Phlyctenular Keratoconjunctivitis
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Phlyctenular Keratoconjunctivitis
Phlyctenular keratoconjunctivitis is an inflammatory syndrome caused by a delayed (aka type-IV) hypersensitivity reaction to one or more antigens. The triggering antigen is usually a bacterial protein (particularly from ''Staphylococcus aureus''), but may also be a virus, fungus (particularly ''Candida albicans''), or nematode. Symptoms * Irritation * Discomfort or pain * Foreign-body sensation * Tearing * Blepharospasm * Photophobia * Mucopurulent discharge (rarely) In cases where the cornea is affected, pain and photophobia are more likely, and corneal scarring can occur (potentially impairing vision). Presentation The syndrome is marked by the appearance of characteristic lesions, known as phlyctenules, on the cornea and/or conjunctiva. These usually manifest as small (1 - 3 or 1 - 4 mm) raised nodules, pinkish-white or yellow in color, which may ulcerate (or, more rarely, necrose) and are often surrounded by dilated blood vessels. Corneal lesions are usually triangular in ...
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Staphylococcus Aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe that can grow without the need for oxygen. Although ''S. aureus'' usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. ''S. aureus'' is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant ''S. aureus'' (MRSA ...
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Tobramycin/dexamethasone
Tobramycin/dexamethasone, sold under the brand name Tobradex, is a fixed-dose combination medication in the form of eye drops and eye ointment, marketed by Alcon. The active ingredients are tobramycin (an antibiotic) and dexamethasone (a corticosteroid). It is prescribed for the treatment of pink eye in combination with bacterial infections. Contraindications It is contraindicated with herpetic and other viral eye infections. Other contraindications include fungal and mycobacterial infections because tobramycin is inactive against those, and the corticoid acts as an immunosuppressive agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with corneal lesions. Side effects Similarly to other corticosteroid eye drops, side effects include hypersensitivity and, especially after long-term use, secondary eye infections, cataract (clouding of the eye lens) and increased intraocular pressure, leading to glaucoma. C ...
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Keratoconjunctivitis
Keratoconjunctivitis is inflammation ("-itis") of the cornea and conjunctiva. When only the cornea is inflamed, it is called ''keratitis''; when only the conjunctiva is inflamed, it is called ''conjunctivitis''. Causes There are several potential causes of the inflammation: * Keratoconjunctivitis sicca is used when the inflammation is due to dryness. ("Sicca" means "dryness" in medical contexts.) It occurs with 20% of rheumatoid arthritis patients. * The term " vernal keratoconjunctivitis" (VKC) is used to refer to keratoconjunctivitis occurring in spring, and is usually considered to be due to allergens. * "Atopic keratoconjunctivitis" is one manifestation of atopy. * "Epidemic keratoconjunctivitis" is caused by an adenovirus infection. * " Infectious bovine keratoconjunctivitis" (IBK) is a disease affecting cattle caused by the bacteria '' Moraxella bovis''. * "Pink eye in sheep and goat" is another infectious keratoconjunctivitis of veterinary concern, mostly caused by '' Chl ...
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Keratitis
Keratitis is a condition in which the eye's cornea, the clear dome on the front surface of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves any of the following symptoms: pain, impaired eyesight, photophobia (light sensitivity), red eye and a 'gritty' sensation. Classification (by chronicity) Acute * Acute epithelial keratitis * Nummular keratitis * Interstitial keratitis * Disciform keratitis Chronic * Neurotrophic keratitis * Mucous plaque keratitis Classification (infective) Viral * Herpes simplex keratitis (dendritic keratitis). Viral infection of the cornea is often caused by the herpes simplex virus (HSV) which frequently leaves what is called a 'dendritic ulcer'. * Herpes zoster keratitis, associated with herpes zoster ophthalmicus, which is a form of shingles. Bacterial * Bacterial keratitis. Bacterial infection of the cornea can follow from an injury or from wearing contact lenses. The bacteria involved ...
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Conjunctivitis
Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva, outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be "stuck shut" in the morning. Swelling of the sclera, white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes. The most common infectious causes are viral infection, viral followed by bacterial infection, bacterial. The viral infection may occur along with other symptoms of a common cold. Both viral and bacterial cases are easily spread between people. Allergies to pollen or animal hair are also a common cause. Diagnosis is often based on signs and symptoms. Occasionally, a sample of the discharge is sent for microbial culture, culture. Prevention is partly by handwashing. Treatment depends on the underlying c ...
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Allergic Conjunctivitis
Allergic conjunctivitis (AC) is inflammation of the conjunctiva (the membrane covering the white part of the eye) due to allergy. Although allergens differ among patients, the most common cause is hay fever. Symptoms consist of redness (mainly due to vasodilation of the peripheral small blood vessels), edema (swelling) of the conjunctiva, itching, and increased lacrimation (production of tears). If this is combined with rhinitis, the condition is termed allergic rhinoconjunctivitis (ARC). The symptoms are due to release of histamine and other active substances by mast cells, which stimulate dilation of blood vessels, irritate nerve endings, and increase secretion of tears. Treatment of allergic conjunctivitis is by avoiding the allergen (''e.g.'', avoiding grass in bloom during "hay fever season") and treatment with antihistamines, either topical (in the form of eye drops), or systemic (in the form of tablets). Antihistamines, medications that stabilize mast cells, and nonsteroida ...
