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Optometry 8260 Fall 2007 Bacterial & Viral Infections of the Eyelid & Conjunctiva Part 1. Eyelid to the Conjunctiva Chapters 11, 23, 24, 25 in Bartlett. Anatomy of the Eyelid. Signs of Bacterial Eyelid Infections. 1) Redness: Diffuse 2) Warm to Touch: 3) Pain on Palpation: 4) Swelling:
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Optometry 8260Fall 2007Bacterial & Viral Infections of the Eyelid & ConjunctivaPart 1 Eyelid to the Conjunctiva Chapters 11, 23, 24, 25 in Bartlett
Signs of Bacterial Eyelid Infections 1) Redness: • Diffuse 2) Warm to Touch: 3) Pain on Palpation: 4) Swelling: • Edema • Inflammation
Signs of Viral Eyelid Infections 1) Redness: • Vesicles with red base → ulcerations 2) Pain on palpation: • Mild 3) Swelling: • Mild to moderate
Vesicles & Pustules • Small blister-like • Usually less than 0.5 cm • Inflammatory cells • Under the epidermis
OtherViral Lid Lesions Verrucae (warts): 1) Raised, multi-lobulated, a pedunculated mass. 2) Round, slightly raised sessile lesion 3) Cornified (keratinized)
Conjunctival Signs: Papillae: • A non-specific reaction of the conjunctiva. • Due to infiltration of inflammatory cells into the substantia propria (PMN’s, mast cells, eosinophils) • Vessels in the center. • Red and flat • Usually start at the tarsal conjunctiva. Allergic and Bacterial
Conjunctival Signs: Follicles: • An aggregation of lymphocytes. • More spherical than papules and translucent to whitish gray. • Usually start in the fornix. Viral, Chlamydial, Toxic agents and certain Bacteria.
Conjunctival Signs: Chemosis: • Swelling of the conjunctiva. • Severity may vary. • When Severe - The cornea will appear to be in a crater surrounded by conjunctiva.
Conjunctival Psedomembranes: • Exotoxins causes epithelium to become necrotic and forms a fibropurulent exudate. • Can be removed without bleeding with forceps.
Mucous Discharge • Amount? • A little (scant, trace, minimal) • A lot (significant) • Nature? • White & ropy • Thick & purulent, hyperpurulent • Timing? • Acute, Chronic, Hyperacute
Watery Discharge • Amount? • Constant • Occassional • Debris? • Itching? • Strongly suggestive of allergy. • Other sources of itching. • Timing? • Acute • Chronic