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  • Mata Merah

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    AmalliaPradistha
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    This document summarizes various eye conditions that cause red eyes with decreased vision including conjunctivitis, keratitis, endophthalmitis, scleritis, and uveitis. It describes the symptoms, signs, causes, investigations, and treatments for each condition. Conjunctivitis can be bacterial, viral, allergic or chlamydial in origin. Keratitis risk factors include contact lens wear and trauma and can be caused by bacteria, fungi or viruses. Endophthalmitis is an intraocular inflammation that requires antibiotics, antifungals or vitrectomy. Scleritis involves the sclera and episcleritis the episcleral tissues. Uveitis is an inflammation

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    mata merah dan DD

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    This document summarizes various eye conditions that cause red eyes with decreased vision including conjunctivitis, keratitis, endophthalmitis, scleritis, and uveitis. It describes the symptoms, signs, causes, investigations, and treatments for each condition. Conjunctivitis can be bacterial, viral, allergic or chlamydial in origin. Keratitis risk factors include contact lens wear and trauma and can be caused by bacteria, fungi or viruses. Endophthalmitis is an intraocular inflammation that requires antibiotics, antifungals or vitrectomy. Scleritis involves the sclera and episcleritis the episcleral tissues. Uveitis is an inflammation

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    63 views59 pages

    Mata Merah

    Uploaded by

    AmalliaPradistha
    This document summarizes various eye conditions that cause red eyes with decreased vision including conjunctivitis, keratitis, endophthalmitis, scleritis, and uveitis. It describes the symptoms, signs, causes, investigations, and treatments for each condition. Conjunctivitis can be bacterial, viral, allergic or chlamydial in origin. Keratitis risk factors include contact lens wear and trauma and can be caused by bacteria, fungi or viruses. Endophthalmitis is an intraocular inflammation that requires antibiotics, antifungals or vitrectomy. Scleritis involves the sclera and episcleritis the episcleral tissues. Uveitis is an inflammation

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    of 59

    &

    MATA MERAH VISUS TURUN

    Lia Meuthia Zaini


    FK Unsyiah / RSUDZA

    MATA MERAH
    VISUS NORMAL
    Konjungtivitis
    Pinguecula
    Pterygium

    MATA MERAH
    VISUS TURUN
    Keratitis
    Glaukoma Akut
    Endophthalmitis
    Episcleritis
    Scleritis
    Uveitis
    Hyphema

    Features of conjungtival inflammation

    SYMPTOMS
    Lacrimation
    Gritty irritation
    Stinging
    Burning
    Itching
    Pain
    Photophobia
    Foreign body sensation

    Features of conjungtival inflammation

    SIGNS

    CONJUNCTIVITIS
    Bacterial

    Allergic

    Viral

    Chlamidya

    Pain

    Minimal

    No pain

    Minimal

    Minimal

    Itching

    Occasiona
    l

    Common

    Common

    Occasional

    Discharge

    Mucopurul
    ent

    Watery/Muc
    oid

    Watery

    Mucopurulent

    Adenoviral

    Causes

    Saph,
    Strep,
    Gonnococcus

    Allergen

    Herpes
    Simple
    x

    C. Trachomatis

    Immunofluorescence

    Investigation

    Gram

    PCR

    -PCR
    -

    CONJUNCTIVITIS
    Bacterial

    Allergic

    Viral

    Chlamidya

    Topical

    - 60% resolve
    without

    - Mast cell
    Erythro
    stabilizers
    micyn
    EO
    symptomatically
    (sodiu
    - cold
    m
    compre Tetracy
    ss
    clin EO
    cromog
    lycate
    artificial Systemi

    KERATITIS
    Bacterial Keratitis
    - Very uncommon in a normal eye (only develop when ocular
    surface have been compromised)
    - Bacteria that penetrate through the normal corneal epithelium :
    N.gonnorhoeae, N.meningitides, C.diphtheriaea, H.influenza
    - The most common pathogen :
    P.aeruginosa, S.aureus, S.pyogenes, S.pneumoniae

    KERATITIS

    Risk Factor :
    1. Contact lens wear
    2. Trauma
    3. Ocular surface disease
    4. Systemic immunosuppression
    5. Diabetes
    6. Vitamin A deficiency