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Blepharitis
Blepharitis is one of the most common ocular conditions characterized by inflammation, scaling, reddening, and crusting of the eyelid. This condition may also cause swelling, burning, itching, or a grainy sensation when introducing foreign objects or substances to the eye. Although blepharitis by itself is not sight-threatening, it can lead to permanent alterations of the eyelid margin. The primary cause is bacteria and inflammation from congested meibomian oil glands at the base of each eyelash. Other conditions may give rise to blepharitis, whether they be infectious or noninfectious, including, but not limited to, bacterial infections or allergies. Different variations of blepharitis can be classified as seborrheic, staphylococcal, mixed, posterior or meibomitis, or parasitic. In a survey of US ophthalmologists and optometrists, 37% to 47% of patients seen by those surveyed had signs of blepharitis, which can affect all ages and ethnic groups. One single-center study of 90 pati ...
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Sunglasses
Sunglasses or sun glasses (informally called shades or sunnies; more names below) are a form of protective eyewear designed primarily to prevent bright sunlight and high-energy visible light from damaging or discomforting the eyes. They can sometimes also function as a visual aid, as variously termed spectacles or glasses exist, featuring lenses that are colored, polarized or darkened. In the early 20th century, they were also known as sun cheaters (cheaters then being an American slang term for glasses). Since the 1930s, sunglasses have been a popular fashion accessory, especially on the beach. The American Optometric Association recommends wearing sunglasses that block ultraviolet radiation (UV) whenever a person is in the sunlight to protect the eyes from UV and blue light, which can cause several serious eye problems. Their usage is mandatory immediately after some surgical procedures, such as LASIK, and recommended for a certain time period in dusty areas, when leaving ...
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Pediatrics
Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the age of 18. The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25. Worldwide age limits of pediatrics have been trending upward year after year. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word ''pediatrics'' and its cognates mean "healer of children," derived from the two Greek words: (''pais'' "child") and (''iatros'' "doctor, healer"). Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties (e.g. neonatology requires resources available in a NICU). History The ear ...
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Erythromycin
Erythromycin is an antibiotic used for the treatment of a number of bacterial infections. This includes respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used during pregnancy to prevent Group B streptococcal infection in the newborn, as well as to improve delayed stomach emptying. It can be given intravenously and by mouth. An eye ointment is routinely recommended after delivery to prevent eye infections in the newborn. Common side effects include abdominal cramps, vomiting, and diarrhea. More serious side effects may include ''Clostridium difficile'' colitis, liver problems, prolonged QT, and allergic reactions. It is generally safe in those who are allergic to penicillin. Erythromycin also appears to be safe to use during pregnancy. While generally regarded as safe during breastfeeding, its use by the mother during the first two weeks of life may increase the risk of pyloric stenosis in th ...
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Doxycycline
Doxycycline is a broad-spectrum tetracycline class antibiotic used in the treatment of infections caused by bacteria and certain parasites. It is used to treat bacterial pneumonia, acne, chlamydia infections, Lyme disease, cholera, typhus, and syphilis. It is also used to prevent malaria in combination with quinine. Doxycycline may be taken by mouth or by injection into a vein. Common side effects include diarrhea, nausea, vomiting, abdominal pain, and an increased risk of sunburn. Use during pregnancy is not recommended. Like other agents of the tetracycline class, it either slows or kills bacteria by inhibiting protein production. It kills malaria by targeting a plastid organelle, the apicoplast. Doxycycline was patented in 1957 and came into commercial use in 1967. It is on the World Health Organization's List of Essential Medicines. Doxycycline is available as a generic medicine. In 2020, it was the 79th most commonly prescribed medication in the United States, with m ...
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Tetracycline Antibiotics
Tetracyclines are a group of broad-spectrum antibiotic compounds that have a common basic structure and are either isolated directly from several species of ''Streptomyces'' bacteria or produced semi-synthetically from those isolated compounds. Tetracycline molecules comprise a linear fused tetracyclic nucleus (rings designated A, B, C and D) to which a variety of functional groups are attached. Tetracyclines are named for their four ("tetra-") hydrocarbon rings ("-cycl-") derivation ("-ine"). They are defined as a subclass of polyketides, having an octahydrotetracene-2-carboxamide skeleton and are known as derivative (chemistry), derivatives of polycyclic naphthacene carboxamide. While all tetracyclines have a common structure, they differ from each other by the presence of chloride, methyl, and hydroxyl groups. These chemical modification, modifications do not change their broad antibacterial activity, but do affect pharmacological properties such as half-life and binding to prot ...
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