simon taylor ma phd frcophth clinical senior lecturer & consultant ophthalmologist
TRANSCRIPT
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The Infected Red Eye
Simon Taylor MA PhD FRCOphthClinical Senior Lecturer & Consultant Ophthalmologist
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Affected ocular structures
Conjunctiva Cornea Intraocular contents Lids and orbit
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Symptoms and signs
SYMPTOMS
Pain Watering Redness Photophobia Diplopia Poor vision
SIGNS
Reduced visual acuity Lid swelling/redness Conjunctival
swelling/injection Corneal ulceration Hypopyon
Restricted eye movements
Relative afferent pupillary defect
Fever
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Bacterial conjunctivitis
Very common Bilateral Redness Grittiness Morning stickiness Normal visual
acuity Staph &
Streptococcus
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Severe conjunctivitis
HAEMORRHAGIC
Enterovirus 70 Highly contagious Self-limiting
GONOCOCCAL
Hyperacute onset Profuse creamy pus Periocular oedema
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Viral Conjunctivitis
Adenovirus Acute onset Bilateral in 60% Watering, redness,
discomfort, photophobia
Follicular response Very contagious
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Neonatal Conjunctivitis
5-14 days after birth
Mainly chlamydial Could be
gonococcal Purulent discharge Papillary reaction Sup. corneal
pannus Conjunctival
scarring
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Corneal infections Contact lens wear
Bacterial Acanthamoeba
Gardening injury or Organic FB Bacterial Fungal
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Wooden foreign body
scedosporium
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Corneal infetions
Elderly, diabetic, use of expired eyedrops
Use of contact lenses
History of foreign body/trauma
Ask about cold sores Marginal
ulcer
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Dendritic ulcers
Viral in origin Pain & Watering Photophobia Treat with Oc.
Aciclovir
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Dendritic ulcers
Dendritic ulceration
AVOID STEROIDS!
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Crystalline keratopathy
Viridans streptococci
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Exogenous endophthalmitis
Following any intraocular procedure Cataract surgery Intravitreal injection
Pain, eyelid swelling, reduced vision and vitritis are all compelling signs
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Endogenous endophthalmitis
BACTERIAL FUNGAL
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Dacryocystitis
Lacrimal Sac Abscess
Acute or chronic Secondary to
blockage of nasolacrimal duct
Watering & discharge
Red, tense, painful swelling
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Orbital cellulitis
Systemically unwell
Restricted eye movements
Optic nerve compromise Colour vision RAPD Distance acuity