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OPHTHALMOLOGY > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is the name given to an infection of the entire eye?

A

Endophthalmitis

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2
Q

Keratitis is an infection of what part of the eye?

A

Cornea

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3
Q

What is cellulitis with regards to the eye?

A

An infection of the skin around the eye

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4
Q

How does bacterial conjunctivitis usually present?

A
  • red eye

- pus discharge

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5
Q

When should you worry about bacterial conjunctivitis?

A

If it is present in neonates

these should all be referred to ophthalmology

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6
Q

What organisms usually cause bacterial conjunctivitis in neonates?

A

Staph aureus
Neisseria gonorrhoeae
Chlamydia trachomatis

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7
Q

What organisms cause bacterial conjunctivitis in other ages?

A

Staph aureus
Strep pneumoniae
Haemophilus influenzae (especially in children)

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8
Q

How is bacterial conjunctivitis treated?

A

Swab

Topical antibiotic - chloramphenicol (drops vs ointment)

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9
Q

When should chloramphenicol not be given?

A

if history of aplastic anaemia

OR should be stopped if suspicion of allergy

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10
Q

Where should chloramphenicol eye drops be kept?

A

Fridge

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11
Q

Why do patients struggle to use chloramphenicol gel?

A

It is very thick and difficult to apply to the infected eye

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12
Q

What viruses commonly cause conjunctivitis?

A

Adenovirus
Herpes simplex
Herpes zoster

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13
Q

How does adenovirus conjunctivitis present?

A

Red bloodshot eye

no pus

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14
Q

What can be a sign of herpes simplex conjunctivitis?

A

vesicles beside the eye

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15
Q

What presentation can make you suspect chlamydial conjunctivitis?

A

Chronic problem (many infections)
Unresponsive to treatments
Present in young adults
May or may not have symptoms of urethritis, vaginitis

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16
Q

What sign of chlamydial conjunctivitis can be found in the eyelid?

A 
Follicular change
(looks like rice)
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17
Q

What complication can chlamydial conjunctivitis cause?

A

subtarsal scarring

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18
Q

How does a bacterial keratitis usually appear?

A

white clouded areas on cornea

hypopyon (white layer of fluid) at bottom of cornea

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19
Q

How is bacterial keratitis treated?

A
  • admission for hourly drops (Ofloxacin)

- Daily review

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20
Q

Bacterial keratitis usually occurs when there is other corneal pathology present. TRUE/FALSE?

A

TRUE

Usually in association with other corneal pathology or contact lens wear

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21
Q

What viruses most commonly cause keratitis?

A

Adenovirus

Herpes

22
Q

What sign is distinctive of herpetic keratitis?

A

Dendritic ulcer

23
Q

What treatment should not be used in herpetic keratitis?

A

Corneal melt and perforation of the cornea

Ulcer dissolves

24
Q

Adenovirus keratitis is usually bilateral and contagious. TRUE/FALSE?

25
What type of infection usually precedes an adenovirus keratitis?
Upper Respiratory Tract Infection (URTI)
26
How is an adenovirus keratitis treated?
Topical antibiotic to prevent secondary infection | Mild steroids to speed up recovery if becomes chronic
27
What sign is distinctive of adenovirus keratitis?
Subepithelial infiltrates
28
What organisms usually cause keratitis from contact lenses?
Acanthamoeba (commonly from tap water) | Pseudomonas aeruginosa
29
Who usually gets fungal keratitis?
Farmers/gardeners: | => history of trauma from vegetation.
30
What symptoms and signs present in orbital cellulitis?
Painful – especially on eye movements Proptosis Pyrexial
31
What imaging is used to look for orbital abscesses?
CT Scan
32
What is meant by pre-septal cellulitis?
Only affects top layers of skin | => not as serious and wont damage any strctures in eye
33
What is dacryocystitis?
Infection of the lacrimal sac due to an obstruction
34
What organisms usually cause orbital cellulitis?
``` Staphylococci Streptococci Coliforms Haemophilus influenzae Anaerobes ```
35
How is orbital cellulitis managed?
If restriction of muscles or optic nerve dysfunction then scan Broad spectrum antibiotics abscess will require drainage
36
How does endophthalmitis usually present?
Painful Decreasing vision Very red eye Sight threatening
37
What is the main cause of endophthalmitis?
Post-surgical (Iatrogenic)
38
What organisms most commonly cause endophthalmitis?
conjunctival “commensals” staph epidermidis
39
What antibiotics are used to treat endophthalmitis and how are they normally delivered?
Antibiotics are injected into vitreous fluid Intravitreal amikacin/ ceftazidime/ vancomycin`
40
What organisms are known to cause chorioretinitis?
CMV in AIDS Toxoplasma gondii Toxocara canis (worm)
41
Toxoplasmosis can enter a latent state and reactivate. TRUE/FALSE?
TRUE | especially in immunocompromised individuals
42
When is toxoplasmosis treated?
If sight threatening, it is treated systemically
43
Toxocara cannot replicate in humans and is therefore self limiting. TRUE/FALSE?
TRUE | can only replicate in animals such as cats or dogs
44
How can a Toxocara infection cause vision loss?
Form granulomas which can cause irreversible visual loss
45
What investigations are used to diagnose eye infections?
``` Swabs for culture Corneal scrapes in bacterial keratitis Aqueous/vitreous fluid sample for culture in endophthalmitis Microscopy/culture for acanthamoeba Serology for toxoplasma and toxocara ```
46
What is grey baby syndrome?
Baby looks grey following chloramphenicol overdose
47
Why do most eye drop bottles have a recommended "use by" date of 28 days after opening?
Pseudomonas can culture in the bottles after this time
48
What antiviral is most commonly used in viral conjunctivitis?
Aciclovir
49
What is used to treat chlamydial conjunctivitis?
topical oxytetracycline | adults may also need oral azithromycin for genital chlamydia infection
50
Chloramphenicol, fusidic acid and gentamicin are all used to treat what eye infection?
Bacterial conjunctivitis
51
Other than offloxacin, what antibiotics can be used to treat Bacterial keratitis?
Gentamicin and Cefuroxime

OPHTHALMOLOGY (12 decks)

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