Corneal & Conjunctival Disorders

staph, strep, pseudomonas

what are the most common organisms for bacterial keratitis &/or conjunctivitis in pediatric patients?

conjunctiva

what part of the eye does chlamydia primarily infect?

adult inclusion conjunctivitis

• serovars D & K

• spreads through hand-to-eye contact w/ infected genital secretions

• can be passed to newborn babies as the baby is born through the vaginal canal of the infected mother

1. mucous discharge

2. redness

3. lid swelling

4. diffuse papillary conjunctivitis

5. no follicles

6. rare corneal involvement

what are the ocular signs of chlamydia infection in neonatal infants?

T

T/F: ocular signs of chlamydia in the 1st 3wks of life are usually self-limiting

C trachomatis bacterium

what is the causative agent of trachoma conjunctivitis?

trachoma conjunctivitis

• 3rd leading cause of blindness worldwide

• serovars A, B, Ba, & C

• transmitted from infected individuals via direct eye-eye spread, hand-eye contact, contaminated objects, eye-seeking flies

• poor sanitation practices contribute

• females > males

• active form is most common in children under 10

• bacterium initiates infection by entering conjunctival epithelial cells & undergoes a biphasic developmental cycle

persistent keratoconjunctivitis characterized by conjunctival inflammation

describe the 1st phase pathophysiology of trachoma conjunctivitis

periods of intense conjunctival inflammation leading to lid scarring, trichiasis, & entropion

describe the 2nd phase pathophysiology of trachoma conjunctivitis

cell-mediated delayed (type 4) hypersensitivity

recurrent trachoma infection triggers a chronic immune response that manifests as a ____________

1. mixed follicular or papillary conjunctivitis

2. mucopurulent discharge

3. superior epithelial keratitis

4. corneal vascularization → pannus

describe active trachoma

1. stellate/linear conjunctival scars or broad confluent scars (Arlt line)

2. effects are most prominent in upper tarsal plate

3. Herbert pits form in superior limbus

4. trichiasis

5. distichiasis

6. corneal vascularization

7. entropion

8. severe corneal opacification

9. destruction of goblet cells & lacrimal gland ductules → dry eye

describe cicatricial trachoma

infection → inflammation → roughening → scarring of inner eyelid surface → trichiasis → corneal surface erosion

describe the pathophysiology of trachoma conjunctivitis

surgery, antibiotics, facial cleanliness, environmental improvement

what is the tx strategy for trachoma conjunctivitis?

azithromycin

what is the preferred antibiotic for trachoma conjunctivitis?

herpes simplex, varicella zoster, adenoviral

what are the potential causes of viral keratitis in pediatric patients?