Infections eye (infeksi mata)

8/17/2019 Infections eye (infeksi mata)

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INFECTIONS

T SITI HARILZA ZUBAIDAH


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Infections

• Stye (External Horeol!"#

– Infecte oil $lan at t%e li "ar$in

– Treat"ent&

• 'ar" co"resses

• Eryt%ro"ycin oint"ent for )*+, ays


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Stye


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Infections

• C%ala-ion (Internal Horeol!"#

– Infecte "ei.o"ian $lan (ac!te orc%ronic#

– Treat"ent& sa"e as stye

• 'ar" Co"resses

• Eryt%ro"ycin oint"ent for )*+, ays

• /LUS& Doxycycline for +0*1+ ays inrefractory cases

• Refer to o%t%al"olo$y for ersistent cases


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C%ala-ion


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C%ala-ion


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Infections

• Con2!ncti3itis

• Bacterial

– Eyelas% "attin$4 "!co!r!lent isc%ar$e4

con2!ncti3al in5a""ation (6it%o!t corneallesions#

– Treat"ent& toical anti.iotics• A!lts& Tri"et%ori"*oly"ixin B or eryt%ro"ycin ros

•

Infants& S!lfaceta"ie +,7 – Contact lens 6earers& nee to co3er Pseudomonas

• Ciro4 o5oxacin4 or to.ra"ycin toical co3era$e


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Bacterial Con2!ncti3itis


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Infections

• Con2!ncti3itis

• Bacterial

– If se3ere !r!lent isc%ar$e an %yerac!te

onset (+1*10 %o!rs#4 nee ro"t o%t%o e3alfor 6or8*! of Gonococcal conjunctivitis


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9onococcal Con2!ncti3itis


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Infections

• Con2!ncti3itis

• :iral• ;onoc!lar


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Infections

• Con2!ncti3itis

• Aller$ic – ;onoc!lar


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Infections

• Heres Si"lex :ir!s – Classic& Denritic eit%elial efect

– ED care eens on t%e site of infection• Eyeli an con2!ncti3a

– Toical anti3irals (tri5!orot%y"iine ros ays of infection& Acyclo3ir


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Infections

• Heres Zoster O%t%al"ic!s

– S%in$les 6it% tri$e"inal istri.!tion4 oc!larin3ol3e"ent4 conc!rrent iritis

– ?/se!oentrite@• ;!co!s corneal la!e 6it% eit%elial erosion

– Treat"ent&• Acyclo3ir

• Toical anti3irals

• 'ar" co"resses

• Oral anal$esics or cyclole$ics for ain relief

– O%t%al"olo$y cons!lt "anatory


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Pseudodentrite


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Infections

• /erior.ital Cell!litis (/resetalCell!litis#

– 'ar"4 in!rate4 eryt%e"ato!s eyelis

only – Treat"ent&

• A!$"entin (if oler t%an years# if non*toxic

• Toxic aearin$4 co"or.iities4 yo!n$er t%an – Hosital a"ission for I: Ceftriaxone


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Infections

• Or.ital Cell!litis (/ostsetal Cell!litis#

– 'ar"4 in!rate4 eryt%e"ato!s eyelis only

– Fe3er4 toxicity4 rotosis4 ainf!l oc!lar

"otility4 li"ite oc!lar exc!rsion – Dia$nosis&

• e"er$ent or.ital an sin!s t%in*slice CT 6


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Infections


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Infections

• Corneal Ulcer

– /ain4reness4 %oto%o.ia

– Etiolo$y& esiccation4 tra!"a4 irect in3asion4

contact lens !se – Slitla" exa"&

• Stainin$ corneal efect 6it% %a-y in=ltrate4

• Hyoon

– Treat"ent&• Toical o5oxacin or ciro ros e3ery %o!r

• Toical cyclole$ia

• Ot%o e3al 6it%in 10 %o!rs


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Hyoon


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Tra!"atic Eye In2!ries

• S!.con2!ncti3al He"orr%a$e – Disr!tion of con2!ncti3al .loo 3essel

– Etiolo$y

• Tra!"a• Snee-in$

• 9a$$in$

• :alsal3a

– 'ill resol3e sontaneo!sly 6it%in 1 6ee8sIf ense4 circ!"ferential .looy c%e"osis

