INFECTIOUS

AND
INFLAMMATORY
CONDITIONS OF
THE EYE
ASSESSMENT AND
MANAGEMENT
DRY EYE SYNDROME
 AKA keratoconjuctivitis sicca
 A dryness of the cornea and
conjunctiva
 Cause:
 Deficiencyin the production of any
of the aqueous, mucin, or lipid tear
film components
DRY EYE SYNDROME
 CLINICAL MANIFESTATIONS:
 Scratchy or foreign body sensation
 Itching
 Excessive mucus secretion
 Inability to produce tears
 Burning sensation
 Redness
 Pain
 Difficulty moving the lids
 Keratitis
DRY EYE SYNDROME
 ASSESSMENT AND DIAGNOSTIC
FINDINGS:
 Slit-lamp examination
 Absent or interrupted tear meniscus
 Conjunctiva is thickened, edematous,
hyperemic, and lacks luster.

 Chronic conjunctival and corneal

irritation
 Corneal erosion, scarring, ulceartion,
thinning, or perforation
DRY EYE SYNDROME
 MANAGEMENT:
 Compliance to regimen
 At day, instillation of artificial
tears
 At night, ointment for eye
hydration and lubrication
 Anti-inflammatory medications
 Surgical treatment:
 Punctal occlusion
 Grafting procedures
 Lateral tarsorrhaphy
CONJUNCTIVITIS
 AKA pink eye
 Inflammation of the conjunctiva
 Causes:
 Bacterial or viral infection
 Allergy
 Environmental factors
CONJUNCTIVITIS
 CLINICAL MANIFESTATIONS:
 Foreign body sensations
 Scratching or burning sensation
 Itching
 Photophobia

 Usually
starts in one eye and then
spreads to the other eye
CONJUNCTIVITIS
 ASSESSMENT AND DIAGNOSTIC
FINDINGS:
4 Main Clinical Features Important
to Evaluate
 Type of discharge
 Type of conjunctival reaction
 Presence of pseudomembranes or true
membranes
 Presence or absence of
lymphadenopathy
 Slit-lampexamination
 Swab smear preparations and
cultures
CONJUNCTIVITIS:
TYPES
 Microbial conjunctivitis
 Bacterial conjunctivitis
 Causative agents:
 Streptococcus pneumoniae
 Haemophilus inlfuenzae
 Staphylococcus aureus
 Manifests acute onset of redness,
burning, and discharge.
 Papillary formation, conjunctival
irritation, and injection in the fornices
 Exudates; difficulty to open eyes;
purulent/mucopurulent discharge
 Lymphadenopathy nad
pseudomembranes
CONJUNCTIVITIS:
TYPES
 Chlamydial conjunctivitis
 Trachoma
 Hot,dry, and dusty climates
 Direct contact or fomites
 Vector: flies and gnats
 s/s: red inflammed eyes, tearing,
photophobia, ocular pain, purulent
exudates, preauricular
lymphadenopathy, and lid edema

 Inclusion conjunctivitis
 Genital chlamydial infection
 Transmission: oral-genital sex, hand-
to-eye, indirect (inadequately
chlorinated pools)
 Eye lesions, mucopurulent
discharge, follicles, and
lymphadenopathy
CONJUNCTIVITIS:
TYPES
 Viral conjunctivitis
 Causes: adenovirus and herpes
simplex virus
 Prominent follicles, watery
discharge
 Preceded by upper respiratory
tract infection
 s/s: extreme tearing, redness, and
foreign body sensation, lid edema,
ptosis, and conjunctival hyperemia
 Epidemic keratoconjunnctivitis
(EKC)
 Seasonal (summer); highly contagious
 Preauricular lymphadenopathy,
occasionally periorbital pain,
marked follicular and papillary
formations
CONJUNCTIVITIS:
TYPES
 Allergic conjunctivitis
 Part of allergic rhinitis or could be
independent allergic reaction
 History of an allergy to pollens and
environmental allergens; asthma
and eczema
 s/s: extreme pruritus, epiphora,
injection, severe photophobia,
stringlike mucoid discharge
 Vernal conjunctivitis (seasonal
conjunctivitis)
 Warm weather
 Large formations of papillae that
cobblestone appearance
CONJUNCTIVITIS:
TYPES
 Toxic conjunctivitis
 Medications
 Chlorine from swimming pools
 Toxic fumes
 Irritants
 Smoke
 Hairspray
 Acids
 Alkalis
CONJUNCTIVITIS
 Management:
 Topical antibiotics
 Eye drops or ointments
 Antibiotic therapy for gonococcal
conjunctivitis
CONJUNCTIVITIS
 Management: (bacterial
conjunctivitis)
 Antibiotics
 For trachoma: broad-spectrum
antibiotics (topical)
 Surgery
CONJUNCTIVITIS
 Management: (viral
conjunctivitis)
 Cold compress
 Prevention of outbreak:
 Hand hygiene
 Environmental cleaning
CONJUNCTIVITIS
 Management: (allergic
conjunctivitis)
 Corticosteroids
 Vasoconstrictors
 Topical epinephrine solution
 Cold compress
 Ice packs
 Cool ventilation
CONJUNCTIVITIS
 Management: (toxic
conjunctivitis)
 Irrigation of saline or sterile water
UVEITIS
 Inflammation of the uveal tract
of the eye including the iris,
ciliary body and choroid.
 Causes:
 Virus
 Bacterial infection
 Parasites
UVEITIS
 Types:
 Nongranulomatous
 s/s:
 acute pain
 Photophobia
 conjunctival infection
 pupil is small and irregular
 blurred vision
 small and fine precipitates on the
posterior corneal surface and in
aqueous humor
 hypopyon
UVEITIS
 Types:
 Granulomatous
 More insidious onset
 s/s:
 Photopobia
 minimal pain
 adversely affected vision
 diffused conjunctival injection
 vitreous clouding
UVEITIS
 Management:
 Wear darkglasses outdoors
 Mydriasis
 Cyclopentolate
 Atropine
 Local corticosteroid drops
 Pred Forte 1%
 Flarex 0.1%
 Systemic corticosteroids
 Intravitreal corticosteroids
 Monoclonal antibody
 Daclizumab
ORBITAL CELLULITIS
 Inflammation of the tissues
surrounding the eye
 Causes:
 Bacteria
 Fungi
 Viralinflammatory conditions
 Foreign bodies
 Preexisting ocular infections
 Causative agents:
 Staphylococci and streptococci
(adults)
 H. infuenzae (children)
ORBITAL CELLULITIS
 s/s:
 Pain
 Lidswelling
 Conjunctival edema
 Proptosis
 Decreased ocular motility
ORBITAL CELLULITIS
 Management:
 Broad spectrum, systemic
antibiotics
 Monitor
 Visual acuity
 Degree of proptosis
 CNS function
 Displacement of globe
 Extraocular movements
 Pupillary signs
 Fundus
 Withabscess formation and
progressive loss of vision
 Surgical drainage
 Sinusotomy
 Antibiotic irrigation