Your eyes can get infections from bacteria, fungi or viruses.

Eye infections can occur

in different parts of the eye and can affect just one eye or both. Two common eye
infections are

I. Conjunctivitis - also known as pinkeye. Conjunctivitis is often due to an

infection. Children frequently get it, and it is very contagious.
II. Stye - a bump on the eyelid that happens when bacteria from your skin get
into the hair follicle of an eyelash.

I. CONJUCTIVITIS

a. What is conjunctivitis?

Conjunctivitis is the term used to describe swelling (inflammation) of the

conjunctiva — the thin, filmy membrane that covers the inside of your eyelids and
the white part of your eye (sclera). Conjunctivitis is often called “red” or “pink” eye
and “madras” eye in south India.

The conjunctiva, which contains tiny blood vessels, produces mucus to keep the
surface of your eye moist and protected. When the conjunctiva becomes irritated or
swollen, the blood vessels become larger and more prominent, making your eye
appear red. Conjunctivitis may occur in one or both eyes.

b. What causes conjunctivitis?

Many different sources of eye irritation can cause conjunctivitis. The most
common are:

• Infections (viral or bacterial);

• Allergies;
• Irritation from something in the environment.
Causative agents:

Bacterial

Children

• Streptococcus pneumonia
• Haemophilus influenza
• Staphylococcus species
• Moraxella species

Adults

• Gram-positive organisms- staphylococcus species, including s. aureus and

s. epidermidis, and other streptococcus species
• Gram-negative organisms- escherichia coli, pseudomonas species and
moraxella species

Viral

• Adenovirus (most common)

c. Types of conjunctivitis

Infective conjunctivitis
Infective conjunctivitis is caused by infection of your eye with bacteria or a virus.

Allergic conjunctivitis
Allergic conjunctivitis can be caused by an allergy, such as an allergy to pollen
(hay fever), house dust mites or cosmetics.

There are four types of allergic conjunctivitis:

• seasonal allergic conjunctivitis - this affects both of your eyes and people
often get it at the same time as hay fever
• perennial allergic conjunctivitis - people with this type of allergic
conjunctivitis have symptoms every day throughout the year in both eyes, often
on waking each morning
• contact dermatoconjunctivitis - this type of conjunctivitis can irritate your
eyelids and it occurs most often in people who use eye drops
• giant papillary conjunctivitis - this is common in people who use soft
contact lenses, although it can also occur in people using hard contact lenses
and after eye surgery

d. Who is at risk for conjunctivitis?

Conjunctivitis (pink eye) is a common condition that anyone is at risk of

contracting.

• The contagious forms of conjunctivitis are from bacteria and viral infections.
Children in daycare or school are often at risk for getting bacterial or viral
conjunctivitis since germs and viruses spread rapidly in these communal
settings.
• Newborn babies are at risk for conjunctivitis if they contract the bacterial
infection from making contact with the mother during the birth process.
• People who wear contact lenses are at risk for conjunctivitis due to poor
hygiene while handling lenses, solutions or cases. So are those who share
eye cosmetics with others.

Non-contagious conjunctivitis is caused by allergies or environmental

irritants. People with seasonal allergies are at risk for conjunctivitis, as are
people who are sensitive to chemicals, smoke or fumes.

e. How is conjunctivitis diagnosed?

• Eye axam
• Culture for analysis
 a. Bacterial conjunctivitis b. bacterial conjuctivitis

f. Symptoms and Manageme Preventio

Signs nt n

Type Symptoms and Signs Management Prevention

Bacterial Red eye Chloramphenicol 0.5% Personal hygiene:
Conjunctivitis Discharge of pus eye drops hand washing
Pain/Photophobia Gentamicin 0.3% eye Correct cleaning and
(especially if secondary drops disinfection of
corneal involvement) Tetracycline 1% eye instruments between
ointment examinations
Intensive instillation for Contact lens hygiene
first day or until
symptoms and signs
reduce
Viral Red eye Cold compresses to Personal hygiene:
Conjunctivitis Watery discharge relieve discomfort hand washing
Itch/Irritation Correct cleaning and
Subconjunctival disinfection of
haemorrhages instruments between
examinations
Allergic Red eye Reassurance Avoid allergens
Conjunctivitis Lacrimation +++ Antihistamines (eye
Itch/Irritation drops or orally)
Trantas spots Steroid eye drops
Cobblestones Cromolyn sodium 4%
Mucus build up eye drops
Lodoxamide 0.1% eye
drops
Bacterial:

• Sudden onset
• Often unilateral
• May progress to other eye in 2-5 days
• Typically resolves in two weeks without treatment
• Often clears in 48-72 hours with treatment

Conjunctivitis, whether bacterial or viral, can be quite contagious if it is infectious.

