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Conjunctival Disorders
Conjuctival disorders
30
Other
Graduate
08/18/2009

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Term
Definition of Conjunctivitis
Definition
Inflammation of the bulbar and or palpebral conjunctiva or less than 4 week duration
Term
Incidence of Conjunctiva
Definition
Most common eye disorder accounts for 1-2% of all ambulatory office visits Most likely dx in a patient with red eye and discharge
Term
Etiology of conjunctivitis Infectios and nonifectious
Definition
Infectious
Bacterial 5%
Viral 95%
Nonifectious
Allergic
nonallergic
Term
Etiology of Acute bacterial Conjunctivitis
Definition
Acute
Staphylococci Aureus- adults
Strep Pneumno, H- Influenzae, pseudomonas aeruginos (contacts)
Term
Pathophysiology of ACUTE Bacterial conjunctivitis
Definition
Invading bacteria induce antigen-antibody inmmune reaction and subsequent inflammation. 2 results self eradication or infection
Term
Presentation of Acute bacterial Conjunctivitis
Definition
injection (redness)
Mucopurulent discharge
matted eyelids and lashes
Mild discomfort
Normal vison
usually unilater but can be bilateral
Term
Risk factors for Acute bacterial Conjunctivitis
Definition
History of contact with infected persons (direct contact or surfaces that are contaminated)
Contact lenses
Term
prognosis for Acute bacterial conjunctivitis
Definition
Resolves on own in 10-14 days
2-3 days wtih treatment you dont have to treat Acute but it will decrease transmission
Term
Most common treatment for Acute bacterial Conjuctivitis
Definition
Erythromycin ointment 1/2 inch bid-qid x 5 days. Sulfa drops 2gtts q4h while awake x 5 days. Bacitracin ointment. Fluoroquinolone drops
Term
Patient education for acute bacterial conjunctivitis
Definition
wash hands freq
Aviod rubbing eyes
don't share washcloths, towels, pillowcases
don't share eyedrops or cosmetics
Term
Etiology for Hyperacute bacterial conjunctivitis
Definition
Neisseria species particulary N. Gonorrhoeae
Term
Presentation of hyperacute B. Conjunctivitis
Definition
copious purulent discharge within 12 hrs of inoculation
rapidly progressive
rednees, irritation, tenderness, lid swelling, Most importnat TENDER PREAURICULAR ADENOPATHY
Term
Treatment of hyperacute B. Conjunctivitis
Definition
Ophthalmological emergency
DX confirmed by culture
Copious irrigation w/ saline solution
single 1 gram dose ceftriaxone IM topical ABX may be added see patient daily
Term
Etiology of Chlamydial conjunctivitis
Definition
Trachom- chlamydia trachomatis A-C not is USA
Inclusion conjunctivitis-Chlamydia trachomatis D-K in USA
Term
Epidemiology of Trachoma
Definition
endemic is 48 countries
Major cause of Blindness WORLD wide
Term
Presentation of Trachoma
Definition
majority asymptomatic
repeated inflammtion of follicular leads to eyelid scarring which leads to entropion and subsequent trichiasis
eyelash abrasion leads to corneal opacification and blindness
Term
Treatment of trachoma
Definition
Azithromycin 20mg single dose oral
Azithromycin drops bid 2-3 days if oral not available
surgery
corneal transplant
Term
Inclusion conjunctivitis Epidemiology
Definition
Adult chlamydial conjuctivitis is a STD
more women the men affected
3-4 million cases each year in US and close to 90 million world wide
Term
Presentation of inclusion conjunctivits
Definition
usually unilateral
redness, discharge, irritation
preauricular lymphadenopathy
Swollen lids
concurrent asymptomatic urogential infection
Term
Treatment of inclusion conjunctivitis
Definition
Doxycycline, tetracycline, erythromycin or azithromycin 1 dose
Term
Neonatal conjunctivitis definition
Definition
conjuctivitis that occurs within the first 4 weeks of life
Term
Etiology of neonatal Conjunctivitis
Definition
N. Gonorrhea-24-48 hours
Bacteria staph, strep, H influ 2-5 days
Virus herpes simplex 1 and 2- 3-15 days serious but rare
Chlamydia- 5-14 days 20- 40% transmission
Term
Neonatal Conjunctivitis Diagnosis
Definition
Gold standard-Isolation by culture
Term
Treatment for neonatal conjunctivitis
Definition
Chlamydia-oral erythromycin 50mg/kg/day in four divided doses for 14 days
Gram + erythromycin0.5% ointment 4 times a day
Gram - PCN G drops
Gram - others Gentamicin or tobramycin ointments
Viral- Trifluorothymidine drops every 2 hours for 7 days
Term
Epidemiology or viral conjunctivitis
Definition
extremly common in US
equal in men and women
Highly contagious
Term
Etiology of viral Conjuntivitis
Definition
Pharyngoconjunctival fever (PCF) most commonly caused by adenovirus type 3
Epidemic keratoconjuctivitis (EKC) caused by adenovirus types 8, 19, 29, and 37
Term
Presentation of Pharyngoconjunctival fever (PCF)
Definition
injection, watery or mucoid discharge, buring, and sandy feeling of eye
tarsal conjunctiva may have follicular or bumpy appearance
may have viral prodome with adenopathy, fever, pharyngitis and malaise
palpable preauricular lymphadenopathy
Term
Presentation of Epidemic keratoconjuctiveitis (EKC)
Definition
injection, watery or mucoid discharge, swollen lids, burning sensation
may have severe forgein body sensation
Keratitis with corneal infiltrates the degrade acuity
may have pseudo membrane (can peel off)
Term
Treament of PCF and EKC viral conjunctivitis
Definition
Symptomatic-cold compress are soothing
most resolve spontaneously w/in days to weeks 1-3 weeks
with EKC consider referal to Ophtho
Term
Patient education on viral conjunctivitis
Definition
highly contagious for 1-2 weeks
wash hand often
don't share towels or makeup
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