Infectious Eye Diseaes Flashcards

1
Q

What is preseptal cellulitis?

A

Infection of soft tissue anterior to orbital septum

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2
Q

Aetiology of preseptal cellulitis?

A

Usually follows periorbital trauma or dermal infection

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3
Q

Rx preseptal cellulitis?

A

-Systemic ABx e.g. amoxycillin-clavulanic acid

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4
Q

Suspected pathogens in preseptal cellulitis?

A

H. influenzae in children; S. aureus or Strep in adults.

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5
Q

What is orbital cellulitis?

A

OCULAR & MED EMERGENCY

-Inflammation of orbital contents posterior to orbital septum

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6
Q

Who is predisposed to orbital cellulitis?

A

-Children, elderly and immunocompromised.

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7
Q

Aetiology of orbital cellulitis?

A

Usually secondary to sinus / facial / tooth infections or trauma. May arise from pre-septal cellulitis.

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8
Q

Treatment orbital cellulitis?

A
  • Admit
  • 2 x blood cultures
  • Orbital CT
  • IV ABx (ceftriaxone + vancomycin)
  • Surgical drainage of abscess and close follow up
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9
Q

Complications of orbital cellulitis?

A
  • Optic nerve inflammation
  • Cavernous sinus thrombosis
  • Meningitis
  • Brain abscess with possible loss of vision and death
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10
Q

Clinical features of pre-septal cellulitis?

A
  • May have fever
  • Mod-severe lid oedema
  • Normal vision
  • No RAPD
  • Mod leukocytosis
  • May have skin infection
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11
Q

Clinical features of orbital cellulitis?

A
  • Fever
  • Severe lid oedema
  • Conjunctival infection
  • Marked chemosis
  • Proptosis
  • Pain on eye movement
  • Decreased ocular mobility
  • Diminished vision
  • +/- RAPD
  • Marked leukocytosis
  • Elevated ESR
  • May have sinusitis, dental abscess
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12
Q

What is dacryocystitis?

A

Acute or chronic infection of the lacrimal sac. Most commonly due to obstruction of nasolacrimal duct.

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13
Q

Cause Herpes Simplex Keratitis?

A

Usually HSV type I (90% population are carriers).

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14
Q

Triggers of herpes simplex keratitis?

A

Stress, fever, sun exposure, immunosuppression.

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15
Q

Clinical features of herpes simplex keratitis?

A
  • Pain, tearing, foreign body sensation, red eye, +/- decreased vision, eyelid oedema.
  • Corneal hypoesthesia
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16
Q

Appearance herpes simplex keratitis?

A

Dendritic (thin and branching) lesion in epithelium that stains with fluorescein.

17
Q

Complications of herpes simplex keratitis?

A
  • Corneal scarring
  • Chronic interstitial keratitis due to penetration of virus into stroma
  • 2” iritis, 2” glaucoma
18
Q

Treatment herpes simplex keratitis?

A
  • Topical antiviral (e.g. trifluridine)
  • Systemic antiviral (e.g. acyclovir)
  • Dendritic debridement
  • NO STEROIDS initially
19
Q

What is Hutchinson’s sign?

A

If tip of nose is involved (nasociliary branch of V1) then eye will be involved in ~75% of cases.
No nasal involvement, eye involved in ~1/3 cases.

20
Q

How can herpes zoster impact the eye?

A

Dermatitis of the forehead (CN V1 territory) may involve the globe.

21
Q

Complications of herpes zoster affecting eye?

A
  • Corneal keratitis, ulceration, perforation and scarring
  • 2” iritis, 2” glaucoma, cataract
  • Muscle palsies (due to CNS involvement); rare
22
Q

Treatment of herpes zoster affecting eye?

A
  • Oral antiviral (e.g. acyclovir)
  • Topical steroids as indicated for keratitis, iritis (supervised by ophthalmologist)
  • Erythromycin ointment if conjunctival involvement.