Eye infections

Question 1

Eye infection (external hordeolu ‘________’) or (internal hordeolum ‘________)

Answer 1

ext: stye
int: acute meibomianitis

Question 2

At the edge of the eyelid or underneath it. Head and it ruptures spontaneously within days. Give causative agents.

Answer 2

Hordeola— S. aureus

Question 3

Incision and drainage are indicated for hordeolum and patient should be referred to an ophthalmologist if the patient does not respond to what treatment for this eye infection

Answer 3

Cloxa or Flucoxacillin

Warm compresses + oral antiStaph agent

Question 4

Purulent or mucopurulent discharge indicates what type of eye infection

Answer 4

Bacterial or Chlamydial conjunctivitis

Question 5

Tx for Chlamydial and Gonococcal conjunctivitis

Answer 5

Chla: Oral tetra (doxy 100 mg 12 hourly) or Eryth (safe in preg) (500 mg 6 hourly) for 7 days, or Azith safe in preg) 1 g PO as a single dose. Amoxi safe in preg).
Gono: Ceftriax 1 g IM as a single dose.

Question 6

Causative agents of this eye infx Viral, bacterial, chlamydial & noninfectious, allergy, foreign body.

Answer 6

Conjunctivitis
*Watery discharge may be associated with upper respiratory infection or adenovirus. Viral causes are follicular reaction and preauricular lymphadenopathy.

Question 7

For this type of conjunctivitis, Children are generally kept out of school for up to 2 weeks after the onset of the infection and tx

Answer 7

Allergic conjunctivitis

Tx topical corticosteroids

Question 8

Bacterial conjunctivitis causative agents for children and adults:

Answer 8

Staphylococcus and/or Streptococcus for adults

Haemophilus influenza more common in children

Question 9

Bac conj tx

Answer 9

Alternative agents include Gentamicin or Tobramycin eye drops (adults), and ointment (for children), or Fusidic acid eyedrops

Question 10

Conjunctivitis in newborn and prophylaxis

Answer 10

ophthalmic neonatum

2.5% aqueous povidone-iodine solution

Question 11

Newborn conj causative agents and txs

Answer 11

Chlamydia trachomatis. Erythromycin syrup (40 to 50 mg/kg/day) in 3 divided doses for 14 days. If needed treat parents for genital infection.
Nisseria gonorrheae.Ceftriaxone 25 to 50 mg/kg IM as a single dose. If needed treat parents for genital infection

Question 12

Mechanical expression of the exudative or granular material, combined w probing and irrigation of the nasolacrimal system w Pen. G eye gtt soln and causative agents

Answer 12

Canaliculitis— Actinomyces, and rarely propiobacterium, nocardia or bacteroids. * Patients should be referred to an ophthalmologist for def tx

Question 13

Infection of nasolacrimal sac. Strep inc. S pneumoniae or S. aureus but culture should guide def tx

Answer 13

Cacrocystitis— Acute infection:
Oral amoxicillin-clavulanate or cefuroxime
Chronic infections: Irrigate the outflow tract with an antibiotic soln such as penicillin G as a temp. measure.

Question 14

Infx of the cornea. Sight-threatening ocular emergency and requires prompt recognition, give causative agents.

Answer 14

Keratitis— Bacteria, Fungi, Herpes simplex virus, acanthamoeba

Question 15

Keratoconjunctivis or Herpes simplex keratitis caused by HSV-1:
Epithelial and Stromal disease txs.

Answer 15

Epithelial disease: Topical antiviral- acyclovir ointment applied to eye 5xday, continued for at least 3 days after healing.
Trifluridine (Viroptic) and idoxuridine (Herplex-D) ophthalmic drops.
Stromal disease. Complex-combination of antiviral therapy and topical corticosteroids.

Question 16

Upper Reps tract infxs causative agents
Common cold (acute rhinitis)- V. Rhinoviruses
Sinusitis- Bac. S. pneumonia
Pharyngitis (Sore throat)- V. Adenovirus, bacteria, S. pyogenes

Answer 16

Acute bronchitis- V. Myxoviruses
Chronic bronchitis- H. influenza
Pneumonia (CAP)- S. pneu, H. influ, M. catarrhalis, M. pneu
Otitis media- S. pneu, H. influ, M. catarrhalis
DOC amoxi, amoclav, azith, clarith, cefurox