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DISEASES OF
CONJUNCTIVA
CONJUNCTIVITIS
DEFINITION
•Conjunctivitis is an
inflammation of the
conjunctiva
characterized by
cellular infiltration and
exudation.
CLASSIFICATION
1.INFECTIVE CONJUNCTIVITIS
 BACTERIAL
• ACUTE BACTERIAL CONJUNCTIVITIS
• HYPERACUTE CONJUNCTIVITIS
• CHRONIC CONJUNCTIVITIS
• ANGULAR CONJUNCTIVITIS
 CHLAMYDIAL CONJUNCTIVITIS
• TRACHOMA
• ADULT INCLUSION CONJUNCTIVITIS
• NEONATAL CHLAMYDIAL CONJUNCTIVITIS
 VIRAL CONJUNCTIVITIS
• ADENOVIRUS CONJUNCTIVITIS
• ENTEROVIRUS CONJUNCTIVITIS
• MOLLUSUM CONTAGIOSUM
• HSV CONJUNCTIVITIS
 OPHTHALIA NEONATORUM
 GRANULOMATOUS CONJUNCTIVITIS
CLASSIFICATION
2.ALLERGIC CONJUNCTIVITIS
 SIMPLE ALLERGIC
 PHLYCTENULAR
 VERNAL (SPRING CATARRH)
 GIANT PAPILLARY.
3.CICATRICIAL CONJUNCTIVITIS
 OCULAR MUCOUS MEMBRANE
PEMPHIGOID
 STEVENS JOHNSONS SYNDROME
 TOXIC EPIDERMAL NECROLYSIS
 SECONDARY CICATRICIAL CONJUNCTIVITIS
4.TOXIC CONJUNCTIVITIS
BACTERIAL CONJUNCTIVITIS
Bacterial contamination of
the eye
Predisposing factors Mode of infection Causative organisms
 Flies,
 Poor hygienic
conditions
 Hot dry climate
 Poor sanitation and
 Dirty habits
1. EXOGENOUS INFECTION:
• Close contact, as air-borne infections or
water-borne infections;
• Vector Transmission (e.g., flies); or
• Infected fingers of doctors, nurses,
common towels, handkerchiefs, and
infected tonometers.
2. LOCAL SPREAD
• Infected lacrimal sac, lids, and
nasopharynx.
3. Endogenous infections
• Gonococcal and meningococcal
infections.
• Staphylococcus aureus
• Streptococcus
pneumoniae
• Streptococcus
pyogenes
• Haemophilus
influenzae
• Moraxella lacunata
• Pseudomona
pyocyanea
• Neisseria gonorrhoeae
• Neisseria meningitidis
• Corynebacterium
diphtheria
Acute bacterial
conjunctivitis
Its characterized by
marked conjunctival
hyperemia and
mucopurulent discharge
from the eye
Causative organisms Symptoms Signs
• Staph aureus
• Koch-weeks bacillus
• Pneumococcus
• Streptocossus
• Discomfort
• Foreign body sensation
• Grittiness
• Blurring of vison
• Redness of sudden
onset
• Mild photophobia
• Mucopurulent discharge
sticking together lid
margins
• Colored halos
• Fakes of mucopus
(fornices, canthi and lid
margins)
• Conjunctival congestion-
fiery red eye
• Chemosis
• Petechial haemorrhages
(pneumococcus)
COMPLICATIONS
• SUPERFICIAL PUNCTATE
EPITHELIOPATHY
• MARGINAL CORNEAL ULCERATION
• SUPERFICIAL KERATITIS
• BLEPHARITIS
• DACRYOCYSTITIS
Treatment Don’t Preventive measures
Topical antibiotis
• Chloramphenicol
• Gentamicin
• Tobramicin
• Freyamicin
Anti-inflammatory
Analgesics
Irrigation of conjuctival
sac with sterile warm
saline
Dark goggles
 No bandage
 No steroids
 Frequent
handwashing
 Avoidance of sharing
towels, handkerchief
and pillow with
others
I. Hyperacute bacterial
conjunctivitis
• AKA. ACUTE PURULENT
CONJUNCTIVITIS OR ACUTE
BLENORRHEA
• Characterized by violent purulent
inflammatory response
Etiology Clinical features treatment
• Gonococcus
• Complications
• Corneal odema, ulceration,
perforation, central necrosis
• Iridocyclitis
• Systemic complications
• Gonorrhea arthritis
• Endocartitis
• Septicaemia
Symptoms
• Pain
• Purulent discharge
• Swelling of eyelids
Signs
• Eyelids are tense and
swollen
• Tenderness
• Discharge-thick purulent
and copious
• Conjuctiva-Chemosis,
red velvety appearance
• Pseudomembrane
maybe seen on the
conjunctival surface
Systemic therapy
• 3rd gen cephalosporins
• Quinolones
Topical antibiotis
• Ofloxacin
• Ciprofloxacin
• Tobramycin
Topical atropine
Irrigation of eyes
II. CHRONIC
BACTERIAL
CONJUNCTIVITIS
Mild catarrhal
inflammation of
conjuctiva
Etiology Clinical features Treatment
Staph aureus
Rare proteus mirabilis
Klebsiella pneumonia
E. coli
Moraxella lacunata
Symptoms
• Burning and grittiness of eye
