Hordeolum: Internal and External Treatment

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Questions and Answers

What is the primary mode of transmission for trachomatis?

Vectors such as ticks

Direct contact between people

Eye-to-eye contact

Autoinoculation from genital secretions (correct)

What is the typical incubation period for trachomatis?

1 week (correct)

3-5 days

2-3 weeks

1-2 months

What is the primary cause of posterior blepharitis?

Bacterial growth due to poor eyelid hygiene

Viral infection of the eyelid

Dandruff of the scalp and eyebrows

Irregular oil production by glands of the eyelids (correct)

What is a common sign associated with trachomatis infection?

Pre-auricular adenopathy Signup and view all the answers

What is the most common cause of anterior blepharitis?

Bacterial infection, specifically Staphylococcus Signup and view all the answers

What is the primary factor associated with the spread of trachomatis?

Poor hygiene and poverty Signup and view all the answers

What does the 'F' in the WHO's SAFE strategy represent?

Face washing Signup and view all the answers

What is the term for inflammation of the tear sac?

Dacrocystitis Signup and view all the answers

What is the most important risk factor for bacterial keratitis?

Contact lens wear Signup and view all the answers

What is the term for inflammation of the eyelid?

Blepharitis Signup and view all the answers

What is the symptom of Staphylococcal anterior blepharitis?

Burning, grittiness, and mild photophobia Signup and view all the answers

What is the term for obstruction of the nasolacrimal duct?

Nasolacrimal Duct Obstruction Signup and view all the answers

What is the most common cause of dacrocystitis?

Staphylococcal infections Signup and view all the answers

What is the treatment for acute dacrocystitis?

Hot compresses and oral antibiotics Signup and view all the answers

What is the characteristic feature of canaliculitis?

Unilateral epiphora Signup and view all the answers

What is the most common causative organism of bacterial conjunctivitis in adults?

Haemophilus influenzae Signup and view all the answers

What is the treatment for canaliculitis?

Canaliculotomy involving a linear incision Signup and view all the answers

What is the characteristic symptom of bacterial conjunctivitis?

Acute onset of redness and discharge Signup and view all the answers

What is the cause of nasolacrimal duct obstruction?

Inflammation of the lacrimal duct Signup and view all the answers

What is the treatment for peri-orbital cellulitis?

Hospital admission and frequent ophthalmic and ENT assessment Signup and view all the answers

What is the characteristic sign of bacterial conjunctivitis?

Diffuse conjunctival injection and intense papillary reaction Signup and view all the answers

What is the cause of peri-orbital cellulitis?

All of the above Signup and view all the answers

Study Notes

Infectious Diseases of the Eye

Internal Hordeolum

Definition: Inflammation of the meibomian gland
Symptoms: Pain, swelling, and redness of the eyelid
Treatment:
- Hot compresses on the eye
- Oral antibiotics
- Remaining nodule removal by an ophthalmologist

External Hordeolum

Definition: Inflammation of the Zeis gland or Moll's gland
Symptoms: Pain, swelling, and redness of the eyelid
Treatment:
- Hot compresses to increase blood supply and aid spontaneous drainage
- Epilating eyelash associated with the infected hair follicle
- Topical antibiotics

Dacryocystitis

Definition: Inflammation of the lacrimal sac
Causes: Obstruction of the nasolacrimal duct, Staphylococcal/Streptococcal infections
Symptoms: Acute dacryocystitis presents with subacute pain, redness, swelling of the medial canthus, and epiphora
Treatment:
- Hot compresses
- Oral antibiotics (flucloxacillin or amoxicillin/clavulanate)
- Incision and drainage may be considered if pus points and the abscess is about to drain spontaneously

Canaliculitis

Definition: Inflammation of the canaliculus
Causes: Actinomyces, anaerobic bacteria that grow in obstructed canaliculi
Symptoms: Unilateral epiphora, chronic mucopurulent conjunctivitis
Treatment:
- Topical antibiotics (Ciprofloxacin)
- Canaliculotomy involving a linear incision into the conjunctival side of the canaliculus

Peri-Orbital Cellulitis

Definition: Infection of the soft tissue behind the orbital septum
Causes: Staphylococcus aureus, Streptococcus pyogenes, sinus infections, local spread, hematogenous spread
Symptoms: Rapid onset of severe malaise, fever, pain, and visual impairment
Complications: Ocular (exposure keratopathy, raised intraocular pressure, occlusion of the central retinal artery/vein), intracranial (meningitis, brain abscess, cavernous sinus thrombosis)
Treatment:
- Hospital admission with frequent ophthalmic and ENT assessment
- Antibiotic therapy
- Surgical intervention may be considered

Bacterial Conjunctivitis

Causes: Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, Neisseria gonorrhoeae, Chlamydia trachomatis
Symptoms: Acute onset of redness, grittiness, burning, and discharge
Signs: Diffuse conjunctival injection, intense papillary reaction, discharge (initially watery, later mucopurulent)

Ophthalmia Neonatorum

Causes: Sexually transmitted pathogens (Chlamydia trachomatis, Neisseria gonorrhoeae) from infected maternal birth canal
Symptoms: Redness, swelling, and discharge in newborns

Blepharitis

Definition: Inflammation of the eyelid margins
Causes: Bacterial (Staphylococcus), seborrheic blepharitis
Symptoms: Burning, grittiness, and mild photophobia with remissions and exacerbations

Trachoma

Definition: Chronic follicular kerato-conjunctivitis caused by Chlamydia trachomatis
Epidemiology: Associated with poverty, overcrowding, and poor hygiene
WHO's SAFE strategy: Surgery, Antibiotics, Face washing, Environment improvement

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Description

This quiz covers the management of internal and external hordeolum, including treatment options and procedures.