MDT Eye Conjunctivitis Flashcards

1
Q

What is an inflammation of the conjunctive, presents with injected pink or red eye(s), eye discharge ranging from mild to purulent, eye discomfort or gritty sensation, and no vision loss?

A

Conjunctivitis

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2
Q

True/False
Conjunctivitis is most commonly infectious (viral or bacterial) or allergic, but can be caused by irritants.

A

True

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3
Q

What is the most common cause of viral conjunctivitis?

A

Adenovirus

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4
Q

True false
Viral conjunctivitis Infection spreads easily, like in clinics and contaminated swimming pools.

A

True

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5
Q

Allergic Conjunctivitis is caused by what

A

……………
Caused by an allergen. Symptomatology is a reaction to the allergen

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6
Q

What type of conjunctivitis ?
Symptoms: Itching, burning, tearing, gritty or foreign body sensation; history of recent upper respiratory tract infection or contact with someone with this issue.

Signs: Watery discharge, red and edematous eyelids, pinpoint subconjunctival hemorrhages, punctate keratopathy (epithelial erosion in severe cases), membrane/pseudomembrane (severe cases).
1) Critical signs: Inferior palpebral conjunctival follicles, tender palpable preauricular lymph node.

A

Viral Conjunctivitis

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7
Q

What type of Conjunctivitis
Symptoms: Itching, watery discharge, and a history of allergies are typical. Usually bilateral.

Signs: Chemosis (swollen conjunctiva), red and edematous eyelids, conjunctival papillae, periocular hyperpigmentation, no preauricular node.

A

Allergic conjunctivitis

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8
Q

What type of Conjunctivitis?
(a) Symptoms: Redness, foreign body sensation, discharge; itching is much less prominent.
(b) Often complain of having to wipe purulent exudate in morning.
(c) Signs:
1) Critical: Purulent white-yellow discharge of mild-to-moderate degree.
2) Other: Conjunctival papillae, chemosis, preauricular node typically absent (unlike gonococcal).

A

Bacterial conjunctivitis (nongonococcal)

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9
Q

What type of Conjunctivitis?
1) Critical: Severe purulent discharge, hyperacute onset (classically within 12 to 24 hours).
2) Other: Conjunctival papillae, marked chemosis, preauricular adenopathy, eyelid swelling.

A

Gonococcal conjunctivitis

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10
Q

What are some ddx for Conjunctivitis?

A

(1) Acute uveitis
(2) Foreign body
(3) Chlamydial keratoconjunctivitis

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11
Q

True/False
Conjunctival cultures/swabs are indicated for these issues:
(1) Viral conjunctivitis
(2) Allergic conjunctivitis

A

FALSE
No conjunctival cultures/swabs are indicated

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12
Q

Labs/Studies/EKG:
Bacterial conjunctivitis (nongonococcal):

A

Send conjunctival scrapings for immediate Gram stain, culture and sensitivities

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13
Q

Labs/Studies/EKG:
Gonococcal conjunctivitis

A

(a) Eye examine the entire cornea for peripheral ulcers (especially superiorly)
(b) Gram stain: Gram-negative intracellular diplococci
(c) Send conjunctival scrapings for immediate culture and sensitivities

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14
Q

Treatment
Viral conjunctivitis
Mild:

A

Artificial tears or tear ointment

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15
Q

Treatment
Viral conjunctivitis
Moderate:

A

Epinastine (Elestat) - Ophthalmic antihistamine for symptomatic relief
-0.05% solution 1 drop to affected eye BID

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16
Q

Treatment
Viral conjunctivitis
Severe: If a membrane/pseudomembrane is present,

A

gently peel with a cotton-tip applicator.

17
Q

Treatment
Viral conjunctivitis
Severe with significant photophobia

A

Ophthalmic Corticosteroids
Consult ophthalmology BEFORE giving steroids

18
Q

Treatment for Allergic conjunctivitis
Mild:
Moderate:

A

Mild: Artificial tears four to eight times per day

Moderate: Patanol 0.1% BID or Epinastine 0.05% QID

19
Q

Treatment for Bacterial conjunctivitis (nongonococcal)

A

Topical antibiotic therapy
Trimethoprim/polymyxin B (Polytrim)
1 drop in affected eye Q 3 hours for 7-10 days.

20
Q

Treatment for Bacterial conjunctivitis (nongonococcal)
if your patient wears contact lenses

A

Ciprofloxacin (Ciloxan) or Ofloxacin (Ocuflox) – Fluoroquinolone antibiotic class.
-Dose: 0.3% Solution, use 1-2 drops in affected eye QID for 5-7 days.

21
Q

Treatment for Bacterial conjunctivitis (nongonococcal)
With associated dacryocystitis

A

Amoxicillin/Clavulanate (Augmentin)
Dose: 875/125 mg BID or 500/125 mg TID

Or
Cephalexin 500mg PO QID

22
Q

Treatment for Gonococcal conjunctivitis

A

Ceftriaxone 1 g IM, PLUS azithromycin 1 g PO both in a single dose.

23
Q

Treatment for Gonococcal conjunctivitis for patients with penicillin/cephalosporin allergy

A

Gentamicin 240mg IM x 1 dose PLUS Azithromycin 2mg PO x 1 dose.

24
Q

True/False
When treating a Gonococcal conjunctivitis patient you should get an optometry or ophthalmology consult due to high risk of corneal perforation.

A

True

25
Q

Treatment for Gonococcal conjunctivitis
If corneal involvement exists…

A

Hospitalize the patient

26
Q

Initial Care of the disease and Follow up:
Viral conjunctivitis

A

-Cool compresses several times per day.
-Counsel the patient
1) Is a self-limited condition that typically gets worse for the first 4 to 7 days
after onset and may not resolve for 2 to 3 weeks (potentially longer with corneal involvement).
2) Is highly contagious.
3) Avoid touching (eyes, shaking hands, sharing towels or pillows, etc.); restrict
work and school.
4) Frequent handwashing.

27
Q

Initial Care of the disease and Follow up:
Allergic conjunctivitis

A

(a) Eliminate the inciting agent.
(b) Cool compresses several times per day.

28
Q

Initial Care of the disease and Follow up:
Bacterial conjunctivitis (nongonococcal)

A

(a) Follow-up every 2 to 3 days initially, then every 5 to 7 days when stable until resolved.
(b) Antibiotic therapy is adjusted according to culture and sensitivity results.

29
Q

Initial Care of the disease and Follow up:
Gonococcal conjunctivitis

A

Treat sexual partners with oral antibiotics for both gonorrhea and chlamydia

30
Q

What are some complications for conjunctivitis?

A

(1) Vision loss or blindness
(2) Orbital or systemic involvement