acute conj 10.02.16
-
Upload
ophthal1234 -
Category
Healthcare
-
view
156 -
download
0
Transcript of acute conj 10.02.16
![Page 1: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/1.jpg)
1
ACUTE CONJUNCTIVITISDr. s.veni priya
![Page 2: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/2.jpg)
2
CLASSIFICATION Based on onset
Acute. Sub-acute. Chronic.
Based on type of Exudates Serous (Viral, allergic, toxic). Catarrhal (allergic – Ropy or thread like thick mucoid discharge). Mucopurulent. Purulent. Pseudo-Membranous / Membranous.
1
2
![Page 3: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/3.jpg)
3
CLASSIFICATION (Continued)
Based on Conjunctival ReactionFollicular.Papillary. Granulomatous.
Based on Etiology Infectious (Bacterial, Viral, Chlamydial, Fungal and
parasitic).Non-infectious (Allergic, Irritants).
3
4
![Page 4: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/4.jpg)
4
RISK FACTORSDisruption of host defense mechanism caused by:
Dry Eye. Exposure due to lid retraction, exophthalmos, lagophthalmos and inadequate blinking. Nutritional deficiencies / Avitaminosis A. Local or Systemic Immune Deficiency:
After topical and systemic immunosuppressive therapy Nasolacrimal duct obstruction and infection. Radiation damage . Trauma. Surgery. Prior Conjunctival inflammation or infection. Systemic Infection. Exogenous inoculation
1
2
3
4
![Page 5: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/5.jpg)
5
TYPES OF ACUTE CONJUNCTIVITIS
Bacterial Conjunctivitis:a. Acute Purulent & Muco Purulentb. Gonococcalc. Membraneous & Pseudo Membraneousd. Angular
Viral – Follicular Conjunctivitis. Chlamydial – Adult & Neonatal Inclusion Conjunctivitis.Ophthalmia Neonatorum Conjunctivitis.
1
2
3
4
![Page 6: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/6.jpg)
6
BACTERIAL CONJUNCTIVITIS Acute Purulent & Muco Purulent Etiology
Contagious Transmitted by discharge Staph.aureus – most common H.aegyptius, N.gonorrhoea.
Clinical Features Hyperaemia Mucous discharge Stickiness of the lids Flakes of mucus & Pus in Fornices and lid margins Haloes Certain clinical features indicates likelihood of certain specific infections.
![Page 7: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/7.jpg)
7
BACTERIAL CONJUNCTIVITIS Acute Purulent & Muco Purulent - Continued
![Page 8: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/8.jpg)
8
BACTERIAL CONJUNCTIVITIS Acute Purulent & Muco Purulent - Continued
TreatmentTopical fluro quinolone – ciprofloxacin, Ofloxacin,
Moxifloxacin, Gatifloxacin.Bacitracin or ciprofloxacin OintmentOral antibiotics for patients with pharyngitis and
haemophilus infection in children.
![Page 9: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/9.jpg)
9
BACTERIAL CONJUNCTIVITIS Gonococcal Etiology
Caused by Neisseria Gonorrhoeae (a bun- shaped Gram-negative intracellular diplococcus).
It is sexually transmitted disease
Clinical FeaturesPre-auricular lymphadenopathy, tenderness and
suppuration.No immunity is conferred by an attack. Associated systemic signs – Urethritis, rise of
temperature and depression.
![Page 10: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/10.jpg)
10
BACTERIAL CONJUNCTIVITIS Gonococcal - Continued Complications• Corneal involvement – Gonococcus is capable of
invading the normal cornea through intact cornea. Location of Corneal Ulcer – Central, Marginal Ulcer , all
round. Progressing rapidly depth-wise leading to perforation and complications associated with it.
Other complications of Gonorrhoeal Conjunctivitis– Iritis , Iridocyclitis .
Non Ocular complications – Arthritis, Endocarditis and Septicaemia.
![Page 11: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/11.jpg)
11
BACTERIAL CONJUNCTIVITIS Gonococcal - Continued
TreatmentOf Gonococcal Conjunctivitis is started on confirmation
ofintracellular Gram-negative diplococci in conjunctival scrapings in clinically suspected cases.
Aim of therapy is to prevent or limit the corneal involvement and to eliminate systemic source.
![Page 12: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/12.jpg)
12
BACTERIAL CONJUNCTIVITIS Gonoccol - Continued
Treatment – Continued Systemic Treatment
Ceftriaxone - 1 gm IM , single dose. Tetracycline In cases where co-existing Chlamydial
Trachomatis infection is suspected and cases with history of allergy to Penicillin / Cephalosporins
Topical Treatment Cleanliness Ciprofloxacin / Ofloxacin/ Gentamicin/ Tobramycin Eye
Drops 2 hrly. Bacitracin Eye Ointment 6 hrly. Cycloplegic (Atropine) – in cases of Corneal involvement .