Practicing good hygiene can help prevent the spread of conjunctivitis if you are
infected. You should:

• Avoid reusing handkerchiefs and towels to wipe your face and eyes;
• Wash your hands often;
• Keep your hands away from your eyes;
• Get new eye cosmetics regularly, and do not share them with other people;

• Properly clean your contact lenses.

II. STYE

A. An external stye (pronounced /ˈstaɪ/) or hordeolum (/hɔrˈdiːələm/) is

an infection of the sebaceous glands of Zeis at the base of
the eyelashes, or an infection of the apocrine sweat glands of Moll.
External styes form on the outside of the lids and can be seen as small
red bumps. Internal styes are infections of the meibomian sebaceous
glands lining the inside of the eyelids. They also cause a red bump
underneath the lid with only generalized redness and swelling visible
on the outside. Styes can last from 1 to 2 weeks without treatment, or
as little as 4 days if treated properly.
 B. Styes are commonly caused by a Staphylococcus aureus bacterial
infection, or by the blocking of an oil gland at the base of the eyelash.
Although they are particularly common in infants, styes are
experienced by people of all ages. Styes can be triggered by poor
nutrition, sleep deprivation, lack of hygiene or rubbing of the eyes.
Sharing of washcloths or face towels should be curtailed to avoid
spreading the infection between individuals.

Symptoms

Redness, tenderness and pain are usually the first symptoms of a stye (though
eyelash styes are less painful and heal with less effort than eyelid styes). These are
followed by:

• Swelling in a small area or the entire eyelid

• The affected eye may water, feel irritated or be sensitive to light
• Discomfort when blinking
• A small yellowish spot (pointing) in the center of a sty, which occurs when
pus collects and expands. Pain is usually is relieved when the sty ruptures,
draining the pus.

Prevention

Wash your hands regularly and avoid touching your eyes to the spread of bacteria.
Avoid sharing eye makeup, especially if you’re prone to recurring styes.

Treatment

While an eyelash stye will usually drain on its own in approximately 2 days, a warm
compress can speeding healing. Apply a washcloth on the affected eye for 10
minutes, four times per day, to release the fluids that have built up inside the stye.
Do not squeeze the stye. Antibiotic ointment, or an antibiotic-steroid combination,
can be used until symptoms have cleared.
If the eyelash stye lasts more than 3 days or the infection appears to be spreading,
consult your eye doctor. You may have a chalazion or another condition that may
require further examination.

Eyelid styes are more stubborn and usually require treatment by a physician. They
may need to be lanced under sterile conditions. Oral antibiotics may be prescribed if
the stye is very large, abscessed or not responding to other treatment.

Contact lenses should not be worn during infection or drainage of a stye. Your
eyecare provider may recommend replacing your contact lenses after the stye has
healed to prevent recurrence or spread of the infection.

OTHER EYE INFECTIONS

1. KERATITIS (bacterial, fungal and viral)

 2. Blepharitis

3. Cholazions

I.KERATITIS

a. Keratitis is a condition in which the eye's cornea, the front part of the eye,
becomes inflamed. The condition is often marked by moderate to intense
pain and usually involves impaired eyesight.

