Eye + Ear infection

Define conjunctivitis and list its main etiologies.

Inflammation/redness of the conjunctiva. Etiologies: infectious (bacterial, viral) and non-infectious (allergic; irritants such as chlorine, shampoo, chemicals, makeup, smoke).

Common bacterial pathogens causing conjunctivitis.

Staphylococcus species, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.

Neonatal conjunctivitis—key pathogens and transmission.

Chlamydia trachomatis and Neisseria gonorrhoeae. Transmission during passage through infected birth canal; mother may be asymptomatic.

Typical causative virus for “pink eye” and other viral causes.

Most common: adenovirus. Others: herpes simplex virus (HSV), varicella-zoster virus (VZV), picornaviruses.

Allergic conjunctivitis—common triggers.

Seasonal pollens/flowers; perennial allergens (dust mites); irritants (chlorinated water, shampoo, chemicals, makeup, smoke).

Bacterial vs viral vs allergic conjunctivitis—discharge characteristics.

Bacterial: viscous/mucopurulent. Viral: watery/serous. Allergic: watery/tearing.

Bacterial vs viral vs allergic conjunctivitis—laterality and feel.

Bacterial: unilateral then may spread; sore/gritty. Viral: often starts unilateral; irritation, red eye. Allergic: typically bilateral; intense itch.

First‑line antibiotic for uncomplicated bacterial conjunctivitis in community setting (per BNF).

Chloramphenicol (topical drops/ointment), when appropriate and no contraindications.

Chloramphenicol eye prep—common adverse effects.

Local discomfort/pain, transient blurred vision, itching/irritation; possible transient taste disturbance after instillation.

Key self‑care and hygiene advice for contagious conjunctivitis.

Hand hygiene; avoid touching/rubbing eyes; avoid makeup and discard items used during infection; avoid contact lenses; separate towels/linens; minimize eye‑to‑eye cross‑contamination.

Timeframe for reassessment in bacterial conjunctivitis after starting treatment.

If no improvement within 48 hours, seek GP review.

When to urgently refer conjunctivitis to GP/Eye clinic.

Age <2 years; affected/changed vision; deep‑seated eye pain; signs of cellulitis; severe photophobia; contact lens wearer with pain—consider keratitis risk.

Stye (hordeolum)—definition and typical cause.

Localized, painful, pus‑filled abscess of eyelid margin. ~90% due to Staphylococci from normal flora entering minor abrasions.

Stye—structures commonly involved.

Eyelash follicle (external or internal hordeolum), sebaceous (Zeis) or apocrine (Moll) glands.

Blepharitis—definition and key association.

Inflammation of eyelid rims; often linked to Staphylococci and skin conditions such as seborrhoeic dermatitis or rosacea.

Clinical clue distinguishing allergic conjunctivitis from infectious types.

Prominent itching and bilateral involvement strongly suggest allergic etiology.

Classic sign favoring bacterial over viral conjunctivitis on waking.

Lids stuck together with mucopurulent discharge/crusting.

Viral conjunctivitis—general course and management principle.

Usually self‑limiting; supportive care (lubricants, cold compresses, hygiene). Antibiotics not indicated unless secondary bacterial infection suspected.

Contact lens wearers with conjunctivitis—special consideration.

Avoid lenses during symptoms; higher risk of keratitis—low threshold for referral and consider Pseudomonas risk if severe pain/photophobia.

Public health message for conjunctivitis in community.

Highly contagious—emphasize hygiene, avoid sharing cosmetics/towels, and consider short absence from close‑contact settings during peak symptoms.

What anatomical landmark divides Otitis Externa from Otitis Media?

tympanic membrane

Which structures are affected in Otitis Externa?

pinna and external auditory canal

Which structures are affected in Otitis Media?

• Middle ear cavity

• Ossicles (malleus, incus, stapes)

• Eustachian tube

What is a key otoscopic sign of Otitis Media?

Bulging tympanic membrane

What are the functions of ear wax?

• Antimicrobial protection

• Traps debris

• Lubricates ear canal

What glands produce ear wax?

sebaceous glands

Management of excessive ear wax?

• Cerumenolytics

• Ear drops

• Syringing (mechanical removal)

Define Otitis Externa.

Inflammation/infection of the external auditory canal

Two most common bacterial causes of Otitis Externa?

• Pseudomonas aeruginosa

• Staphylococcus aureus

Why is Pseudomonas aeruginosa associated with swimming?

• Survives in water

• Resistant to disinfectants

• Thrives if chlorine is inadequate

Non-bacterial causes of Otitis Externa?

• Fungal infections

• Allergic reactions

First-line treatment for mild Otitis Externa?

Acetic acid ear drops (topical)

Second-line treatment for Otitis Externa?

Aminoglycoside + steroid ear drops

What is a key safety concern with aminoglycoside ear drops?

Ototoxicity if tympanic membrane is perforated

Duration of ear drop therapy for Otitis Externa?

7-14 days

Which population is most affected by Otitis Media?

<10 yrs

Three common bacterial causes of Otitis Media?

• Streptococcus pneumoniae

• Haemophilus influenzae

• Moraxella catarrhalis

Common viral causes of Otitis Media?

• RSV

• Rhinovirus

• Influenza

Why are children more prone to Otitis Media?

• Shorter, more horizontal Eustachian tubes

• Easier spread of respiratory infections

A child with a cold has ear pain and a bulging tympanic membrane. Diagnosis?

Otitis Media