Eye infections. Hossain Jabbari, MD, MPH, ID & TM Infectious Diseases Dept., Digestive Diseases Research Institute (DDRI) TUMS

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Eye infections Hossain Jabbari, MD, MPH, ID & TM Infectious Diseases Dept., Digestive Diseases Research Institute (DDRI) TUMS

Eye: An overview

Eye: An overview The eye is one of the most complex parts of the body. There are more than a billion parts all working in synchronization. The eyesight is one of the most important senses, a fact supported by the amount of brain that is dedicated to process the information received through the eye Eye in spiritual concepts and as a communication tool!

Eye injuries: as an overview 1 Physical hazards: Trauma, Sharp injuries 2 Chemical Hazards: Chemical burns (Acid, alkaline), 3 Biological Hazards: bacteria, viruses, parasites, 4 Genetic hazards: coloboma,

Coloboma

Eye Anatomy (Cont d)

Eye Anatomy (Cont d)

Eye Anatomy (Cont d)

Eye Anatomy (Cont d)

Eye Anatomy

Eye Anatomy (Cont d)

Eye Anatomy (Cont d)

Eye Infections

External Eye Diseases

Rt. facial nerve paresis

Abscess of meibomian gland (meibomianitis )

Chalazion

Purulent dacryocystitis OD

Chronic dacryocysitis with abscess formation

Elephantiasis Nostras

Herpes Zoster

Internal hordeolum - a meibomian abscess

HSV I of the lid

Abscess of meibomian gland

Preseptal cellulitis

Trachoma with extensive superior tarsal conjunctival scarring

Varicella/ chickenpox: loss of lashes lower lid

Viral papilloma

Tularemia, oculoglandular

Herpes zoster ophthalmicus with Hutchinson's sign

Herpes zoster ophthalmicus

Conjunctiva

Conjunctiva (Cont d) The conjunctiva (plural conjunctivas or conjunctivae): Clear mucous membrane that covers the sclera (white part of the eye) and lines the inside of the eyelids. It helps lubricate the eye by producing mucus and tears

Conjunctiva (Cont d) Conjungtivitis ( Pink eye or Madras eye) : Inflammation of the conjunctiva Red eye (hyperaemia), irritation (chemosis) and watering (epiphora) of the eyes are symptoms common to all forms of conjunctivitis

Conjunctiva (Cont d) Conjungtivitis causes: Viral conjunctivitis Allergic conjunctivitis Bacterial conjunctivitis Chemical conjunctivitis Neonatal conjunctivitis is often defined separately due to different organisms

Viral conjunctivitis: Conjunctiva (Cont d) Adenovirus (the most common cause) HSV (the most problematic) Less common causes include:vzv, enterovirus 70, Coxsackie A24, molluscum contagiosum, vaccinia, HIV Rarely, during systemic infection ( influenza virus, EBV, paramyxovirus (measles, mumps, Newcastle), rubella)

Molluscum contagiosum: with follicular conjunctivitis

Conjunctiva (Cont d) Acute hemorrhagic conjunctivitis (AHC): A prominent hemorrhagic component soon appears that is characteristic of this infection Coxsackie group A24 (CA24) and enterovirus E70 (EV70) strains

Acute Hemorrhagic Conjunctivitis (AHC)

Conjunctiva (Cont d) Epidemic Keratoconjunctivitis (EKC): A type of adenovirus ocular infection Sudden onset of acute follicular conjunctivitis with watery discharge, hyperemia, chemosis, and ipsilateral preauricular lymphadenopathy Pharyngo Conjunctival Fever (PCF)

Adenoviral conjunctivitis

Viral keratoconjunctivitis

Epidemic Keratoconjunctivitis

Epidemic Keratoconjunctivitis

Conjunctiva (Cont d) Bacterial conjunctivitis : Streptococci Staphylococci Chlamydia GC

Bacterial Conjunctivitis

Bacterial conjunctivitis

Acute mucopurulent bacterial conjunctivitis

Conjunctiva (Cont d) Allergic conjunctivitis Itching and tears Seasonal conjunctivitis Rhino conjunctivitis

Allergic conjunctivitis

Conjunctiva (Cont d) Chemical conjunctivitis Due to either an acidic or alkali substance Litmus paper is an easy way to rule out the diagnosis ( Normal ph :7.0 7.2) Irrigation with copious water

Conjunctiva (Cont d) Neonatal conjunctivitis A form of bacterial conjunctivitis contracted by newborns during delivery GC, Chlamydia Chemical (Silver nitrate)

Cornea

Cornea (Cont d)

Cornea (Cont d) Keratitis: Keratitis is inflammation of the cornea Superficial Keratitis Deep Keratitis

Cornea (Cont d) Amoebic keratitis: (the most serious corneal infection) Acanthamoeba keratitis (AK) in contact lens wearers

Amoebic keratitis

Cornea (Cont d) KeratitisBacterial keratitis Staphylococcus aureus Pseudomonas aeruginosa

Bacterial Keratitis

Pseudomonas keratitis (suppurative)

Interstitial keratitis with congenital syphilis

Inactive interstitial keratitis in congenital syphilis

Corneal ulcer from bacterial infection

Cornea (Cont d) Fungal keratitis: Fusarium Candida

Cornea (Cont d) Viral keratitis: Herpes simplex keratitis (Dendritic ulcer) Herpes zoster keratitis

Dendritic keratitis HSV - active

Disciform keratitis (HSV)-active with neovascularization

HSV Disciform keratitis - active stage with neovascularization of cornea.

HSV keratitis & HSV iritis

Herpetic Keratitis

Cornea (Cont d) Parasititic Keratitis: Onchocercal keratitis : O. volvulus infection by infected blackfly bite River blindness

Scleritis & Episcleritis

Episcleritis

Scleritis

Scleritis

Episcleritis, sectoral

Retina

Infection of other parts of the eye

Uveitis Uvea: 1. Iris 2. Chroid 3. Cilliary body

Endogenous suppurative iritis

Cataracta complicata with chronic uveitis

TB Uveitis

Tuberculosis (TB) uveitis - iritis

Hypopyon

Trachoma with pannus crassus

Trachoma: a perfect photo of established trachoma with conjunctivitis, florid pannus, corneal scarring, and trichiasis

Leprosy: patient is blind due to leprotic uveitis and keratitis

Syphilis and Trachoma: tertiary syphilis with gumma distruction of nose and trachoma

Endophthalmitis

Pan-endophthalmitis

Diagnosis

Treatment

Thanks for your kind attention!