Causes
o Bacterial infections
o Syphilis: Interstitial keratitis in syphilis may be due to an immune-
mediated reaction to an unknown treponemal antigen. Interstitial
keratitis may be seen in congenital and acquired syphilis.
o Mycobacterial infections: Tuberculosis and leprosy are two
mycobacterial infections that may be causative agents in the
pathogenesis of interstitial keratitis.
o Lyme disease:2 The causative organism in Lyme disease is the
spirochete Borrelia burgdorferi and is typically transmitted by the deer
tick vector, Ixodes.
o Viral infections
o Herpetic infections of the cornea comprise a myriad of clinical findings.
A complete discussion is beyond the scope of this section. Herpetic
stromal disease may take the form of interstitial keratitis and
represents an important entity in the differential diagnosis. Typical
findings of interstitial keratitis may be present along with an immune
ring, which may be diagnostic.
o Epstein-Barr virus also belongs to the herpes family of viruses and may
have variable presentation in corneal disease. Unilateral or bilateral,
multifocal or discrete infiltrates may be present, which may benefit
from topical corticosteroids.
o Mumps typically causes lacrimal gland inflammation, but cornea
involvement may occur with a variable presentation, ranging from
punctate epithelial keratopathy to nummular keratitis.
o Cornea involvement in measles is typically a superficial keratitis and is
generally self-limiting. However, measles has been associated with
vitamin A deficiency in malnutrition, and the combination of these
factors may promote stromal infiltration and perforation.

o Filamentous fungi

o Aspergillus fumigatus
o Fusarium spp.
 o Yeasts
o Candida

b. Treatment

Treatment depends on the cause of the keratitis. Infectious keratitis generally

requires antibacterial, antifungal, or antiviral therapy to treat the infection. This
treatment can involve prescription eye drops, pills, or even intravenous therapy.
Over-the-counter eye drops are typically not helpful in treating infections. In
addition, contact lens wearers are typically advised to discontinue contact lens wear
and discard contaminated contact lenses and contact lens cases.

Antibacterial solutions include Quixin (levofloxacin), Zymar (gatifloxacin), Vigamox

(moxifloxacin), Ocuflox (ofloxacin — available generically). Steroid containing
medications should not be used for bacterial infections, as they may exacerbate the
disease and lead to severe corneal ulceration and corneal perforation. These include
Maxitrol (neomycin+polymyxin+dexamethasone — available generically), as well as
other steroid medications.. One should consult an ophthalmologist or optometrist
for treatment of an eye condition.

Some infections may scar the cornea to limit vision. Others may result in perforation
of the cornea, (an infection inside the eye), or even loss of the eye. With proper
medical attention, infections can usually be successfully treated without long-term
visual loss.

Fungal keratitis
Bacterial keratitis viral keratitis

2.BLEPHARITIS

A. Blepharitis refers to chronic inflammation of the eyelids. Blepharitis is one of

the most common disorder of the eye and is often the underlying reason for eye
discomfort, redness and tearing.

There are 3 forms of blepharitis (staphylococcal, seborrheic and MGD). All three
forms of blepharitis are chronic in nature. Patients with staphylococcal blepharitis
are relatively young (mean age 42 years) with a short history of ocular symptoms
(mean 1.8 years). Patients with seborrheic blepharitis and MGD blepharitis are
generally older and have a longer history of ocular symptoms.

In staphylococcal blepharitis there is scaling and crusting along the eye

lashes. In seborrheic blepharitis there is greasy scaling along the eyelashes.
Patients frequently have seborrheic dermatitis as well. In Meibomian gland
dysfunction (MGD) there are prominent blood vessels crossing the eyelid margin. In
addition there is pouting or plugging of meibomian gland openings, and poor
expressibility and/or turbidity of the oily meibomian secretions. Patients with MGD
frequently are noted to have coexisting rosacea and seborrheic dermatitis
(Rosacea's Red Face ). Use of isotretinoin (Accutane), an oral medication for
severe cystic acne, has also been implicated as a cause of blepharitis.

b. Signs and eye symptoms of blepharitis include:

Burning, itching, light sensitivity, and an irritating, sandy, gritty sensation that is
worse upon awakening.

c. Blepharitis Treatment

Blepharitis is a chronic disease for which there is no cure, and requires long-term
treatment to keep it under control. Treatment consists of 2 phases (Acute phase
and Maintenance phase). Acute phase treatment involves intensive therapy to
rapidly bring the disease under control. In the maintenance phase the goal is to
indefinitely continue the minimum amount of therapy that is necessary to keep the
disease quiet. Herein we will not focus on the treatment of specific steroid
responsive complications of blepharitis like marginal ulcers and phlyctenules, as
they are less common and require specific diagnosis. We will focus on the
treatments that help control the blepharitis process itself. Needless to say,
controlling blepharitis itself, will reduce all the other blepharitis related
complications.
Warm Compresses followed by Lid Scrubs.