![Page 13: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/13.jpg)
13
BACTERIAL CONJUNCTIVITISMembranous & Pseudo Membranous
EtiologyCaused by C.diphtheriae, Beta haemolytic strettocci, H.aegyptius, Staph.aureus
& E.coliOccurs in children in assosiation with neasels , searlet fever, influenza &
whooting cough.
Clinical FeaturesSwelling of lidsEucopurulant dischargeWhite Membrane on everting lidGreat danger of corneal ulcerations – 6 to 10 days. Increase risk of symbletharon.
![Page 14: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/14.jpg)
14
BACTERIAL CONJUNCTIVITISMembranous & Pseudo Membranous - Continued
TreatmentSystemic Treatment
4,000 to 10,000 units of anti diphtheretic serum.Penicillin
Topical Treatment Topical 10,000 units / ml drops made from injectable
preparations.
![Page 15: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/15.jpg)
15
BACTERIAL CONJUNCTIVITISAngular
EtiologyCaused by Staphylococci and more typically by
Moraxella Lacunata. Incubation period is usually 4 days . Symptoms - Redness, discomfort, frequent blinking,
sharp pricking pain and mucopurulent discharge.
Clinical FeaturesCongestion limited to intermarginal strip at inner and
outer canthi and neighbouring bulbar conjunctiva. Excoriation of skin at inner and outer palpabral angles .
![Page 16: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/16.jpg)
16
BACTERIAL CONJUNCTIVITISAngular - Continued
Complications
Chronic conjunctivitis, Blepheritis, corneal ulcer (marginal or central associated with hypopyon) .
Attack does not confer immunity, and relapses may occur. Swelling of lids.
TreatmentTopical Treatment
Tetracycline eye ointment .Eye drops containing Zinc also beneficial, acts by
inhibiting proteolytic ferment.
![Page 17: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/17.jpg)
17
VIRAL CONJUNCTIVITIS TYPES• Acute Follicular Conjunctivitis• Sub Acute or Chronic Follicular Conjunctivitis• Epidemic Keroto Conjunctivitis.• Pharyngo Conjuctival fever.• Heaymorrhagic Conjunctivitis• Acute Herpitic Conjunctivitis• Herps Simplex Conjunctivitis
![Page 18: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/18.jpg)
18
VIRAL CONJUNCTIVITIS(Continued)
Clinical Features Serous or watery discharge Conjunctival foillicals. Sub Conjunival haemorrhage Punctate epithelial opacities Preoricular lymph node. Decreased corneal sensation.
Treatment Topical Treatment
Artificial Tears Antibiotic eye drops to prevent secondary infection.
![Page 19: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/19.jpg)
19
OPHTHALMIA NEONATORUM Etiology
Neisseria Gonorrhoeae, Streptococcus Pneumoniae, Staphylococcus etc.
Chlamydial Trachomatis, Chalmydial OculogenitalisChemical Conjunctivitis due to Silver Nitrate 1or 2%
(used as Crede’s method) Clinical Features
Purulent bilateral conjuntival dischargeHyper acute blenorrhoeaSwelling of lidsMucopurulent discharge
![Page 20: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/20.jpg)
20
OPHTHALMIA NEONATORUM (Continued)
Complications Corneal Ulcer : Oval ulcer, just below the centre of
cornea, rarely oval marginal ulcer, progressive ulcer resulting in – perforation of corneal ulcer, prolapse of uveal tissue, purulent uveitis, prolapse of lens, prolapse of vitreous.
Scarring of cornea, adherent leucoma, anterior staphyloma, anterior capsular cataract, anophthalmitis.
Non development of fixation due to corneal opacity during first 3 weeks.
Nystagmus due to non-development of macular fixation
![Page 21: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/21.jpg)
21
OPHTHALMIA NEONATORUM(Continued)
Treatment
Systemic Treatment Ceftriaxone – 25 to 50 mg/kg single dose.Cefatoxine – 100 mg / kg single dose.
Topical Treatment Saline irrigation Topical flouro quinolones.Topical cycloplejia.
![Page 22: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/22.jpg)
22
ACUTE CONJUNCTIVITIS
QUESTION & ANSWER SESSION
![Page 23: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/23.jpg)
23
Thank you
![Page 24: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/24.jpg)
24
Thank you
![Page 25: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/25.jpg)
25
Thank you
![Page 26: acute conj 10.02.16](https://reader035.fdocuments.us/reader035/viewer/2022070602/5877c0ae1a28ab39588b4773/html5/thumbnails/26.jpg)
26
Thank you