is resent4 "!st r!le o!t $lo.e r!t!re


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• Con2!ncti3al A.rasion

– S!er=cial a.rasions

• Treat"ent& 1*> ays of eryt%ro"ycin

oint"ent

– Oc!lar forei$n .oy s%o!l .e excl!e


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• Corneal A.rasion

– Tearin$4 %oto%o.ia4 .le%arosas"4 se3ere ain

– Fl!orescein& ye !ta8e at efect site

–R!le o!t forei$n .oy

– Treat"ent&• Cyclole$ic

• Toical To.ra"ycin4 Eryt%ro"ycin4 or

Bacitracin


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• Corneal Forei$n Boies

– ;ay .e re"o3e 6it% =ne neele ti4 eye s!4or eye .!rr after toical anest%etic alie

– T%en treat as a corneal a.rasion

– Dee corneal sto"a FB or t%ose in central3is!al axis re!ire o%t%o cons!lt for re"o3al

– R!st rin$s can .e re"o3e 6it% eye .!rr4 .!t

not !r$ent – Ot%o follo6 ! in 10 %o!rs for resi!al r!st or

ee stro"al in3ol3e"ent


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• Li Lacerations

– ;!st excl!e a"a$e to eye annasolacri"al syste"

– Fl!orescein stainin$ in t%e tear layert%at aear in t%e a2acent lac con=r"nasolacri"al in3ol3e"ent

– ;ost re!ire o%t%o cons!lt


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• Bl!nt Tra!"a

– I""eiately assess inte$rity of $lo.ean 3is!al ac!ity

– E3al et% of anterior c%a".er4 !ilsi-e4 "onoc!lar .linness r!t!re$lo.e


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• Hy%e"a


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• Hy%e"a – Bloo in t%e anterior c%a".er – Sontaneo!s or ost*tra!"a – Treat"ent&

• /lace t%e t !ri$%t to allo6 inferior settlin$ of .loo• Excl!e r!t!re $lo.e• Dilate t%e !il 6it% atroine• ;eas!re intraoc!lar ress!re if >, ""H$ aly