Antibiotic treatment
The use of an ointment on the eyelid margin immediately after lid scrubbing may
help to increase patient comfort. The choice here is usually Erythromycin eye
ointment or Tobradex eye ointment (steroid-antibiotic combination). In addition, the
antibiotics help to further reduce the bacterial load on the eyelids.
Oral tetracyclines (doxycycline or minocycline) for about 3 months can be
used in recalcitrant Meibomian Gland Dysfunction (MGD) cases. Tetracycline
antibiotics affect the meibomian gland secretions, inhibit bacterial lipases as well as
reduce the eyelid bacterial load.

3.cholazion

A chalazion pronounced /kəˈleɪziən/ (plural chalazia /kəˈleɪziə/), also known as

a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused
by inflammation of a blocked meibomian gland, usually on the upper eyelid.
Chalazia differ from styes (hordeola) in that they are subacute, nontender, and
usually painless nodules. They may become acutely inflamed but, unlike a stye, are
usually point inside the lid rather than on the lid margin. A chalazion or meibomian
cyst could take months to fully heal with treatment and could take years to heal
without any major complications.

Blepharitis cholazion
The protective outer layer of the eye, sometimes referred to as the “white of the
eye” is called the sclera and it maintains the shape of the eye. The front portion of
the sclera, called the cornea, is transparent and allows light to enter the eye. The
cornea is a powerful refracting surface, providing much of the eye's focusing power
(Cassin and Solomon, 1997). Attached to the sclera are six extraocular muscles
responsible for movement of the eyes (Bianco, 2002). The choroid is the second
layer of the eye and lies between the sclera and the retina. It contains the blood
vessels that provide nourishment to the outer layers of the retina (Cassin and
Solomon, 1997). The iris is the part of the eye that gives it color. It consists of
muscular tissue that responds to surrounding light, making the pupil, or circular
opening in the center of the iris, larger or smaller depending on the brightness of
the light (Pachler and Rizun, n.d.).
Light entering the pupil falls onto the lens of the eye where it is altered before
passing through to the retina. The lens is a transparent, biconvex structure,
encased in a thin transparent covering. The function of the lens is to refract and
focus incoming light onto the retina for processing (Moorfields Eye Hospital, 2002).
The retina is the innermost layer in the eye. It converts images into electrical
impulses that are sent along the optic nerve to the brain where the images are
interpreted. The retina can be compared to the film of a camera. It is composed of
light sensitive cells known as rods and cones interconnected by a complex mesh of
neurons that provide early stage visual processing. Rod cells are primarily in the
outer retina, do not discriminate colors, have low spatial resolution, support vision
in low light (“night vision”), are sensitive to object movement and provide
peripheral vision. Cone cells are densely packed within the central visual field,
function best in bright light, process acute images and discriminate colors
(Montgomery, 2002).
The macula is located in the back of the eye, in the center of the retina. Within the
macula is an area called the fovea centralis. This area contains the highest
concentration of cones, produces the sharpest vision, and is used to see details
clearly (Moorfields Eye Hospital, 2002).
The inside of the eyeball is divided by the lens into two fluid-filled sections. The
larger section at the back of the eye is filled with a colorless gelatinous mass called
the vitreous humor. The smaller section in the front contains a clear, water-like
material called aqueous humor (Discovery Fund for Eye Research, 1999). A
circular canal, called the Canal of Schlemm provides a drainage system for the
aqueous humor from the eye into the bloodstream. Blockages in the Canal of
Schlemm are believed to be contributing factors in the development of glaucoma
(Bianco, 2002).
The conjunctiva is a mucous membrane that begins at the edge of the cornea and
lines the inside surface of the eyelids and sclera, which serves to lubricate the eye.
Inflammation of this membrane results in conjunctivitis, commonly known as pink
eye (Bianco, 2002; Cassin and Solomon, 1997).
 MEDINA COLLEGE OZAMIS CITY

COLLEGE OF NURSING

COMMON EYE INFECTIONS

NCM 104 CD

1ST SEMESTER SY 2010-2011

SUBMITTED BY:

PALANAS, RODERIC

RACHO, ROY

RIVERA, CELERINA

ROSAL, MEGAN

SUBMITTED TO:

MS. MARINA JUNE COLCOL