MSN

What is conjunctivitis?
 “Inflammation or infection of the conjunctiva”
(Ignatavicius and Workman, 2006)

 Inflamamtion occurs due to exposure to

allergen or irritants (chemicals films or
smoke) and its not contagious.
 Infectious conjunctivitis occur with
bacterial or viral infection – its readily
transmitted from person to person.

 Bacterial conjunctivitis –caused by

staphylococcus aureus, haemophilus
influenza or pseudomonas aeroginosa
 Eye redness (hyperemia).
 Swollen, red eyelids.
 More tearing than usual.
 Feeling as if something is in the eye (foreign-
body sensation or keratoconjunctivitis).
 An itching or burning feeling.
 Mild sensitivity to light (photophobia).
 Drainage from the eye. (watery at first then
thick with threads of mucous.
 Presenting signs and symptoms
 Swab for culture of discharge
 Treatment by antibiotic eye drops or
ointment. This generally clears the symptoms
within a few days.
 Give gentamicin eye drops
 Topical steroids eg prednisolone or antibiotic
steroid combination eg (Maxtrol) neomycin
dexamethazone combination)
 Usually runs its course in one to two weeks.
 Since its‟ is not caused by bacteria, viral
conjunctivitis does not respond to antibiotics.
 Give artificial tears helps relieve symptoms.
 Give antiviral agents such as vidarabine
topical
 Anti-inflammatory agents eg dexamethasone
or predinisolone
 Document amount, colour and type of
discharge.
 Encourage hand hygiene by patient and care
giver (before and after eye drops)
 avoid touching unaffected eye
 Avoid sharing wash clots and towels
 Instruct pt to avoid make-up
What Is Pinkeye?
• Pinkeye -- also called
conjunctivitis -- is redness and
inflammation of the clear
membranes covering the whites
of the eyes and the membranes
on the inner part of the eyelids.
• Pinkeye is most often caused by a
virus or by a bacterial infection,
although allergies, toxic agents,
and underlying diseases can also
play a role.
Is Pinkeye Contagious?
• Viral and bacterial pinkeye are extremely
contagious.
• It‟s easily spread through poor hand
washing or by sharing an object (like a
towel) with someone who has it.
• It can also spread through coughing and
sneezing. Kids diagnosed with pinkeye
should stay out of school or day care for a
short period of time.
• Allergic pinkeye (caused by seasonal
pollens, animal dander, cosmetics, and
perfumes) and chemical pinkeye (from
toxic chemicals) is not contagious)
Symptom: Eye Redness
• Red eyes, or hyperemia, are the typical,
telltale symptom of pinkeye.
• Pinkeye is a common condition that is
rarely serious and will not cause long-
term eye or vision damage if promptly
detected and treated.
• The symptoms of bacterial pinkeye
usually affect both eyes.
• Viral pinkeye symptoms typically begin
in one eye and involve the other eye
within a few days.
• Symptoms of allergic pinkeye usually
involve both eyes.
• Swelling of the eyelids is most common
with bacterial and allergic pinkeye.
Symptom: Lots of Tearing
Viral and allergic pinkeye are
known for causing more tear
production than usual.
Symptom: Itchy or Burning Eyes
You would know it if you felt it --
that overwhelming itchy, burning
feeling in the eyes, which is typical
of pinkeye.
Symptom: Drainage from the Eyes
• A clear, watery drainage is
common with viral and allergic
pinkeye.
• When the drainage is more
greenish-yellow (and there‟s a
lot of it), this is likely bacterial
pinkeye.
Symptom: Sensitivity to Light
• Pinkeye can cause mild
sensitivity to light
(photophobia).
• A child who has severe
symptoms, such as changes in
eyesight, photosensitivity, or
severe pain may have an
infection that has spread
beyond the conjunctiva and
should be re-examined.
Symptom: „Something in the
Eye‟
• You may notice a bothersome
feeling like something is
stuck in your eye.
• Or, a child may describe the
feeling as sand in the eye.
Irritation or a gritty feeling in
the eye can indicate a
bacterial cause of pinkeye.
Pinkeye Diagnosis
• A doctor can often diagnose pinkeye
just by its distinguishing symptoms.
• However a slit lamp exam may be
required.
• In some cases, a swab of the
discharge from the eye is sent to a
