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2 Ophthalmology > Microbiology in Ophthalmology > Flashcards

Microbiology in Ophthalmology Flashcards

1
Q

what is an infection of the conjunctiva called

A

conjunctivitis

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2
Q

what is an infection of the cornea called

A

keratitis

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3
Q

what is an infection of the entire eye called

A

endophthalmitis

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4
Q

what bacteria causes bacterial conjunctivitis in neonates

A

staph azures
neisseria gonorrhoea
chlamydia trachoma’s

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5
Q

what bacteria causes bacterial conjunctivitis in all other ages

A

staph aures
strep pneumonia
haemophilus influenza (especially in children)

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6
Q

how do you treat bacterial conjunctivitis

A

swab
topical antibiotic - chloramphenicol
drops/oitment

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7
Q

when should you avoid using chloramphenicol in the treatment of bacterial conjunctivitis

A

history of aplastic anaemia or allergy

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8
Q

what viruses cause viral conjunctivitis

A

adenovirus
herpes simplex
herpes zoster

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9
Q

key difference in the presentation of viral vs bacterial conjunctivitis

A

bacterial - pussy discharge

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10
Q

how does chlamydial conjunctivitis tend to present

A

chronic history
unresponsive to treatments
bilateral conjunctivitis in young adults
may or may not have vaginitis/urethritis
Looks like lots of little bumps under the eye lids- these can cause scarring to cornea so must be treated

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11
Q

what can cause keratitis

A

bacteria
viruses
fungi

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12
Q

what are the characteristics of bacterial keratitis

A

v rare
looks bad - v serious
white lump on cornea
level of white cells in the eye

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13
Q

that is the treatment for bacterial keratitis

A

hourly drops - even over night so needs admission

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14
Q

main risk factors for bacterial keratitis

A

contact lens wearers

other corneal pathology

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15
Q

what viruses can cause viral keratitis

A

herpes

adenovirus

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16
Q

characteristics of herpes keratitis

A

a dendritic ulcer on the eye - looks like bolt of lightening

v painful, recurrent

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17
Q

what happens if herpes keratitis is treated with steroids

A

can cause corneal melt and perforation of the cornea

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18
Q

characteristics of adenovirus keratitis

A

bilateral
follows URTI
contagious
sub epithelial infiltrates

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19
Q

treatment for adenovirus keratitis

A

topical antibiotic to prevent secondary infection (bacterial keratitis can be caused by other corneal pathologies)

can require steroids to speed up recovery if it becomes chronic

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20
Q

what fungi can cause keratitis

A

acanthamoeba

pseudomonas aeruginosa

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21
Q

what is a hypopyon

A

inflammatory infiltrate built up in the eye - looks like a white line

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22
Q

characteristics of fungal keratitis

A

not as painful as bacterial
history of trauma from vegetation
takes long time to heal

23
Q

what is orbital cellulitis

A

inflammation of eye tissues due to infection spread from the sinuses into the orbit

24
Q

characteristics of orbital cellulitis

A

painful - especially on eye movements
often associated with paranasal sinusitis
can compromise the optic nerve
swollen puffy red eye - skin around the eye is v swollen

25
Q

why is it important to differentiate between preseptal an orbital

A

because orbital can cause compartment syndrome

26
Q

what organisms cause orbital cellulitis

A 
staph 
strep 
coliforms 
haemophilus influenzae 
anaerobes
27
Q

treatments for orbital cellulitis

A

if there’s any signs of restriction of muscles or optic nerve dysfunction - scan

give broad spectrum AB and monitor closely

sometimes abscesses need drainage

28
Q

what is endophthalmitis

A

rare and devastating infection inside the eye

v painful with decreasing vision - sight threatening

29
Q

what causes endophthalmitis

A

post surgical or endogenous ( if they have a systemic infection clumps of bacteria can get into the eye)

30
Q

treatment for endophthalmitis

A

difficult to treat infection inside eye - cut off from immune system

intravitrial
amikacin/ceftazimide/vancomycin

systemic antibiotics given as well

31
Q

causative organisms of endophthalmitis

A

conjunctival commensals

most common - staph epidermidis

32
Q

what is chorioretinitis

A

infection of the retina and choroid

33
Q

what causes chorioretinitis

A

cytomegalovirus seen in patents with AIDS

Toxoplasma gondii

toxocara Canis (worm)

34
Q

characteristics of toxoplasma gondii chorioretinitis

A 
protozoa 
get it from cats and raw meat 
mild flu like illness 
rarely causes any other problems 
enters the latent phase with cysts forming 
needs treatment if life threatening
35
Q

characteristics of toxocara Canis

A

worm
get it from cats and dogs
unable to replicate in humans
remains an immature form of worm (larvae)
self limiting as cannot replicate
form granulomas which can cause irreversible vision loss

36
Q

investigations for conjunctivitis

A

swabs for culture - bacterial, chlamydial, viral

37
Q

investigation for bacterial keratitis

A

corneal scape

38
Q

investigation for endophthalmitis

A

aqueous/vitreous culture

39
Q

investigation for ancanthamoeba

A

microscopy/culture

type of keratitis

40
Q

investigation for toxoplasma and toxocara

A

serology

41
Q

what are the 3 main ways antibiotics kill cells

A

inhibit cell protein synthesis
inhibit cell wall synthesis
inhibit nucleic acid synthesis

42
Q

what is the most commonly used antibiotic for eye infections

A

chloramphenicol

43
Q

how does chloramphenicol act

A

inhibits peptides transferase enzyme (therefore inhibits bacterial protein synthesis)

44
Q

what organisms is chloramphenicol bactericidal for

A

strep

haemophilus

45
Q

what organism is chloramphenicol bacterostatic for

A

staph

46
Q

side effects of chloramphenicol

A

allergy
irreversible aplastic anaemia (v r are)
grey baby syndrome

47
Q

what antibiotics inhibit cell wall synthesis

A

penicillins and cephalosporins - have common B lactic ring which inhibits the enzyme which makes the bacterial cell wall

48
Q

what antibiotics inhibit nucleic acid synthesis

A

quinolone eg. ofloxacin inhibit enzymes that compress bacterial DNA into supercoils

inhibition of DNA gyrase leads to unwinding of DNA coils and cell death

49
Q

what is a common contaminate of eyedrops bottles

A

pseudomonas - eyedrop preservatives keep them clean of contaminants but only last 4 weeks

50
Q

antibiotics for bacterial conjunctivitis

A

chloramphenicol
(treat most except pseudomonas)

fusdic acid (treats staph aures)

gentamicin (treats gram -ve bacterias including pseudomonas)

51
Q

what antivirals are used in viral eye infections

A

Aciclovir

used for dendritic ulcers of the cornea

52
Q

what antibiotic is used for chlamydial conjunctivitis

A

topical oxytetracycline

53
Q

antibiotics for bacterial keratitis

A

Ofloxacin
-treats most gram -ve but not strep pneumonia)

gentamicin and cefuroxime (combination treats most gram + and -)

2 Ophthalmology (16 decks)

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