COMMON OPTHALMOLOGY DISEASES

1. COMMON OPTHALMOLOGY DISEASES Prepared by :Dr.LatifaMari’e

2. Ocular symptoms are a frequent presenting chief complaint from patients in the outpatient setting. Although most physicians do not have specialized formal training in ophthalmology, most common ocular conditions can be effectively diagnosed and managed by non-ophthalmologists without the use of subspecialty equipment. Triaging which patients can be treated without referral is the most important first step.

5. Bacterial conjunctivitis is a microbial infection involving the mucous membrane on the surface of the eye. Symptoms :eye redness,pain,discharge.Itcan be differentiated from viral conjunctivitis by the purulent discharge (shown). It is typically benign and self-limiting, but significant ocular morbidity may develop • Frequent handwashing and avoidance of shared linens can help prevent the spread of infection • The mainstay of treatment is empiric topical antibiotic therapy with a broad-spectrum agent

6. Tha most common organism is: • Staphylococcus aureus • Haemophilusinfluenza • Streptococcus pneumoniae  • Pseudomonas aeruginosa

7. . In sexually active individuals, Neisseria gonorrhoeae and Chlamydia must be considered. If clinically suspicious, culture specimens and gram stains can be used to identify the specific etiologic agent. • Treated with systemic antibiotics .

9. Viral conjunctivitis is an infection of the mucous membrane of the surface of the eye. The most common virus responsible is adenovirus, but other viruses have also been identified including herpes simplex, varicella-zoster, picorna, pox, and human immunodeficiency virus. Infections are usually self-limited, but compared to bacterial conjunctivitis they last longer (2-4 weeks), show less inflammation, do not have purulent discharge, and a preauricular lymph node may be palpable. Most patients report itching, foreign body sensation, tearing, redness, and photophobia.

10. Treatment is largely supportive with artificial tears, cold compresses, and good hand hygiene. Antiviral therapy is reserved for cases of varicella-zoster and herpes simplex infection. Patients in whom appropriate therapy fails or corneal involvement develops should be referred to an ophthalmologist.

12. Allergic conjunctivitis is an eye inflammation caused by an allergic reaction to substances like pollen or mold spores. • Usually bilateral. • Acute allergic conjunctivitis • This is a short-term condition that is more common during allergy season. Your eyelids suddenly swell, itch, and burn. You may also have a watery nose. • Chronic allergic conjunctivitis • A less common condition called chronic allergic conjunctivitis can occur year-round. It is a milder response to allergens like food, dust, and animal dander. Common symptoms come and go but include burning and itching of the eyes and light sensitivity.

13. Treatment measures • an oral or over-the-counter antihistamine to reduce or block histamine release • anti-inflammatory or anti-inflammation eye drops • steroid eye drops • avoid exposure to harsh chemicals, dyes, and perfumes

19. Chalazions are lipogranulomas of either a meibomian gland or a Zeis gland. They develop when lipid breakdown products leak into the surrounding tissues from either bacterial enzymes or retained sebaceous secretions and incite a granulomatous inflammatory reaction. On examination, chalazions appear as single, firm, nontender nodules deep within the lid or tarsal plate (shown). They are more common on the upper vs lower lid because of the increased number and length of meibomian glands on the upper lid. Eversion of the eyelid may show a dilated meibomian gland.

21. A hordeolum is an acute focal infection involving the glands of Zeis, referred to as a stye or external hordeola (shown), or the meibomian glands, referred to as an internal hordeola. Hordeolums are an acute, focal infectious process, while chalazions are a chronic, noninfectious granulomatous reaction. Hordeola are focal abscesses of polymorphonuclear leukocytes and necrotic debris with symptoms of pain, warm, swelling, and edema. Infections are typically self-limited and will either spontaneously rupture and drain or be absorbed within 1-2 weeks. Conservative therapy involves eyelid hygiene, warm compresses, and massage, with topical antibiotics for associated blepharoconjunctivitis or active drainage. Systemic antibiotics are reserved for the development of preseptal cellulitis. Surgical incision and drainage is indicated for cases refractory to medical therapy or for very large hordeolums.

23. Blepharitis is inflammation of the eyelid, usually from bacterial colonization. It can be divided into anterior (eyelashes and follicles) or posterior (meibomian gland orifices) inflammation. Blepharitis is often associated with systemic diseases such as rosacea or seborrheic dermatitis. Patients typically report burning, watering, foreign body sensation, photophobia, pain, decreased vision, and erythema. Physical examination findings are typically depending on the underlying systemic process, but erythema and crusting are common findings. The image shown is from a patient with ocular rosacea and shows eyelid telangiectasias (yellow arrow) and inspissatedmeibomian glands (white arrow). Treatment consists of eyelid hygiene, lubricant eye drops, systemic antibiotics for refractory cases, and the discriminate use of steroids in case of ulcers or conjunctivitis.

25. Subconjunctival hemorrhages are very common ocular findings. They are caused by bleeding between the conjunctiva and the sclera. They may be traumatic, spontaneous, or secondary to a systemic illness (bleeding disorder, hypertension, febrile infections). The hemorrhages are typically asymptomatic and do not require any treatment. For patients with mild irritation, artificial tears can be used. The elective use of aspirin and nonsteroidal anti-inflammatory drugs is discouraged for refractive cases.

27. A pterygium is an elevated, superficial, external ocular mass that forms over the perilimbal conjunctiva and extends onto the corneal surface. Pterygia are caused by collagen degeneration and fibrovascular proliferation. Increased exposure to ultraviolet light is a risk factor. Clinically, patients may be asymptomatic, or complain of symptoms related to the elevation of the conjunctiva such as redness, itching, blurred vision, and irritation. Patients are typically observed without intervention unless there is significant discomfort or obstruction of the visual axis

29. Trichiasis is a condition in which the eyelid turns inward and eyelashes rub against the eye. usually seen in elderlies. If left untreated, it may lead to corneal abrasions, corneal scarring, microbial keratitis, and loss of vision. Diagnosis is made by direct visualization of the eyelid, with eversion of the lid to reveal hidden lashes. In the image shown, trichiasis has caused corneal scarring and loss of vision. Conservative treatment involves plucking the offending eyelashes and administering lubricant drops, but many patients will require surgery to either destroy or reposition the lash and follicle.

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