Sandbox ID Eye

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Conjunctivitis

  • Conjunctivitis, acute[1]
  • Bacterial conjunctivitis
  • Empiric antimicrobial therapy,
Note: Topical steroids are not recommended for bacterial conjunctivitis.
  • Pathogen-directed antimicrobial therapy
  • Chlamydia trachomatis
  • Inclusion conjunctivitis
  • Conjunctivitis secondary to trachoma
  • Neisseria gonorrhoeae
  • Hyperacute bacterial conjunctivitis, adult
Note: Dual therapy to cover Chlamydia is indicated.
  • Staphylococcus aureus, methicillin-resistant (MRSA)
  • Herpetic conjunctivitis
  • Herpes simplex virus
  • Preferred regimen: Acyclovir 1 drop topical 9 times per day OR Acyclovir 400 mg PO 5 times per day for 7-10 days OR Valacyclovir 500 mg PO tid for 7-10 days
Note: Topical steroids should be avoided.
  • Varicella zoster virus
Note: Treatment usually consists of a combination of oral antivirals and topical steroids.

Blepharitis

  • Empiric therapy
  • Blepharitis
Note (1): Cure is usually not possible with blepharitis. Eyelid hygiene may provide symptomatic relief for both anterior and posterior blepharitis.
Note (2): Cyclosporine topical drops 0.05% may be helpful in some patients with posterior blepharitis.
  • Specific considerations
  • Mebomian gland dysfunction :
Note (1): Tetracyclines are contraindicated in pregnancy, nursing women and those with history of hypersenstivity to Tetracycline
Note (2): Patients with contact-lens-associated giant papillary conjunctivitis have an increased frequency of mebomian gland dysfunction.
  • Dry eye
  • Preferred regimen: Cyclosporine topical and Omega-3 fatty acids two 1000 mg capsules tid per day
Note: Diet modification is helpful.
  • Deramtological conditions with seborrhiec blepharitis and mebomian gland dysfunction
Note: In some patients Azithromycin oral may lead to abnormalities in electrical activity of heart with the potential to create serious irregularities in heart rhythm
  • Demodicosis
Preferred regimen: Metronidazole gel to eyelid skin
Alternative regimen: Ivermectin oral in recalcitrant Demodex bleharitis
  • Ocular Rosacea
Note (1): In patients with chronic blepharitis that does not respond to therapy, the possibility of carcinoma should be considered, particularly if associated with a loss of eyelashes.
Note (2): Isotretinoin used to treat cystic acne is associated with significant increase in colonization of conjunctiva with Staphylococcus aureus blepharitis and disruption of trear function. Discontinuation of isotretinoin leads to improvement in most cases.

Endophthalmitis, bacterial

Endophthalmitis, bleb-related

Endophthalmitis, candidal

Endophthalmitis, chronic

Endophthalmitis, mold

Endophthalmitis, post-cataract surgery, acute

Endophthalmitis, post-cataract surgery, chronic

Endophthalmitis, post-tramatic

Keratitis, bacterial

Keratitis, fungal

Keratitis, protozoal

Keratitis, viral

Ocular syphilis

Ocular toxocariasis

Ocular toxoplasmosis

Ocular tuberculosis

Orbital cellulitis

Periocular Infection

Retinal necrosis, acute, CMV

Retinal necrosis, acute, HSV or VZV

Retinal necrosis, progressive outer, VZV

Retinitis, CMV

Stye

Uveitis, acute anterior

Uveitis, Lyme disease

References

  1. Azari, Amir A.; Barney, Neal P. (2013-10-23). "Conjunctivitis: a systematic review of diagnosis and treatment". JAMA. 310 (16): 1721–1729. doi:10.1001/jama.2013.280318. ISSN 1538-3598. PMC 4049531. PMID 24150468.