The cornea is the clear layer that covers your pupil and iris. Keratitis results from either an infection bacterial, viral, fungal, or parasitic or an eye injury. See your doctor as soon as possible to stop the infection if you notice any keratitis symptoms. Some treatments for keratitis include:.
Endophthalmitis is severe inflammation of the inside of your eye resulting from a bacterial or fungal infection. Candida fungal infections are the most common cause of endophthalmitis. This condition can happen after certain eye surgeries, such as cataract surgery, although this is rare. It may also happen after your eye is penetrated by an object.
Some symptoms to watch out for, especially after surgery or an eye injury, include:. You may also receive a corticosteroid shot to relieve inflammation.
Seek emergency medical attention in these cases — never try to remove an object from your eye by yourself. Blepharitis is an inflammation of your eyelids, the skin folds covering your eyes.
This type of inflammation is usually caused by clogging of the oil glands inside the eyelid skin at the base of your eyelashes. Blepharitis may be caused by bacteria. A sty also called a hordeolum is a pimple-like bump that develops from an oil gland on the outer edges of your eyelids.
These glands can get clogged with dead skin, oils, and other matter and allow bacteria to overgrow in your gland. The resulting infection causes a sty. See your doctor if the pain or swelling gets worse, even with treatment. A sty should disappear in about 7 to 10 days.
Uveitis happens when your uvea gets inflamed from infection. The uvea is the central layer of your eyeball that transports blood to your retina — the part of your eye that transmits images to your brain. Most cases of chlamydial conjunctivitis are unilateral and have concurrent genital infection. Symptoms usually include conjunctival hyperemia, mucopurulent discharge and lymphoid follicle formation.
Oral antibiotics such as azithromycin or doxycycline are effective treatments. Infection of the cornea microbial keratitis is an ophthalmic emergency requiring immediate attention as it can progress rapidly.
It is a significant cause of corneal blindness 8 and is one of the most common causes of visual impairment in working age adults. If infectious keratitis is suspected, the practitioner should take a history to look for risk factors such as contact lenses, corneal abrasions, physical and chemical trauma, refractive surgery, diabetes, immunosuppressive diseases and topical steroids.
Bacterial infection is the most common cause of infectious keratitis. Common causal bacteria include S. Less commonly, fungi or acanthamoeba can be responsible. Suspect acanthamoeba if a patient has been swimming or in a spa while wearing contact lenses. Specific antifungal or anti-acanthamoebal therapy is needed and treatment may take some months. The signs and symptoms of bacterial keratitis are shown in the Table and Fig.
These scrapings are sent for Gram stain and culture to identify the organism. To begin, treatment has to be empiric because the results can take over 48 hours, and the condition can progress rapidly with loss of vision or even the eye if treatment is not started. Topical antibiotics are the mainstay of treatment and options include monotherapy with fluoroquinolones ciprofloxacin 0.
Compared to ofloxacin, ciprofloxacin increases the risk of white corneal precipitates. Chloramphenicol is the most common first-line antibiotic prescribed for red eye.
It is a bacteriostatic broad-spectrum antibiotic but lacks activity against P. Keratitis caused by herpes simplex virus is an important cause of infectious blindness in developed countries. The global incidence of herpes simplex keratitis was calculated at approximately 1.
If suspected, the practitioner should ask about a history of cold sores or previous viral keratitis as this can be the first clue to the diagnosis. The clinical features of herpes simplex virus keratitis Table can be identified on slit lamp examination. Epithelial herpes simplex keratitis typically manifests as a dendritic ulcer.
To visualise the ulcer, fluorescein staining and a cobalt blue light are needed Fig. Stromal herpes simplex keratitis presents with haze or opacity of the stroma, with or without ulceration, scarring or vascularisation. Endothelial keratitis is characterised by keratitic precipitates on the endothelium and corneal oedema. Endophthalmitis is an inflammation inside the eye that can be caused by infection with microbes, including bacteria or fungi Fig.
The Table lists the clinical features. Endophthalmitis is an ocular emergency, requiring urgent referral to an ophthalmologist to prevent permanent loss of vision.
It is a rare condition and its incidence depends on the cause. Risk factors for endophthalmitis include cataract surgery, intravitreal injections for age-related macular degeneration , trauma, filtering bleb for glaucoma , corneal infection, bacteraemia or fungemia. Endophthalmitis due to systemic infection may be associated with intravenous drug use.
Worldwide, cataract surgery is the most common cause of endophthalmitis, occurring in around 1 in cases. The incidence of endophthalmitis following intravitreal injections is increasing along with the widespread use of intravitreal antivascular endothelial growth factors for managing neovascular age-related macular degeneration and diabetic retinopathy.
The risk of endophthalmitis is 0. Typically, patients present within five days of the injection with decreased vision and pain. The most common microorganisms involved are coagulase-negative staphylococci, S. A minor procedure is needed to obtain samples of vitreous and aqueous humour to isolate the organism. Urgent treatment is needed with intravitreal antibiotics such as ceftazidime or vancomycin injected by an ophthalmologist.
In some cases vitrectomy may be beneficial to avoid loss of vision. Bacterial infections are typically treated with antibiotic drops which may cause systemic adverse effects. The volume of commercial dispensers 25—50 microlitres exceeds the capacity of the conjunctival sac 10 microlitres , therefore a large volume of the liquid drains out of the eye. This liquid may be systemically absorbed through different pathways including conjunctiva, nose, lacrimal drainage, pharynx, gastrointestinal tract, aqueous humour, lids, cheeks and inner ocular tissues.
A minimal dose and concentration of the antibiotic must be used in pregnancy to limit systemic absorption. Patients must be advised of punctual occlusion, nasolacrimal pressure and wiping away extra liquid to prevent systemic absorption. Antibiotics and antivirals such as chloramphenicol, tobramycin, fluoroquinolones and topical aciclovir are considered safe to use during pregnancy.
Patients with eye infections typically present with pain, blurred vision and a red eye. Conjunctivitis is the most common eye infection to present to primary healthcare providers and rarely threatens vision. Corneal infection keratitis and endophthalmitis are less common but pose a serious risk to vision.
If the patient has a history of blurred vision, pain, photophobia, corneal opacity or hypopyon, specialist assessment is urgently needed. Primary healthcare providers should avoid prescribing topical antibiotics for an eye infection unless the patient has bacterial conjunctivitis. Viral conjunctivitis is common and self-limiting.
Urgent referral to an ophthalmologist for microbiological samples and treatment is needed for infectious keratitis and endophthalmitis. Conflict of interest: The authors have received financial support from the Sydney Eye Hospital Foundation. National Center for Biotechnology Information , U. Journal List Aust Prescr v. Aust Prescr. Published online Jun 1. Author information Article notes Copyright and License information Disclaimer.
Keywords: conjunctivitis, endophthalmitis, eye infection, keratitis. This article has been cited by other articles in PMC. Introduction Eye infections are a common presenting problem in primary care. Infectious conjunctivitis Conjunctivitis is a common condition that causes dilation of the conjunctival blood vessels and results in inflammation. Several viruses and bacteria can cause conjunctivitis pink eye , some of which are very contagious. Each of these types of germs can spread from person to person in different ways.
They usually spread from an infected person to others through. However, if you still have symptoms, and your activities at work or school include close contact with other people, you should not attend.
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