toical Ti"olol

• E"er$ent Ot%o e3al


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• Hy%e"a

– Ris8 for 6orse re.lee in t%e next 1*ays is 3ery %i$%


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• Blo6o!t Fract!res

– Inferior an "eial 6all "ost at ris8

– E3al!ate for•

inferior rect!s entra"ent (iloia on !6ar $a-e#• infraor.ital ner3e arest%esia

• s!.c!taneo!s e"%yse"a (6%en .lo6in$ t%e nose#

– Or.ital c!t CT scan

–

Treat"ent& r!le o!t oc!lar tra!"a an $i3e oralGe5ex

– Isolate .lo6o!t fract!re o%t%o e3al in > +,ays


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• Blo6o!t Fract!res


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• /enetratin$ Tra!"a


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• C%e"ical Oc!lar In2!ry

– Aci or al8ali treat t%e sa"e

– I""eiately 5!s% (at t%e scene#

– Contin!e to 5!s% !ntil H is nor"al ()J,#

• C%ec8 6it% !rine istic8

– Rec%ec8 H after s6eein$ t%e fornices

for retaine articles – ;eas!re IO/


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• C%e"ical Oc!lar In2!ry

– Treat"ent&

• Cyclole$ic

• Eryt%ro"ycin oint"ent

• Narcotic ain "es

• Tetan!s

–

I""eiate o%t%o e3al if not co"letelynor"al after initial "eas!res


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• Cra-y 9l!eK

– In2!ry occ!rs only as a res!lt of %ararticles t%at for" after ryin$

– O%t%o !ses cra-y $l!e as treat"ent inclinic

– Treat"ent&

• Eryt%ro"ycin oint"ent

• Re"o3e ieces t%at are easy to re"o3e

• Ot%o can re"o3e resi!al $l!e 6it%in 0%o!rs


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• Cra-y 9l!eK

– ;ineral oil "ay %el searate t%e lis

– Ne3er !se acetone or ot%er s!.stance

t%at .rea8s ! $l!e


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Ac!te :ision Loss

• Ac!te An$le Clos!re 9la!co"a

– Eye ain4 %eaac%e4 clo!y 3ision4colore %alos aro!n li$%ts4 con2!ncti3al

in2ection – Fixe4 "i*ilate !il

– Increase IO/ (0,*), "" H$#

•Nor"al ran$e is +, 1, "" H$

– Na!sea4 3o"itin$


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Ac!te :ision Loss

• Ac!te An$le Clos!re 9la!co"a


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Ac!te :ision Loss

• Ac!te An$le Clos!re 9la!co"a – I""eiate treat"ent&

• Ti"olol

• Aracloniine

• /renisolone acetate – If IO/ , "" H$ or se3ere 3ision loss&

• Aceta-ola"ie ,,"$ I:

– If no ecrease in IO/ or 3ision i"ro3e"ent&• I: ;annitol

– /ilocarine +*17 in aMecte eye4 ilocarine,J7 in contralateral eye (after IO/ 0, "" H$#

– I""eiate O%t%o cons!lt


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Ac!te :ision Loss

• Otic Ne!ritis

– In5a""ation of t%e otic ner3e

• Infection4 e"yelination4 a!toi""!ne x

– /resentation&• :ision re!ction (oor color ercetion#

• /ain 6it% extraoc!lar "o3e"ent

•

AMerent !illary efect – S6ellin$ of t%e otic isc "ay .e seen


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Ac!te :ision Loss

• Otic Ne!ritis


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Ac!te :ision Loss

• Otic Ne!ritis

– Dia$nosis

• Re Desat!ration Test

– Stare at .ri$%t re o.2ect 6it% nor"al eye only – O.2ect 6ill aear in8 or li$%t re in aMecte eye

– Treat"ent

• Disc!ss 6it% O%t%o


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Ac!te :ision Loss

• Central Retinal Artery Occl!sion

– Ca!ses• T%ro".osis4 e".ol!s4 $iant cell arteritis4 3asc!litis4

sic8le cell isease4 tra!"a

– /recee .y a"a!rosis f!$ax

– /ainless 3ision loss• ;ay .e co"lete or artial

– AMerent !illary efect

– /ale f!n!s 6it% narro6e arterioles anse$"ente 5o6s (.oxcars# an .ri$%t re"ac!la (c%erry re sot#


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Ac!te :ision Loss

• Central Retinal Artery Occl!sion

– Treat"ent&

• Oc!lar "assa$eK

– + secons of irect ress!re 6it% s!en release

• Toical ti"olol or I: aceta-ola"ie

• E"er$ent Ot%o e3al


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Ac!te :ision Loss

• Central Retinal :ein Occl!sion

– T%ro".osis i!retics an oralcontraceti3es reisose

– /ainless4 rai "onoc!lar 3ision loss – F!noscoy&

• DiM!se retinal %e"orr%a$e

•Cotton 6ool sots

• Otic isc ee"a

• ?Bloo an t%!ner@


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Ac!te :ision Loss



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Ac!te :ision Loss


– Treat"ent&

• ASA >1

• O%t%o referral


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Ac!te :ision Loss

• Te"oral Arteritis (9iant CellArteritis#

– Syste"ic 3asc!litis t%at can ca!se

isc%e"ic otic ne!roat%y – Us!ally

• , years ol

•Fe"ale

• /oly"yal$ia r%e!"atica


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Ac!te :ision Loss

• Te"oral Arteritis (9iant Cell Arteritis#

– /resentation&

• Heaac%e

• a6 cla!ication• ;yal$ias4 fati$!e

• Fe3er4 anorexia

• Te"oral artery tenerness

• TIA or stro8e

• AMerent !illary efect


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Ac!te :ision Loss


– Dia$nosis

• Dont 6aste yo!r ti"e if yo! s!sectia$nosis

• ESR4 CR/

• Te"oral artery .iosy ($ol stanar#

– Treat"ent

• I: sterois an O%t%o cons!lt


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Ac!te :ision Loss



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Infections eye (infeksi mata)

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