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secondary
Hordeolum
KALAZION
Causes:
- Rapid onset
- Conjunctival inflammation & purulent discharge
Bacterial Conjunctivitis
Management:
Clinical presentation :
- Bleeding spot
- Hyperlacrimation
- Secretion minimal
- Follicle in upper tarsal conjunctiva
Management :
- Hygiene
- Artificial tears
- Antibiotic secondary infection
Viral Conjunctivitis
Age 5 25 yo
Types: palpebral type and limbal type
Symptoms :
- Itchy
- Usually recurrrent in summer
Signs
:
- Bilateral inflammation
- Papil, giant papil, cobblestone in upper
tarsal conjunctiva
- Trantas dots in limbal cornea
Management:
Signs :
Redness maybe sectoral or diffuse
The attack often reaches its peak within 12
Simple sectorial
episcleritis
Simple diffuse
episcleritis
Signs :
One or more tender nodules within the
episcleral tissue
Bright red to pink in colour
Nodule may be tender to touch and usually
mobile
lubricants
Systemic th/ :
Oral NSAID
Less morbidity
and aching
Signs :
Vascular congestion and
dilatation associated with
edema
Redness may be generalized or
localized to one quadrant
The swollen sclera loses its
normal appearance and takes
on a dusky hue
Globe usually tender to touch
Presentations :
Insidious onset of pain followed by increasing
Initial treatment:
Systemic non-steroidal anti-inflammatory drugs
(NSAIDs).
scleral inflammation.
The onset of pain and localised
redness may at first be gradual,
however within three to four days,
extremely severe and persistent pain
has usually developed, radiating to the
patients temple, brow or jaw. It
characteristically worsens at night
Vaso-Occlusive :
Associated with rheumatoid arthritis
Isolated patches of scleral oedema with
rheumatoid arthritis
Pain is absent, vision unaffected
Presence of asymptomatic yellow/grey
patches near the limbus without vascular
congestion. These patches are necrotic areas
of sclera caused by obliterative arteritis
involving the deep scleral plexus
40-50%
Rheumatoid Arthritis
Wegeners Granulomatosis
Systemic Lupus Erythematosus
Inflammatory bowel disease
Relapsing polychondritis
Posterior scleritis
SIGNS
Proptosis and
ophthalmoplegia
retinal
Disc swelling Exudative
detachment
Choroidal folds
Subretinal exudation
prednisolone
happen to anyone.
Certain factors increase your risk for corneal
erosion:
- Having a history ofeye injury
- Having a corneal disease, such as corneal
dystrophy
- Having had an eye ulcer, such as from a
herpes simplex infection
- Wearingcontact lensesincluding lenses that
are improperly fitted or not properly cared for.
Initial treatment:
Staphylococcu Filamenteo
s
us
Streptoccocus Fusarium
Pseudomonas Aspergillu
s
Yeast
Candida
Herpes
simplex
Herpes
zoster
Acanthamo
eba
Microsporid
ium
Bacterial Keratitis
Initial
Pain <<
Discharge <<
Eyelid edema or conjunctival injection <<
Density of the stromal infiltrate << (in the
Fungal Keratitis
Symptoms
Foreign body sensations
Gradually increasing pain
Diminution of vision
Signs
Non-specific
Conjunctival injection
Epithelial defect
Grayish white or yellowish white
Specific
Feathery margins (70%)
Elevated edges
gray/brown pigmentation
Rough texture
Satelite lessions (10%)
Fixed hypopyon (45-66%)
Endothelial plaque
Posterior corneal abcess (rare)
Ring infiltrates
Candida keratitis
Satelite lession
Infiltrat ring
Onset : insidious
During initial period Fewer inflammatory
keratitis
Given hourly during day time
Given 2 hourly during night time
Continued for 2 weeks after the resolution of infection
If worsening : use topical amphotericin B 0,15% with or
without fluconazole 2%
Responds slowly
Improvement :
Diminution of pain
Decrease in size of infiltrate
Disappearance of stellite lesions
Rounding out of the feathery margins of ulcer
Viral Keratitis
Predominantly unilateral
Bilateral only 3%
Manifestation of HSV Keratitis
Infectious epithelial keratitis
Neurotrophic epithelial keratitis
Herpetic stromal keratitis
Endothelitis
Punctate
keratitis
Dendritic keratitis
Geographic Ulcers
Antiviral
Agent
Route
Strengt
Frequency
Vidarebine
Topical
3% EO
5x/day
Trifluridine
Topical
1% Sol
2 hly while
awake
Topical, Oral
3% EO
200mg, 400mg
tab
5x/day
1000 mg tab
3x/day
Acyclovir
Valacyclovir
Topical, Oral
Protozoal
course
Localized to the corneal epithelium in early cases
May manifest as a diffuse punctate epitheliopathy or
dendritic epithelial lesion ~ misdiagnosed as herpetic
keratitis
Stromal infection ~ central cornea in early cases
have a gray-white superficial, nonsuppurative
infiltrate
As the disease progresses a partial or complete ring
infiltrate in the paracentral cornea
Enlarged corneal nerves radial perineuritis
Limbitis or focal, nodular, or diffuse scleritis
Early diagnosis!
Early epithelial stage respond well to