    KERATITIS
    Diagnosis
    Clinical features
    1. History (particular attention paid to risk factors)
    2. Presenting symptoms (pain, photophobia, blurred vision, and
    discharge)
    3. Signs
    - infiltrate with ciliary injection
    - epithelial defect associated with infiltrate around the margin
    - enlargement of the infiltrate associated with stromal oedema and
    small hypopyon
    - severe infiltration
    - progressive ulceration
    corneal perforation
    endophthalmitis

    KERATITIS

    peripheral infiltration

    enlargement of infiltrate

    hypopyon

    advance keratitis

    KERATITIS
    Diagnosis
    Microbiology
    - Gram staining
    Differentiated bacterial species into Gram positive and Gram negative
    - Culture media
    Blood agar, Chocolate agar
    - Sensitivity report
    Susceptible, Intermediate, or Resistant

    KERATITIS
    Treatment
    General principles
    1. Decision
    Treatment should be initiated even gram stain is negative and before the
    result of culture are available
    2. Antibiotics
    - topical antibiotics
    - oral antibiotics
    - subconjunctival
    3. Mydriatics
    - prevent the formation of posterior synechiae
    - reduce pain from ciliary spasm
    4. Topical steroids
    - only in some cases with special attention

    KERATITIS

    KERATITIS
    Causes of failure
    1. Incorrect diagnosis
    2. Inappropriate choice of antibiotics
    3. Drug toxicity
    4. Gram negative ulcers

    Ciprofloxacin corneal precipitates

    KERATITIS

    Visual rehabilitation
    1. Lamelar keratoplasty
    2. Rigid contact lenses
    3. Cataract surgery

    KERATITIS
    Fungal Keratitis
    - Fungi are microorganism that have rigid walls and multiple
    chromosomes containing both DNA and RNA.
    - The main types
    1. Filamentous ( Aspergillus spp, Fusarium solani,
    Scedosporium spp)
    2. Yeasts (candida spp)

    KERATITIS
    Clinical features
    1. Presenting symptoms
    - foreign body sensation, photophobia, blurred vision, discharge.
    - history of trauma or chronic ocular surface diseases
    2. Signs
    a. Filamentous keratitis
    - grey yellow stromal infiltrate with indistinct margins
    - satellite lesions
    - hypopyon
    - feathery edge
    b. Candida keratitis
    - yellow white infiltrate associated with dense suppuration

    KERATITIS
    Investigation
    1. Gram and Giemsa
    2. Cultures
    Sabouraud dextrose agar
    3. Histology

    KERATITIS
    Treatment
    1. Removal of the epithelium
    2. Topical treatment
    Antifungal : natamycine 5%, econazole 1%,
    Amphotericin B 0.15%, miconazole 1%
    3. Subconjunctival antifungal
    Fluconazole
    4. Systemic
    Itraconazole, Voriconazole
    5. Mydriatic
    6. Keratoplasty in unresponssive cases

    Endophthalmitis is a clinical diagnosis made when


    intraocular inflammation involving both the posterior
    and anterior chamber is attributable to bacterial or
    fungal infection

    1. post operative endophthalmitis


    2. endogenous bacterial endophthalmitis
    3. endogenous fungal endophthalmitis

    Diagnosis
    Clinical features
    1. History (trauma, intra-ocular operative, corneal ulcer)
    2. Presenting symptoms (severe pain, photophobia, blurred vision)
    3. Signs
    - ciliary injection
    - infiltrate of the cornea (history of corneal ulcer)
    - hypopyon
    - signs of previous intra-ocular operative
    - Vitreous Cells !!!!!!! (USG)

    Treatment
    1. Antibiotics/antifungal
    - topical
    - systemic
    - intravitreal
    2. Mydriatics
    - prevent the formation of posterior synechiae
    - reduce pain from ciliary spasm
    3. Vitrektomi
    4. Evisceration

    SCLERITIS

    SCLERITIS

    SCLERITIS

    SCLERITIS

    EPISCLERITIS VS

    SCLERITIS

    - Inflammation of the uvea


    - Infectious
    Traumatic
    Neoplastic
    Autoimmune

    Symptoms of Uveitis
    - blurred vision
    - floaters
    - pain
    - photophobia
    - redness
    - epiphora

    Signs of Uveitis

    Corticosteroid administration

    Thank You

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