(+)Mucopurulent discharge

H. influenza - most common etiology in children

with URTI; Chlamydia or gonococcus - most
common among newborns; Moraxella and
Staphylococcus are common among adults
BACTERIAL CONJUNCTIVITIS

Most often unilateral and acute in onset

Antibiotic eye drops

TREATMENT
Oral antibiotics - also administered in patients with
Hemophilus, Chlamydia or gonococcal conjunctivitis

(+)Watery discharge

(+)Itchy
(+) mucoid to muco-purulent eye discharge

chronic; immunologic in nature; most patients have

atopy or an atopic predisposition Pneumococcus - most common cause;
Pseudomonas - common among contact lens
wearers
ALLERGIC CONJUNCTIVITIS
(+)pale papillary reaction on the upper bulbar
conjunctivae BACTERIAL KERATITIS
(+)Pain and (+)Discharge (+) blurring vision if the lesion is on central cornea

(-)Pain and (+)Discharge

Removal of environmental triggers
Topical antibiotics applied every 15 minutes to every
hour during first few days of treatment
Cold compress

TREATMENT TREATMENT Keratectomy - done in moderate to severe cases

Antihistamine eye drops - to control symptoms

Idea
Short-term topical steroids - in moderate to severe
cases
(+)Photophobia

(+)Watery discharge
Most cases are idiopathic; others may be cause by
Herpes virus and Mycobacterium tuberculosis
(-)Itchy

(+)keratic precipitates on inner surface of cornea;

UVEITIS (+)iris adhesion to the lens
The most common cause of acute onset eye redness

(+)History of exposure to a person with "sore eyes" Topical steroid drops - if located at the anterior part
of the eye

VIRAL CONJUNCTIVITIS or "sore eyes"

Adenoviral - most common conjunctival infection
Periocular steroid injection - if located in the
TREATMENT
posterior pole
Duration - few days to 2-4 weeks; self-limiting

Oral steroids - used in patients with bilateral

disease/ systemic evidence of inflammation
Hand wash

Red eye
Avoiding direct contact with eye discharge (+)Photophobia

TREATMENT
Antibiotic eyedrops - may be given in patients with (+)Deep boring pain/severe pain
secondary bacterial infection

Purplish sclera or violaceous red; Edema or thinning

Mild steroid drops and cold compress - help reduce of sclera; No change with epinephrine drops
SCLERITIS
inflammation

systemic corticosteroids
a.k.a. keratoconjunctivitis sicca If non-infectious scleritis

NSAIDS
common among elderly TREATMENT

anti-inflammatory therapy should never be started

due to decreased tear production or increased tear without accompanying or prior treatment with
If infectious scleritis antimicrobial therapy
evaporation
DRY EYE
(-)Pain and (-)Discharge

worse with wind and dry climates (+)Pain and (-)Discharge Less or (-) Photophobia
presents with foreign body sensation and mild eye
redness

(+)Mild pain or none

Topical instillation of aqueous tear replacement/
artificial tears TREATMENT
Unaffected sclera, salmon color; No scleral changes;
Blanches with epinephrine drops
EPISCLERITIS

Topical vasoconstrictor

Topical NSAID

TREATMENT
Fluorometholone eye drops 4x/day

Mild to moderate

Lubricating drops

Topical steroid

Prednisolone acetate eye drops 4-6x/day

Severe form

Ibuprofen 400mg 3x/day

(-)Photophobia

Pain is associated with headache; (+)blurring of

vision; some patients complain of seeing rainbow
haloes

ACUTE GLAUCOMA
Eye pressure is abnormally elevated due to an acute
obstruction

Acetazolamide or hyperosmotic oral solutions

TREATMENT Topical ocular hypotensive agents

Laser Iridotomy - definitive management