
Q

Viral causes of conjunctivitis?

A
  1. adenovirus - The most common cause of viral conjunctivitis is infection
  2. herpes simplex virus (HSV)
  3. picornavirus
  4. EBV
  5. Mumps
  6. Influenza virus
  7. herpes zoster virus
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8
Q

Causes of bacterial conjunctivitis?

A
  1. Staphylococcus aureus,
  2. Streptococcus pneumoniae,
  3. Haemophilus species,
  4. Moraxella,
  5. Corynebacterium diphtheriae,
  6. Neisseria species, and enteric gram-negative rods
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9
Q

Gonococcal conjunctivitis?

A
  1. cause - Neisseria gonorrhoeae
  2. signs + symptoms - hyperpurulent discharge
  3. treatment - ceftriaxone is the drug of
    choice
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10
Q

Chlamydial conjunctivitis?

A
  1. Cause - Chlamydia trachomatis
  2. signs + symptoms - Unilateral and have concurrent genital infection
  3. treatment - Oral antibiotics such as azithromycin or doxycycline are effective treatments
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11
Q

Cause of Trachoma?

A

Serotypes A, B and C of C. trachomatis
- Repeated infections causes the eyelashess turn inwards leading to scarring and blindness
> 1.9 million people blinded by trachoma

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12
Q

Epidemiology of trachoma?

A
  • More than 42 countries endemic
  • Preschool children at risk, get it from family members
    Note: 15 countries declared by WHO to have eliminated trachoma
    including Malawi as of 5th October 202
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13
Q

Stages of trachoma?

A
  1. Trachomatous inflammation follicular (TF)
    - five or more follicles of larger than 0.5 mm on upper tarsal conjunctiva
  2. Trachomatous inflammation intense (TI)
    - inflammatory thickening obscuring more than half the normal deep tarsal vessels
  3. Trachomatous conjunctival scarring (TS)
    - presence of easily visible scars in the tarsal conjunctiva
  4. Trachomatous trichiasis (TT)
    - at least one eyelash rubbing on the eyeball or evidence of recent removal of in-turned eyelashes
  5. Corneal opacity (CO)
    - corneal opacity blurring part of pupil margin
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14
Q

What is the SAFE strategy?

A
  1. Erythromycin and tetracycline for 5 days repeatedly
  2. Single dose azithromycin
  • Initiated in 1993
  • Antibiotics supplied by manufacturer (Pfizer)
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15
Q

What is infectious keratitis?

A

infection of the cornea (microbial keratitis) is an ophthalmic emergency requiring immediate attention
- one of the most common causes of visual impairment in working age adults

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16
Q

Risk factors for infetious keratitis?

A
  1. contact lenses
  2. corneal abrasions
  3. physical and chemical trauma
  4. refractive surgery
  5. diabetes
  6. immunosuppressive diseases
  7. topical steroids
17
Q

Other causes of infectious keratitis?

A
  1. Parasites
    - African sleeping sickness
    - leshmaniasis
    - cryptosporidia
  2. Fungal
    - candida spp
    - blastomyces spp
18
Q

Causes of bacterial keratitis?

A
  1. S. aureus
  2. coagulase-negative staphylococci
  3. S. pneumoniae
  4. Pseudomonas aeruginosa^.
  5. Less commonly, fungi or acanthamoeba
19
Q

Symptoms of bacterial keratitis?

A
  1. pain
  2. decreased vision
  3. tearing
  4. itching
  5. photophobia
20
Q

Signs of bacterial keratitis?

A
  1. redness
  2. discharge
  3. epithelial ulcers corneal infiltrates
21
Q

Diagnosis of bacterial keratitis?

A
  1. Slit lamp examination
  2. corneal scrapings
  3. Empiric abx
22
Q

Treatment of bacterial keratitis?

A

Topical abx are mainstay of treatment

23
Q

What is herpes simplex keratitis?

A
  • The global incidence of herpes simplex keratitis was calculated at
    approximately 1.5 million/year
  • primary or recurrent depending on whether it is the patient’s first
    episode
  • ask about a history of cold sores or previous viral keratitis
24
Q

Treatment for HSV keratitis?

A
  1. oral antivirals (aciclovir or valaciclovir)
  2. topical steroids
25
Q

What is infectious endopthalmitis?

A

inflammation inside the eye that can be caused by infection with microbes, including bacteria or fungi

26
Q

Risk factors for infetious endopthalmitis?

A
  1. Cataract surgery,
  2. intravitreal injections trauma,
  3. filtering bleb (for glaucoma),
  4. corneal infection,
  5. bacteraemia or fungemia
27
Q

Most common causes of infectious endophhalmitis?

A
  1. coagulase negative staphylococci
  2. S. aureus
  3. streptococci
  4. Gram-negative bacilli
28
Q

Clinical features of infectious endopthalmitis?

A
  1. pain
  2. redness
  3. Decreased vision
  4. Hypopyon
29
Q

Treatment for infectious endopthalmitis?

A
  1. intravitreal antibiotics such as ceftazidime or vancomycin injected by an
    ophthalmologist.
  2. vitrectomy may be beneficial to avoid loss of vision
    - Samples may be sent to the laboratory if acquired
    - systemic abx may be given*
30
Q

What is uveitis?

A

Inflammation of the iris, ciliary body and choroid
1. Anterior (iritis)
2. Intermediate (pars planitis)
3. Posterior (retinitis, choroiditis)
4. Pan uveitis usually TB or syphilis
- Anterior causes are usually viral (HSV)
- usually, no systemic features

31
Q

Etiologies of uveitis?

A
  1. CMV
  2. Toxoplasmosis
  3. Lyme disease
  4. Brucellosis
  5. leprosy
32
Q

Diagnosis of uveitis?

A

Clinical
Laboratory findings, culture of vitreous humour and even PCR
Serological tests can be used to rule out causes

33
Q

Name Infections of the eyelid?

A
  1. hordeolum
  2. chalazion
  3. marginal blepharitis
34
Q

Hordeolum?

A

acute infection of a sebaceous gland of the lid, usually caused by Staphylococcus aureus

35
Q

Chalazion?

A

a sterile granulomatous reaction to inspissated sebum within an obstructed meibomian gland

36
Q

Marginal blepharitis?

A

is a diffuse inflammation of the lid margins

Head and Neck Microbiology (5 decks)

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