Opthalmology-Infections Flashcards
What is keratitis, what are the types
Inflammation of the cornea/ bacterial, viral, fungal, parasitic
What increases the risk of keratitis
Topical steroids, cornea trasnplant,soft contact lens wear, trauma
What is the most common keratitis
Bacterial keratitis
What are the pathogens that cause bacterial keratitis
Staph aureus and staphylococcal pneumonia, Pseudomonas aeruginosa, Moraxella
What is the most common presentation of bacterial keratitis, others
Mucopurulent discharge/ decreased vision, photophobia, pain, hyperemia (redness), eyelids also affected
What can be used to treat bacterial keratitis (broad spectrum)
Ciprofloxacin 0.3%, ofloxacin 0.3%, norfloxacin 0.3%, gatifloxacin 0.3%, moxifloxacin 0.5%
What is the dosing interval for floriquinolones, side effects
Every 2 hours/ stinging, burning, bitter taste
What antibiotic class is good gains gram positive organisms, works best against staph
Cephalosporins, Vancomycin
What cycloplegic agent would be given with antibiotics, why
Scopolamine 0.25% TID, improves patient discomfort and possible adherence of the iris to the cornea or lens
If the bacterial infection is vision threatning what is the regimen
Tobramycin or gentamicin every 30-60 minutes alternating with cefazolin or vancomycin every hour WITH oral fluroquinolones
What drug should be avoided for bacterial or virus infections in the eye, why
Steroids, suppress immune system allowing bacteria to grow while also inducing corneal thinning increasing the risk of corneal perforation
What are the types of viral keratitis
Herpes-simplex, Varicella-zoster, Epstein-Barr, Cytomegalovirus
What is the most common cause of corneal ulceration and corneal blindness
Herpes simplex
What is the hallmark symptom of herpes simplex viral infection
Crusting on eyelids and dendritic lesion
When would antibiotic medication be used in herpes simplex viral kerativis
Eyelid/skin involvement, erythromycin or bacitracin BID OR warm or cool soaks
What is treatment for corneal epithelial disease caused by herpes simplex, add ons
Trifluridine 1% 1gtt nine times a day OR ganicilovir 0.15% gel five times a day, Scopalamine 0.25% TID or homatropine 5% TID PLUS oral acyclovir 400 mg every day for 5 days
What is the treatment for corneal stroma disease due to herpes simplex, add ons
Trifluridine 1% 1gtt TID-QID OR oral acyclovir 400 mg by mouth five times a day, Scopolamine 0.25% TID AND Prednisolone acetate 1% 1 gtt QID
What is the hallmark symptom of varicella-zoster virus
Rash only on ONE side of head and hutchinson sign (rash at the tip of the nose)
What is the treatment for viral keratitis
Oral acyclovir 800 mg five times a day for 7-10 days
Which fungi cause fungal keratitis
fusarium, aspergillus, candida albicans
What is the treatment regimen to treat fungal keratitis, add on
Natamycin 5% drops every 1-2 hours around the clock tapered over 4-6 weeks OR amphotericin B 0.15% drops PLUS flucytosine topical and oral/ Scopalamine 0.25% TID, voricanazole, flucanozole, and ketoconazole
What is the most common cause parasite to cause parasitic keratitis, where is it found
Acanthamoeba, contact lenses (93%) and contaminated water
What is the treatment regimen of acenthamoeba
PHMB 0.02% or chlorhexidine 0.02 every hour (corneal transplant)
What is a way to prevent contact lens contamination
STAY AWAY FROM WATER, follow directions of lens and lens case changing (replace every 3 months), DO NOT SLEEP in LENSES
What is blepharitis
superficial bilateral chronic inflammtory condition of the lid margins (common cause of recurrent conjunctivitus)
How is blepharitis treated
Eyelid scrub BID, warm compresses, artifical tears, erythormycin or bacitracin (severe)
What is a hordeolum, how is it treated
Localized, red, swollen,acutely tender area on upper or lower lid, warm compresses (4 days at most)
What is chalzion, how is it treated
Hard, non-tender swelling of upper or lower lid with redness and swelling, warmcompresses with massage and possibly steroids
What is the differnce between pre-septal and orbital cellulitis
Pre-septal is restricted to the eye and surronding skin and caused by staph aureus while orbital is the orbital septum and associated with systemic symptoms as well caused by S.pneumoniae (extension of a sinus infection)
T/F: cellulitis is serious and needs to be treated with antibiotics at a hospital immediately
True
What causes endophthalmitis, treatment
infection inside the globe of the eye (connected to surgery), Intravitreal vancomycin AND ceftazidime or amikacin
What is bacterial conjunctivitis, what causes
Pink eye: S. pneumoniae, H. influenzae, pseudomonas, moraxella, gonococcal
T/F: IF someone has bacterial conjunctivitis they should be given amoxicillin
False: Bacterial conjunctivitis is self limiting
How is severe bacterial conjunctivitis treated
Trimethoprim/polymixin B, gentamicin/tobramycin, erythromycin, fluroquinolones
What is the most common cause of viral conjuncitivts
adenovirus
T/F: Nothing can be given for viral conjunctivits and it is self limiting
True
What is the eye infection that is seen to be a medical emergency
Orbital cellulitis
