Microbiology Flashcards
Keratitis affects…
the cornea
Endophthalmitis affects…
the whole globe
Common causes of bacterial conjunctivitis in neonates
Staph aureus, neisseria gonorrhoeae, Chlamydia trachomatis
Common causes of bacterial conjunctivitis in all ages
staph aureus, strep penumoniae, haemophilus influenza
Common treatment for bacterial conjunctivitis
chloramphenicol drops or ointment (qds)
How do you confirm bacterial conjunctivitis?
tissue swab from the fornix - you may wish to give an LA drop first
Common causes of viral conjunctivitis (3)
Adenovirus, Herpes simplex, herpes zoster
How might adenovirus conjunctivitis present?
watery, red eye following URTI
Treatment for adenovirus conjunctivitis
cold compress should suffice, give antibacterial drops if worried about secondary infection
Presentation of herpes zoster conjunctivitis
Hutchisons sign, red eye and spots on nose
Treatment of herpes zoster conjunctivitis
anti-virals such as acyclovir
Complication of herpes zoster ophthalmicus
post-herpetic neuralgia
What is hutchisons sign?
vesicles on the side of the nose which precede herpes zoster ophthalmicus
Common presentation of chlamydial conjunctivitis
often chronic history which is unresponsive to treatment, suspect if bilateral conjunctivitis in young adults
Clinical sign of chlamydial conjunctivitis
rice grains in eyelids which can cause chronic follicular scarring of the lid
What is a hypopyon?
an obvious fluid level in the anterior segment of the anterior chamber
Bacterial keratitis treatment
hourly eye drops for at least 48 hours and daily review
Presentation of herpes viral keratitis
Dendritic ulcers with a very painful eye which can be recurrent. Pain is less each time but vision will deteriorate
Treatment of viral keratitis
Zovirax
Must be avoided with viral keratitis
Steroids - may cause a corneal melt
Presentation of adenoviral keratitis
Usually after URTI, subepithelail infiltrates but self-limiting. Can be contagious
Orbital cellulitis presentation
Painful and swelling around the eye. May be pyrexial. Proptosis may occur. Well defined redness around the orbit
Treatment of orbital cellulitis
broad spectrum antibiotic and monitor closely. Abcess may require draining
Cause of endophthalmitis
post-surgical or endogenous
Presentation of endophthalmitis
VERY painful, with decreasing vision and very red eye - sight threatening
Treatment of endophthalmitis
Intravitreal antibiotics and topical antibiotics
Toxoplasma gondii
protozoan infection. 10% have it in latent form. From cats and raw meat
Cautions for Chloramphenicol
Aplastic anemia; grey baby syndrome
Alternative antibiotic if chloramphenicol not an option?
Ofloxacin
Common contaminant of eyedrops after 4 weeks
Pseudomonas