• Mild chronic redness
• Difficulty keeping eyes open
• Mild mucoid discharge
• Watering
• Feeling of sleepiness
Signs
• Congestion of posterior
conjunctival vessels
• Mild papillary hypertrophy in
palpebral conjunctiva
• Sticky look on the surface of
the conjunctiva
• Lid margins maybe congested
Topical antibiotics
• Chloramphenicol
• Tobramycin
• Gentamicin
Astringent eye drops
• Zinc-boric acid drops
III. ANGULAR
CONJUNCTIVITIS
• It’s a mild grade inflammation confined to
the conjunctiva and lid margins near the
angles associated with maceration of the
surrounding skin
Etiology
Causative organism
• Moraxella axenfield
Source
• Nasal cavity
Mode of infection
• Contaminated fingers or
handkerchief
Pathology
MA bacillus
Proteolytic enzyme collected at
angles by action of tears
Maceration of the conjunctival ep.,
lid margins and surrounding skin
Vascular and cellular response
Mild grade chronic inflammation
Symptoms Signs Treatment
• Irritation
• Burning sensation
• Discomfort in the eye
• Redness in the angle of the
eyes
• Dirty-white foamy
discharge at the angles
Complications
• Blepharitis
• Shallow marginal catarrhal
corneal ulcer
• Hyperemia of bulbar
conjunctiva near canthi
• Hyperemia of lid margins
near angles
• Excoriation of skin near
angles
Curative treatment
• Oxytetracycline eye
ointment
• Zinc lotion
THANKYOU

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Conjunctivitis

  • 2. CONJUNCTIVITIS DEFINITION •Conjunctivitis is an inflammation of the conjunctiva characterized by cellular infiltration and exudation.
  • 3. CLASSIFICATION 1.INFECTIVE CONJUNCTIVITIS  BACTERIAL • ACUTE BACTERIAL CONJUNCTIVITIS • HYPERACUTE CONJUNCTIVITIS • CHRONIC CONJUNCTIVITIS • ANGULAR CONJUNCTIVITIS  CHLAMYDIAL CONJUNCTIVITIS • TRACHOMA • ADULT INCLUSION CONJUNCTIVITIS • NEONATAL CHLAMYDIAL CONJUNCTIVITIS  VIRAL CONJUNCTIVITIS • ADENOVIRUS CONJUNCTIVITIS • ENTEROVIRUS CONJUNCTIVITIS • MOLLUSUM CONTAGIOSUM • HSV CONJUNCTIVITIS  OPHTHALIA NEONATORUM  GRANULOMATOUS CONJUNCTIVITIS
  • 4. CLASSIFICATION 2.ALLERGIC CONJUNCTIVITIS  SIMPLE ALLERGIC  PHLYCTENULAR  VERNAL (SPRING CATARRH)  GIANT PAPILLARY. 3.CICATRICIAL CONJUNCTIVITIS  OCULAR MUCOUS MEMBRANE PEMPHIGOID  STEVENS JOHNSONS SYNDROME  TOXIC EPIDERMAL NECROLYSIS  SECONDARY CICATRICIAL CONJUNCTIVITIS 4.TOXIC CONJUNCTIVITIS
  • 6. Predisposing factors Mode of infection Causative organisms  Flies,  Poor hygienic conditions  Hot dry climate  Poor sanitation and  Dirty habits 1. EXOGENOUS INFECTION: • Close contact, as air-borne infections or water-borne infections; • Vector Transmission (e.g., flies); or • Infected fingers of doctors, nurses, common towels, handkerchiefs, and infected tonometers. 2. LOCAL SPREAD • Infected lacrimal sac, lids, and nasopharynx. 3. Endogenous infections • Gonococcal and meningococcal infections. • Staphylococcus aureus • Streptococcus pneumoniae • Streptococcus pyogenes • Haemophilus influenzae • Moraxella lacunata • Pseudomona pyocyanea • Neisseria gonorrhoeae • Neisseria meningitidis • Corynebacterium diphtheria
  • 7. Acute bacterial conjunctivitis Its characterized by marked conjunctival hyperemia and mucopurulent discharge from the eye
  • 8. Causative organisms Symptoms Signs • Staph aureus • Koch-weeks bacillus • Pneumococcus • Streptocossus • Discomfort • Foreign body sensation • Grittiness • Blurring of vison • Redness of sudden onset • Mild photophobia • Mucopurulent discharge sticking together lid margins • Colored halos • Fakes of mucopus (fornices, canthi and lid margins) • Conjunctival congestion- fiery red eye • Chemosis • Petechial haemorrhages (pneumococcus)
  • 9. COMPLICATIONS • SUPERFICIAL PUNCTATE EPITHELIOPATHY • MARGINAL CORNEAL ULCERATION • SUPERFICIAL KERATITIS • BLEPHARITIS • DACRYOCYSTITIS
  • 10.
