Corneal disorders and inflammatory

Bacterial Keratitis

An acute corneal infection, most commonly caused by contact lens wear, presenting with a white/grey corneal infiltrate and a hypopyon.

Dendritic Ulcer

A pathognomonic, branching corneal ulcer caused by Herpes Simplex Virus type 1 (HSV-1).

Acanthamoeba Keratitis

A rare, aggressive corneal infection caused by a tap water or swimming pool organism contaminating contact lenses, characterized by severe pain out of proportion to clinical signs.

Ring Infiltrate

A classic, late-stage corneal finding indicating advanced Acanthamoeba keratitis and extensive corneal damage.

Penetrating Keratoplasty (PKP)

A full-thickness corneal transplant graft used as the gold standard for severe stromal disease, which carries a long recovery time and the highest risk of graft rejection.

DSAEK / DMEK

Selective endothelial corneal transplants that replace only the inner layer of the cornea, offering faster recovery and lower rejection risks.

RSVP Rejection Signs

The critical acronym taught to corneal graft patients indicating potential emergency graft rejection: Redness, Sensitivity to light, Vision decrease, and Pain.

Bacterial Conjunctivitis

A highly contagious conjunctival infection characterized by mucopurulent (yellow/sticky) discharge and crusting that sticks the eyelids shut.

Viral Conjunctivitis

A highly contagious adenoviral eye infection characterized by watery discharge, a foreign body sensation, and an enlarged pre-auricular lymph node.

Allergic Conjunctivitis

A bilateral, non-infectious conjunctival inflammation where intense itching is the predominant symptom, accompanied by stringy mucoid discharge and chemosis.

Pre-Septal Cellulitis

A localized periorbital skin infection located anterior to the orbital septum that causes eyelid swelling and redness, but preserves normal eye movement and vision.

Orbital Cellulitis

A severe medical emergency involving infection post-septal (behind the orbital septum) within the orbit contents, causing proptosis, reduced vision, and pain on eye movement.

Uveitis

An inflammation of the eye's uveal tract that can affect the iris, ciliary body, or choroid, frequently associated with underlying systemic diseases.

Posterior Synechiae

An abnormal adhesion of the iris to the anterior lens capsule, which distorts the pupil and can block aqueous drainage, causing secondary angle-closure glaucoma.

Hypopyon

An accumulation of inflammatory cells and pus that settles in the lower portion of the anterior chamber, indicating severe intraocular inflammation or spreading infection.

What is the number one cause of bacterial keratitis, and what are the primary causative organisms?

Contact lens wear is the primary cause, with Pseudomonas (especially in soft lens users) and Staphylococcus being the main organisms.

Why is eye patching strictly forbidden in cases of suspected bacterial keratitis or corneal ulcers?

Patching creates a warm, moist, and dark environment that accelerates bacterial growth and increases the risk of corneal perforation.

What major patient education rules must a nurse teach contact lens wearers to prevent Acanthamoeba keratitis?

Never rinse lenses in tap water, never shower or swim while wearing lenses, use only sterile solution, and replace the lens storage case every 3 months.

What are the primary clinical features that differentiate a dangerous orbital cellulitis from a pre-septal cellulitis?

Orbital cellulitis presents with proptosis (bulging eye), pain during extraocular muscle movements, double vision (diplopia), and reduced visual acuity.

What underlying systemic disease and genetic marker are highly associated with recurrent anterior uveitis (iritis)?

Ankylosing spondylitis (along with IBD and psoriasis) and the HLA-B27 genetic allele are heavily associated with anterior uveitis flares.

What dual topical pharmacological therapies are required to treat anterior uveitis, and what is the nurse's priority monitoring parameter?

Treatment requires topical steroids to reduce inflammation and mydriatics to dilate the pupil and prevent synechiae; the priority nursing action is monitoring IOP at every visit due to steroid-induced glaucoma risks.

What immediate nursing interventions are required when a contact lens user presents with a central white corneal infiltrate and a hypopyon?

Remove the contact lens immediately, document baseline visual acuity, do not patch the eye, and facilitate an urgent, same-day referral to an ophthalmologist.

What are the priority hourly nursing assessments and life-threatening complications to watch for in a child hospitalized with orbital cellulitis?

Perform hourly assessments of visual acuity, extraocular movements, and pupillary responses; closely monitor for life-threatening complications like cavernous sinus thrombosis, meningitis, and brain abscesses.

Why can a TNF inhibitor like etanercept affect the clinical management of a patient experiencing recurrent anterior uveitis?

Etanercept is paradoxically associated with triggering uveitis flares; coordination between rheumatology and ophthalmology is necessary to potentially switch the patient to a different agent like adalimumab.

What infection control measures and school/work restrictions apply to a patient diagnosed with viral (adenoviral) conjunctivitis?

The patient must practice strict hand hygiene, use separate towels, disinfect touched surfaces, and stay home from work or school for 7 to 10 days due to epidemic spread.