Keratitis + Anterior uveitis Flashcards
name 3 common causative bacteria for bacterial keratitis
Pseduomonas Aeruginosa
Staphylococcus Aureus
Streptococcus
what is the most common risk factor for bacterial keratitis?
contact lense wearer
the bacteria usually responsible for bacterial keratitis in contact lens wearers
Pseudomonas Aeruginosa
fungal causes of microbial keratitis?
- Candida
- Aspergillus
- Fusarium
symptoms of microbial keratitis?
- unilateral painful eye that mimics conjunctivitis
- foreign body sensation
- photophobia
- reduced vision
why does microbial keratitis warrant immediate ophthalmology review?
Potential blinding due to corneal scarring + neovascularisation or perforation
which bacteria is not sensitive to chloramphenicol?
Pseudonomas aeruginosa
what clinical sign imposes a threat to corneal perforation?
Hypopyon
Management of bacterial keratitis?
- Corneal scrape
- Broad spectrum abx: Fluoroquinolones
Hypopyon is…
pus in the anterior chamber
what does herpes simplex keratitis most commonly present with?
dendritic corneal ulcer
what is the presentation of herpes simplex keratitis (4)
- red
- painful
- photophobia
- reduced visual acuity
How is Fluorescein dye used and what may it reveal in an epithelial ulcer?
Fluorescein is an orange dye; visualised using cobalt-blue filter, which causes the dye to fluoresce a bright green colour
It only stains non in tact epithelium, therefore highlighting the area of epithelial loss
likely pathogen causing a dendritic ulcer
Herpes simplex virus
management of dendritic ulcer
Topical Aciclovir
cream for skin lesions
Immediate referral to ophthalmology
what is inflamed in anterior uveitis/iritis?
Uveal tract
- ciliary body
- iris
- retina
- choroid
presenting features of anterior uveitis? (6)
Acute onset of
- ocular discomfort + pain
- irregular + small pupil
- photophobia
- blurred vision
- red eyes
- lacrimation
what 2 signs should be looked for in anterior uveitis?
hypopyon
+
posterior synechiae
what is posterior synechiae?
Iris adhering to the cornea causing an raised IOP
what is a hypopyon?
inflammatory cells + pus in the anterior chamber
3 associated conditions with anterior uveitis
- ankylosing spondylitis
- IBD
- reactive arthritis
Management of anterior uveitis?
- Urgent referral to ophthalmology
- Cycloplegic
- Steroid eye drops
Purpose of giving cycloplegics in the management of anterior uveitis
Dilate the pupil to relive pain and photophobia
what cycloplegics can be given in anterior uveitis?
Atropine
or
Cyclopentolate
is Episcleritis or Scleritis associated with worse pain and photophobia?
Scleritis