  • 11. Treatment Don’t Preventive measures Topical antibiotis • Chloramphenicol • Gentamicin • Tobramicin • Freyamicin Anti-inflammatory Analgesics Irrigation of conjuctival sac with sterile warm saline Dark goggles  No bandage  No steroids  Frequent handwashing  Avoidance of sharing towels, handkerchief and pillow with others
  • 12. I. Hyperacute bacterial conjunctivitis • AKA. ACUTE PURULENT CONJUNCTIVITIS OR ACUTE BLENORRHEA • Characterized by violent purulent inflammatory response
  • 13. Etiology Clinical features treatment • Gonococcus • Complications • Corneal odema, ulceration, perforation, central necrosis • Iridocyclitis • Systemic complications • Gonorrhea arthritis • Endocartitis • Septicaemia Symptoms • Pain • Purulent discharge • Swelling of eyelids Signs • Eyelids are tense and swollen • Tenderness • Discharge-thick purulent and copious • Conjuctiva-Chemosis, red velvety appearance • Pseudomembrane maybe seen on the conjunctival surface Systemic therapy • 3rd gen cephalosporins • Quinolones Topical antibiotis • Ofloxacin • Ciprofloxacin • Tobramycin Topical atropine Irrigation of eyes
  • 15. Etiology Clinical features Treatment Staph aureus Rare proteus mirabilis Klebsiella pneumonia E. coli Moraxella lacunata Symptoms • Burning and grittiness of eye • Mild chronic redness • Difficulty keeping eyes open • Mild mucoid discharge • Watering • Feeling of sleepiness Signs • Congestion of posterior conjunctival vessels • Mild papillary hypertrophy in palpebral conjunctiva • Sticky look on the surface of the conjunctiva • Lid margins maybe congested Topical antibiotics • Chloramphenicol • Tobramycin • Gentamicin Astringent eye drops • Zinc-boric acid drops
  • 16. III. ANGULAR CONJUNCTIVITIS • It’s a mild grade inflammation confined to the conjunctiva and lid margins near the angles associated with maceration of the surrounding skin
  • 17. Etiology Causative organism • Moraxella axenfield Source • Nasal cavity Mode of infection • Contaminated fingers or handkerchief
  • 18. Pathology MA bacillus Proteolytic enzyme collected at angles by action of tears Maceration of the conjunctival ep., lid margins and surrounding skin Vascular and cellular response Mild grade chronic inflammation
  • 19. Symptoms Signs Treatment • Irritation • Burning sensation • Discomfort in the eye • Redness in the angle of the eyes • Dirty-white foamy discharge at the angles Complications • Blepharitis • Shallow marginal catarrhal corneal ulcer • Hyperemia of bulbar conjunctiva near canthi • Hyperemia of lid margins near angles • Excoriation of skin near angles Curative treatment • Oxytetracycline eye ointment • Zinc lotion

Editor's Notes

  1. Consider talking about: Eye examination Specialized tests
  2. Consider talking about: Ancient near east and the Greek period Ancient India Medieval Islam Modern Period Ophthalmic surgery in Great Britain 19th and 20th centuries Central Europe
  3. Consider talking about: Australia and New Zealand Bangladesh Canada Finland India Nepal Ireland Pakistan Philippines United Kingdom
  4. Consider talking about: 18th–19th centuries 20th–21st centuries
  5. Consider talking about: 18th–19th centuries 20th–21st centuries