Microbial infection of eye and

Ear

By : Dr. Sumayah Ibraheem

2023-2024
 Infections of the Eye

 The ocular globe (OG) is constantly exposed to

microorganisms (MO) from the environment, including
normal transient flora and systemic infections carried through
the bloodstream .

 In addition, other factors may contribute to the risk of

infection such as the use of contact lenses, age of the patient,
evolutionary state of dry eye, chronic obstruction of the
nasolacrimal duct, previous ocular infections, trauma, surgery
and systemic diseases, being any structure of the ocular
globe(OG) prone to be colonized by microorganisms.

 The pathogens that cause them vary widely from viruses,
bacteria, fungi or parasites, which can be part of the transitory
flora or invade tissues.
 Prevalence depends on age, immune status of the patient,
geographic location, and climate.

 Bacteria are the pathogens that cause most cases of ocular

infections, which can be mono or poly microbial, which are
associated with multiple types of eye infections such as
conjunctivitis, keratitis, blepharitis, orbital cellulitis and etc.
 Infections of the Eye
Infectious eye diseases can be categorized in two ways:
Firstly, according to the part of the eye that's infected or
inflamed.
1- Conjunctivitis, for example, is an inflammation of the
conjunctiva.
 Conjunctivitis

 The conjunctiva is the thin transparent layer of tissue that

lines the inner surface of the eyelid and covers the white part
of the eye.
 Conjunctivitis (many times referred to as pinkeye) .
 The most common organisms are viral, particularly those
from the group known as adenoviruses. Bacterial infections
are less frequent. Both viral and bacterial conjunctivitis are
quite contagious ( easily passing from one person to another or
from a person's infected eye to the uninfected eye).
 What is Pinkeye?
 Although most eye inflammations result in a pink discoloration of
the eye, the term “pinkeye” usually used for conjunctivitis caused
by infection with a bacteria or virus. One of the most severe forms
of pinkeye is the result of infection with several particular strains
of adenovirus, this infection called epidemic keratoconjunctivitis.
 Predisposing factors:-
 Flies
Poor hygienic conditions
Hot dry climate
Poor sanitation
 Viral conjunctivitis differs from bacterial conjunctivitis in
the following ways:
• Eye discharge tends to be watery in viral conjunctivitis and
thicker white or yellow in bacterial conjunctivitis.
• An upper respiratory infection increases the likelihood of a
viral cause.
• A lymph node in front of the ear may be swollen and painful
in viral conjunctivitis but is usually not in bacterial
conjunctivitis.
 Note :These factors of differentiation , however, cannot
always accurately differentiate viral conjunctivitis from
bacterial conjunctivitis.
 There three types of conjunctiva :
 Trachoma is another type of conjunctivitis caused by
Chlamydia trachomatis.

 Fungal Conjunctivitis are rare and occur mainly in people

who use corticosteroid eye drops for a long time or have eye
injuries involving organic matter, such as plants or dirt.
Candida, the fungus that causes thrush, is one of more than 60
types of fungus that can infect the eye.
 Inclusion conjunctivitis usually spreads by contact with
genital secretions from a person who has a genital
chlamydial infection.
 Trachoma is another type of conjunctivitis caused by
Chlamydia trachomatis.
 Gonococcal conjunctivitis is another type of conjunctivitis
and is caused by Neisseria gonorrhea , a sexually transmitted
disease that may spread to the eye by contact with genital
secretions from a person who has a gonorrheal infection.
Severe infections may scar the conjunctiva, causing
abnormalities in the tear film. Sometimes, severe
conjunctival infections spread to the cornea (the clear layer
in front of the iris and pupil).
 Symptoms
 Symptoms :
 When it infected, the conjunctiva becomes pink (from
dilated blood vessels), and a discharge appears in the eye.
This discharge may also cause the vision to distortion. Vision
improves when the discharge is blinked away.
 Diagnosis
 Diagnosis of infectious conjunctivitis include evaluation of the
symptoms and appearance of the eye .
 Sometimes we need to culture samples of infected secretions in
certain situations include:
➢ When the symptoms are severe or recurring.