lab for analysis to determine the
cause.
Treating Pinkeye
• Bacterial pinkeye is treated with
antibiotic eyedrops, ointment, or
pills to clear the infection.
• Most viral pinkeye cases have no
specific treatment -- you just have
to let the virus run its course, which
is usually four to seven days.
• Some viral causes of pinkeye may
require antiviral medications.
• Allergic pinkeye symptoms should
improve once the allergen is
removed and the allergy itself is
treated.
• Chemical pinkeye requires prompt
washing of
Easing Symptoms
• To reduce pain and to remove the
discharge of bacterial or viral pinkeye,
use a cold or warm compress on the
eyes.
• Make sure to use a different
washcloth for each eye to prevent
spreading any infection. And use clean
washcloths each time.
• Clean the eye from drainage by
wiping from the inside to the outside
of the eye area.
• For allergic pinkeye, an antihistamine
may be used to alleviate symptoms.
How Long Am I Contagious?
• With bacterial pinkeye, you can usually
return to work or school 24 hours after
antibiotics have been started, as long as
symptoms have improved.
• With viral pinkeye, you are contagious as
long as the symptoms last.
Preventing Its Spread
• If you or your child has infectious
pinkeye, avoid touching the eye area,
and wash your hands frequently,
particularly after applying medications
to the area.
• Never share towels or handkerchiefs,
and throw away tissues after each use.
• Change linens and towels daily.
• Disinfect all surfaces, including
countertops, sinks, and doorknobs.
• Throw away any makeup used while
infected.
 Chronic, bilateral scaring form of
conjunctivitis caused by chlamydia
trachomatis.
 Chief cause of preventable blindness in the
world
 Incidence is higher in warm, moist climates
where sanitation is poor.
 Incubation period 5-14 days
 At first resembles bacterial conjunctivitis
 Tearing
 Cloudy cornea
 Swollen eyelids
 Photophobia
 Oedema of eye lid and conjunctiva
 Formation of follicles on upper eyelid
conjunctiva
 Scaring of eyelids as disease progresses
 Entropion causing eye lashed to damage the
cornea
 History
 Presenting signs
 Eye examination reviews scaring inside upper
eyelid
 Culture and sensitivity of eye swab
 Four week course of or erythromycin
 eyelid surgery may be needed to prevent
long-term scarring,
 Corneal scaring
 blindness
 Instruct client to wash hands before and after
touching eye
 Avoid sharing wash clothes and keep them
away from those of unaffected individuals
 Complete entire course of antibiotics
 Results from change in tear composition,
lacrimal gland malfunction, altered tear
distribution.
 Decreased tear production can be due to
drugs such as beta blocker, diseases such as
leukemia‟ radiation or chemical burns, injury
to the facial nerve (CNVII)
 Feeling of foreign body in the eye
 Burning and itching eye
 Photophobia
 Tears may contain strands of mucus
 Application of cyclosporine ophthalmic
emulsion to increase tear production
 Application of artificial tears
 Surgery to correct eyelid position
 Treatment of underlying cause
 Hordeolum (stye)
 Infection of the sweat gland in the eyelid
 Characterized by a red swollen, tender area
on the skin surface side of the eyelid.
 As it grows, it fills with purulent materials
causing pain
 Usually caused by staphy aureas, staphy
epidermidis and streptococcus.
 Apply warm compresses four times a day
 Apply anti-bacterial ointment.
 I&D
 Antibiotics especially an internal stye i.e
cloxacillin
 Chalazion (meibomian cyst, tarsal cyst, or
conjunctival granuloma) .
 Inflammation of sebaceous gland in the eyelid
begins with redness and swelling similar to
hordeolum followed by a gradual painless
swelling at the gland.
 When fully developed, no inflammatory signs
are present
 Warm compress for 15 minutes four times a
day
 Application of ophthalmic ointment
 Surgical removal
 Apply antibiotic ointment after surgery
 Rest the eye for 6 hours using non-pressure
eye patch.
 Apply warm compress after use of eye patch
 Instill antibiotic eye-drops after use of
compress
1. Uveitis( Iris, choroid and Cilliary body)
2. Retinitis
3. Chorioretinitis
4. Blepharitis