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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
Conjunctivitis in a newborn is termed ophthalmia neonatorum (ON) or neonatal conjunctivitis. The incidence ranges from 2% to 12%.65 Although ON is less common, it remains an important cause of childhood corneal blindness in developed countries, and even of mortality in developing regions of the world.65,66 It is seen in babies of mothers affected by sexually transmitted diseases (STDs) caused by C. trachomatis (serotypes D–K) and Neisseria gonorrhoeae.67 Chemical substances like erythromycin, tetracycline, or silver nitrate are also known to cause ON. Chemical conjunctivitis presents within 24 hours and is self-limiting. The bacterial causes of ON however need antibiotic treatment.67 Affected babies present with congested, swollen eyes and sticky discharge usually within 2–14 days of birth. Chlamydial ON is more common than gonococcal ON. Most cases of chlamydial ON are mild to moderate in nature whereas gonococcal ON tends to be more severe.66
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Neisseria gonorrhoea:Gram-negative diplococcus bacterium.Infects the baby during childbirth.Causes ophthalmia neonatorum.Causes urethritis.Can cause perihepatitis.
Infections
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
Gonorrhoea in pregnancy is associated with premature rupture of membranes and premature delivery, and in the post-partum period with severe endometritis and pelvic infection.112 Infection can be transmitted to the infant during delivery, with a 30–50% risk of ophthalmia neonatorum.113 This presents in the first few days of life with a profuse, purulent conjunctival discharge and if untreated can result in blindness.
Challenges in treating ophthalmia neonatorum
Published in Expert Review of Ophthalmology, 2021
Faith Uche Ukachukwu, Afshan Rafiq, Lori A. S. Snyder
The current internationally recommended treatment for gonorrhea in the reproductive tract is a dual therapy with azithromycin (1–2 g) and ceftriaxone (250–500 mg). N. gonorrhoeae resistance to ceftriaxone has been observed in several countries including Austria, England, France, Japan, Norway, Slovenia, Spain, and Sweden [140,141,142,143], with rising resistance figures world-wide [141,143]. The rise in gonorrhea cases that are nearly impossible to treat due to high-level resistance to both azithromycin and ceftriaxone [78,79] will inevitably lead to difficult and potentially impossible to treat cases of ophthalmia neonatorum. From a global public health point of view, a new therapeutic compound or antimicrobial agent is essential for effective control of infectious ophthalmia neonatorum.
The practise of paediatric optometry in a low‐resource environment
Published in Clinical and Experimental Optometry, 2020
Stephen Ocansey, Emmanuel Kwasi Abu, Odamtten Nii armah, Enyam Ka Morny
Binocular vision screening in paediatrics is crucial in the detection of ocular conditions (for example strabismus, anisometropia) which may cause amblyopia.2005 Binocular vision assessments were found to be inadequate and the most commonly used method for assessing the binocular vision status of toddlers and pre‐schoolers was the Cover test. In contrast to the study in Australia,2003 this study found that other important tests such as the NPC, suppression and stereopsis measures, which are widely used as part of the assessment of binocular visual status of children, were not used by optometrists in Ghana. It was not surprising that the least diagnosed conditions reported among the optometrists were amblyopia and phoria. The most diagnosed condition of ophthalmia neonatorum among toddlers and allergic conjunctivitis among pre‐schoolers is also not surprising. Post‐natal infections are common among infants when antibiotics are not used after delivery while a dusty and unhygienic environment precipitates infections among pre‐schoolers when exposed. Moreover, since infections exhibit more severe and noticeable signs, parents find it more appropriate to send their children for care compared to binocular or refractive anomalies. Perhaps if more optometrists were performing binocular vision assessment, the proportion of diagnosed binocular and refractive anomalies such as phoria and amblyopia could have been higher than reported. The gap in treatment/management options could be attributed to inadequate exposure to the skill during training since the majority expressed adequate knowledge of the sensitive period for detecting amblyopia.
A Systematic Review of Clinical Practice Guidelines for Infectious and Non-infectious Conjunctivitis
Published in Ophthalmic Epidemiology, 2022
Ving Fai Chan, Ai Chee Yong, Augusto Azuara-Blanco, Iris Gordon, Sare Safi, Gareth Lingham, Jennifer Evans, Stuart Keel
The data base search yielded 3778 titles and abstracts, for screening and 60 (1.59%) eligible CPGs were selected for full paper review, among which 45 were excluded because they were not relevant to the topic of interest,19–54 possible conflicts of interest were not clearly stated and/or the author affiliations were not listed,55–59 the average score of the two researchers for AGREE II items 4, 7, 8, 12, or 22 was less than three and/or the sum of the average score of the two researchers for all nine items was less than 45.60–63 (Figure 1) We finally included the following 15 CPGs: Atopic Keratoconjunctivitis (AKC). The College of Optometrists. 2019.64CL-associated Papillary Conjunctivitis (CLAPC), Giant Papillary Conjunctivitis (GPC). The College of Optometrists. 2017.65Conjunctivitis (Acute Allergic). The College of Optometrists. 2019.66Seasonal Allergic Conjunctivitis (Hay Fever Conjunctivitis); Perennial Allergic Conjunctivitis. The College of Optometrists. 2019.67Conjunctivitis Medicamentosa (also Dermatoconjunctivitis medicamentosa). The College of Optometrists. 2019.68Consensus Document on Allergic Conjunctivitis (DECA). Sánchez-Hernández et al. 2015.69Conjunctivitis – Allergic. The National Institute for Health and Care Excellence. 2017.70Conjunctivitis (Bacterial). The College of Optometrists. 2018.71Conjunctivitis (Viral, non-herpetic). The College of Optometrists. 2019.72Conjunctivitis, Chlamydial (Adult inclusion conjunctivitis). The College of Optometrists. 2019.73Ophthalmia Neonatorum. The College of Optometrists. 2018.74Vernal Keratoconjunctivitis (Spring catarrh). The College of Optometrists. 2019.75Conjunctivitis Preferred Practice Pattern. American Academy of Ophthalmology. 2018.76Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum. US Preventive Services Task Force. 2019.77Conjunctivitis – Infective. The National Institute for Health and Care Excellence. 2018.78