➢ When Chlamydia trachomatis or Neisseria gonorrhea is thought

to be the cause.
➢ When the person has an immune system defect (such as human
immunodeficiency virus [HIV]/AIDS).
➢ When the person has had an eye problem, such as a corneal
transplant .
 Treatment

 Treatment
 • For discharge, washing the eyelid and use warm or
cool compresses.
 • For bacterial conjunctivitis, antibiotic eye drops or
ointment.
 • Frequent use of hand sanitizers and other
precautions to avoid spreading the infection.
 Bacterial keratitis
 2- Bacterial keratitis: This is an infection of the cornea that
caused by common bacteria found on the skin and in the mouth
and nose. Normally, these bacteria can't penetrate the outer layer of
the eye, and cause only conjunctivitis.
 However, eye injury, lack of oxygen due to contact lenses, or a
weak immune system, all can facilitate entry of them into the
cornea.
 Fungi can cause fungal keratitis under similar circumstances
 The condition may be caused by a wide range of bacteria,
fungi and parasites including:
 • Staphylococci
 • Streptococci
 • Pseudomonads
 • Enterobacteriaceae
 • Corynebacterium species
 • Moraxella species
 • Haemophilus
 • N. gonorrhoea
 • Aspergillus species
 • Candida species
 Secondly according to the
causative agent
 A- Ocular histoplasmosis (OHS): is an eye
condition that can develop in people who have a
lung infection called histoplasmosis.
 Histoplasmosis is a fungal infection
(Histoplasma capsulatum) of the lungs, which
is caught by inhaling spores. It's common in
river valleys around the world. Over 90% of
adults in the southeastern US have had
histoplasmosis, which usually causes no
symptoms.
 The lung infection that causes OHS — happens when people
breathe in spores from a fungus called Histoplasma capsulatum.
This fungus is often found in soil that has bird or bat droppings
(poop) in it. Spores from the fungus can go into the air when
someone moves the soil around.
 Histoplasma capsulatum is one of several systemic dimorphic
fungal pathogens that switch their growth program from an
infectious mold form in the soil to a pathogenic yeast form in
mammalian hosts. H. capsulatum causes up to 500,000
infections per year in the U.S. alone, making it the most
common cause of fungal respiratory infections in healthy
hosts. Infection occurs when the soil is disrupted, facilitating
dispersion of hyphal fragments or spores that are inhaled by
humans.
Photomicrograph showing the
environmental form of
Histoplasma

 Photomicrograph showing the environmental

form of

 Histoplasma
 B. Eye infections accompany sexually
transmitted diseases (or genital diseases):- There
are a great many eye infections that are actually complications
of sexually transmitted (STIs) or genital diseases such as
syphilis, chlamydia, gonorrhea, crab lice, herpes simplex,
thrush, and hepatitis B. Gonorrheal eye infections are examples
of extremely common STIs that can cause conjunctivitis,
though they don't usually cause serious damage to the eye in
adults.
 The infection gets into the eye either directly through genital
fluids such as semen, or when infected people rub their eyes
after handling infected genital areas.

 Babies born to genitally infected women are at especially

high risk of eye infection.
 Example for this infection :
❑Inclusion conjunctivitis usually spreads by contact with
genital secretions from a person who has a genital chlamydial
infection.
❑Gonococcal conjunctivitis is another type of conjunctivitis
and is caused by Neisseria gonorrhea , a sexually transmitted
disease that may spread to the eye by contact with genital
secretions from a person who has a gonorrheal infection.
Severe infections may scar the conjunctiva, causing
abnormalities in the tear film. Sometimes, severe
conjunctival infections spread to the cornea (the clear layer
in front of the iris and pupil).
 Neisseria gonorrhea is one of the few bacteria capable of
penetrating the protective layers of the eye, causing inner-
eye infection.
 Ear infections
 An ear infection is an inflammation of the middle ear, usually
caused by bacteria, that occurs when fluid builds up behind the
eardrum.
Anyone can get an ear infection, but children get them more
often than adults.
 In fact, ear infections are the most common reason parents
bring their child to a doctor.
 The scientific name for an ear infection is otitis media (OM).

 Diagnosis Ear Infections

 A doctor use a pneumatic otoscope is an

examination that allows determination of the
mobility of a patient's tympanic membrane (TM) in
response to pressure changes. The normal tympanic
membrane moves in response to pressure.
Immobility may be due to fluid in the middle ear,
Ear infection
 Symptoms

pain inside the ear.
 high temperature (fever).
 lack of energy.
 discharge running out of the ear.
 feeling of pressure or fullness inside the ear.
 itching and irritation in and around the ear.
 lack of energy.
 slight hearing loss - if the middle ear becomes filled with fluid.
 Treatment

 Severe infections ( infections in young babies ) may require

antibiotics. Children who get severe infections often may
need surgery to place small tubes inside their ears. The tubes
relieve pressure in the ears so that the child can hear again.
 Causes An ear infection
 Causes An ear infection usually is caused by bacteria and often
begins after a child has a sore throat, cold, or other upper
respiratory infection.
 middle ear infection may be caused by Bacteria,
like Streptococcus pneumoniae and Haemophilus influenzae
that are the two most common bacterial causes.
 Causes spread to the middle ear; if the upper respiratory
infection is caused by a virus, such as a cold, bacteria may be
drawn to the microbe-friendly environment and move into the
middle ear as a secondary infection. Because of the infection,
fluid builds up behind the Causes eardrum.