Infections of the Eye
Keith Struthers in Clinical Microbiology, 2017
Bacterial conjunctivitis is characterized by an inflamed red eye and associated discharge. Severe infection with significant eyelid oedema, extreme hyperaemia and a profuse purulent discharge needs special mention. In this setting, bacteria such as Neisseria gonorrhoeae and Neisseria meningitidis may be involved, and the massive release of lytic enzymes from dead and dying neutrophils damages the cornea. Ulceration and perforation of the cornea here, or following trauma, allow organisms to reach the anterior chamber and from there the vitreous humour, producing endophthalmitis (Figure 15.3). In the hospital setting, Pseudomonas aeruginosa can also initiate an aggressive keratitis, and can be of particular importance in the intensive care unit (ICU) patient who has had superficial trauma to the cornea during their management. With keratitis there is usually some degree of pain and vision loss; the ICU patient will not usually be able to relay these symptoms.
Nasal, bronchial, conjunctival, and food challenge techniques and epicutaneous immunotherapy of food allergy
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2020
Allergic conjunctivitis is a symptomatic disorder of the eye that results from immunoglobulin E (IgE)–mediated mast cell degranulation initiating the release of histamine, cytokines, chemokines, and the recruitment of inflammatory cells. Common symptoms and signs of allergic conjunctivitis include ocular itching, tearing, redness, and chemosis, which is otherwise known as swelling of the conjunctiva. The conjunctiva is a thin, protective, mucosal membrane that covers the anterior sclera extending to behind the eyelids [57]. Allergic conjunctivitis symptoms are estimated to affect approximately 15%–20% of the population worldwide, with the United States reporting a prevalence of 40% [58,59]. Patients with allergic conjunctivitis often experience a reduced quality of life with a potential impact on daily activities such as reading, driving, and sleeping [60].
Clinical Toxicology of Snakebite In Africa and The Middle East / Arabian Peninsula
Jürg Meier, Julian White in Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
Thirteen cases were reported from northern Nigeria35,50,53. One received venom in both eyes, one in one eye and up one nostril and the others into one eye. In all cases there were symptoms of acute chemical conjunctivitis: intense pain, watering of the eye, spasm and swelling of lids, congestion and oedema of the conjunctivae and cornea and a whitish discharge (Figure 27). Five patients developed nothing more than a simple conjunctivitis but in six there was evidence, by fluorescein staining, slit lamp biomicroscopy or by development of complications, of corneal ulceration. One patient developed hypopyon, suggesting that venom had entered the anterior chamber53. One showed signs of anterior uveitis (Figure 28). One presented with a perforating corneal ulcer with gross endophthalmitis requiring enucleation (Figure 29). One patient was found to have a dense opacity causing blindness, the result of having venom spat into that eye five years before. Pugh et al examined 19 patients spat at between six months and 53 years before13. Eight had superficial punctate corneal nebulae, two epithelial punctate staining of the lower periphery of the cornea and three others had other keratopathies.
Association between atopic dermatitis and conjunctivitis in adults: a population-based study in the United States
Published in Journal of Dermatological Treatment, 2021
Kevin K. Wu, Andrea J. Borba, Pierce H. Deng, April W. Armstrong
Conjunctivitis can be diagnosed with a detailed patient history and eye examination (7). Hyperemia of the eye is a hallmark symptom of conjunctivitis. Other symptoms of conjunctivitis may include pain, pruritus, and eye discharge. In bacterial, viral, and allergic conjunctivitis, pain is usually mild or absent. In a patient with continuous watery or serous discharge and pruritus, the diagnosis is most likely allergic conjunctivitis. Treatment for allergic conjunctivitis includes topical agents such as histamine receptor antagonists, mast cell stabilizers, nonsteroidal anti-inflammatory drugs, and corticosteroids. Patients with allergic conjunctivitis should avoid allergens by limiting outdoor exposure and keeping windows closed. Contact lens wearers should avoid putting on lenses during episodes of allergic conjunctivitis because doing so may trap allergens and exacerbate symptoms. In a patient with continuous watery or serous discharge without pruritus, the diagnosis is most likely viral conjunctivitis. Treatment for viral conjunctivitis is supportive and includes cold compresses, artificial tears, and topical ocular decongestants. In a patient with continuous and purulent discharge, the cause is most likely bacterial. Treatment for bacterial conjunctivitis is also supportive because most patients with bacterial conjunctivitis improve after two to five days without antibiotics (7). If the patient reports moderate to severe pain, photophobia, or blurred vision, an emergent ophthalmology referral is appropriate.
Ocular Involvement in Muckle-Wells Syndrome
Published in Ocular Immunology and Inflammation, 2020
Sukru Cekic, Ozgur Yalcinbayir, Sara Sebnem Kilic
Two members of this family refused to have an extensive ophthalmic examination. Therefore, ocular findings in both eyes of nine individuals of the family were presented in this cross-sectional study. Each participant completed various questionnaires about their past and present symptoms and past ocular history. The onset age of the ocular symptoms were also inquired. A comprehensive ophthalmological examination, corneal topography and optical coherence tomography (OCT) evaluations were performed. Questionnaire of the symptoms covered the history of conjunctivitis including the irritated pink eye, conjunctival swelling, foreign body sensation, increased tear secretion and discharge of pus or mucus. We also questioned the recovery of symptoms after the commencement of therapy. Ophthalmological examination was performed by the same ophthalmologist (OY) and included ocular motility tests, best corrected visual acuity (BCVA) assessment, intraocular pressure measurement, slit-lamp biomicroscopy and fundoscopy. Signs of keratoconus, band keratopathy, subepithelial and/or anterior stromal corneal scarring, posterior stromal corneal opacification, corneal edema, cells and flare within the anterior or posterior chamber and vitreous, anterior or posterior synechia of the iris, phakic status of the lens, signs of past uveitis including pigment dispersion, and hyalinized keratic precipitates were examined in the slit-lamp biomicroscopy. The lesions on the retina and optic nerve were inspected during the dilated funduscopic examination.
COVID-19-related Conjunctivitis Review: Clinical Features and Management
Published in Ocular Immunology and Inflammation, 2023
William Binotti, Pedram Hamrah
Therefore, the real incidence of ocular findings in SARS-CoV-2 infection remains unclear since most of the published studies were on hospitalized patients. Nonetheless, our pooled meta-analysis data showed a weighted mean incidence of 11.4% (95% CI = 6.4–17.2%) for all ocular manifestations in COVID-19.7,9,11 The main symptoms and signs related to the infection were ocular pain 31.2% (95% CI = 23.7–38.7%), conjunctival redness or congestion 10.8% (95% CI = 3.0–18.7%), follicular conjunctivitis 7.0% (95% CI = 2.1–11.8%), and itching 6.55% (95% CI = 0.2–12.8%).7 The average duration of conjunctival congestion was 5.9 ± 4.5 days.10 Interestingly, in a study assessing clinical symptoms in health-care workers with mild COVID-19 symptoms, ocular pain showed an incidence of 34.4% among confirmed cases and a significant association with COVID-19 (odds ratio = 4.5, 95% CI = 2.7–7.4; p < .001).33
Related Knowledge Centers
- Antibiotic
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- Eyelid
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