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12/4/2010
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EYE DISORDERS DUE TO
TROPICAL DISEASES
dr. NURCHALIZA H SIREGAR, SpM
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SYSTEMIC BACTERIAL
INFECTIONS AND THE EYE
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BRUCELLOSIS ( MEDITERRANEAN FEVER )
CAUSED : GRAM NEGATIVE BACILLI
( BRUCELLA ABORTUS, B MELITENSIS
OR B SUIS )
EYE COMPLICATIONS
- UVEITIS ( CHRONIC & GRANULOMATOUS )
- IRIDOCYCLITIS (KERATIC PRECIPITATES WITH CELLS AND CIRCULATING PROTEINS IN THE ANTERIOR CHAMBER)
- KERATITIS (EPITHELIAL OPACITIES)
- OPTIC NEURITIS (RARE)
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- EXTRA OCULAR MUSCLE
(LOCAL INFLAMATION OR SIXTH CRANIAL NERVE
PARALYSIS → BASAL MENINGOENCEPHALITIS )
DIAGNOSIS
SEROLOGICAL TEST
ISOLATION OF ORGANISM FROM BLOOD, URINE, PUS
MANAGEMENT
- TOPICAL MYDRIASIS/CYCLOPLEGIA (ANTERIOR UVEITIS)→ATROPINE SULFATE 1%
- TOPICAL CORTICOSTEROID
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TULARAEMIA
CAUSED : GRAM NEGATIVE BACILLUS,
PASTEURELLA TULARENSIS (FRANCISELLA TULARENSIS)
SYSTEMIC DISEASE & ITS TRANSMISSION FROM ANIMAL (RABBITS)
EYE COMPLICATIONS (OCCUR WHEN THE ORGANISM PENETRATES THE CONJUNCTIVA→UP TO 2 WEEKS)
ITCHING, PHOTOSENTIVITY, PAIN, REDNESS,
CHEMOSIS (CONJUNCTIVAL OEDEMA)
PARINAUD’S OCULOGLANDULAR SYNDROME
TREATMENT SYSTEMIC TREATMENT
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TUBERCULOSIS
CAUSED : MYCOBACTERIUM TUBERCULOSIS
EYE COMPLICATION
- EYELID SCARRING AND CORNEAL EXPOSURE→LUPUS VULGARIS
- PAPILLARY CONJUNCTIVITIS
- PHLYCTENULAR KERATOCONJUNCTIVITIS→HYPERSENSITIVITY REACTION TO THE TUBERCULOPROTEIN (SMALLYELLOW/PINK NODULES ON THE CORNEOSCLERAL MARGIN)
- INTERSTITIAL KERATITIS
- SCLERITIS (ANTERIOR) OR (POSTERIOR)→THICKENING OF SCLERA DUE TO GRANULOMA FORMATION
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- IRIDOCYCLITIS :
GRANULOMATOUS WITH LARGE KERATIC PRECIPITATES (MUTTON FAT KERATIC PRECIPITATES),AND SMALL WHITE NODULES AT THE PUPIL MARGIN OR ON THE IRIS STROMA (KOEPPE NODULES)
- CHOROIDITIS
- PANUVEITIS
- OPTIC NEURITIS
- PERIPHLEBITIS RETINAE (DEVELOPING COUNTRIES)
MANAGEMENT
TOPICAL CORTICOSTEROID ( PHLYCTEN RESPON )
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MENINGOCOCCAL MENINGITIS
CAUSED : GRAM NEGATIVE N. MENINGITIDIS
EYE COMPLICATION
INVOLVED CRANIAL NERVE → EXTRA OCULAR
IMBALANCE
ENCEPHALITIS + OPTIC NEURITIS→POSTNEURITIC ATROPHY
CONJUNCTIVITIS
ANTERIOR UVEITIS
LOSS VISION (CORTICAL BLINDNESS)
MANAGEMENT
LOCAL INFLAMATION SHOULD BE TREATED
APPROPRIATELY
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DIPTHERIA
CAUSED : CORYNEBACTERIUM DIPTHERIAE
EYE COMPLICATION
MEMBRANOUS CONJUNGTIVITIS WITH EYELID OEDEMA,DISCHARGE AND LOCAL LYMPH NODE ENLARGEMENT
CORNEAL ULCERATION
MANAGEMENT
DIPHTHERIA ANTITOXINS
PENICILLIIN OR ERYTROMYCIN
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ANTHRAX
CAUSED : B ANTHRACIS
CUTANEOUS ANTHRAX INVOLVED EYELID AND
PERIORBITAL REGIONS
INFECTIONS IS BY DIRECT CONTACT WITH CONTAMINATED SKINS AND OTHER ANIMAL PRODUCT, AND TRANSMITTED BY INSECT
EYELID COMPLICATION
EYELID → SCARRING → ECTROPION
MANAGEMENT
SYSTEMIC THERAPY (PENICILLIN)
EYELID SURGERY
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CHOLERA
CAUSED : BACILLUS VIBRIO CHOLERA
EYE COMPLICATION
SEVERELY DEHYDRATED → SUNKEN EYE
CONJUNCTIVITIS
CORNEAL ULCERATION AND CORNEAL OEDEMA
SEVERE ILL PATIENT ( THE EYELIDS ARE LEFT OPEN,
WITH CONSEQUENT DEHYDRATION, EXPOSURE
KERATOCONJUNCTIVITIS & CORNEAL ULCER
INCREASED RISK OF CATARACT ( ACUTE SYSTEMIC DEHYDRATION )
MANAGEMENT
ARTIFICIAL TEARS & DEPEND ON EYE COMPLICATION
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THYPOID FEVER
CAUSED : SALMONELLA TYPHII (FOUND IN WATER,MILK,ICE-CREAM AND OTHER FOOD STUFF)
EYE COMPLICATION
ROSE SPOTS ( CONJUNCTIVA )
CATARACT ( DEHYDRATION )
EXTRAOCULAR MUSCLE & PUPILARY ABNORMALITY
( NERVOUS SYSTEM )
MANAGEMENT
SYSTEMIC THERAPY
TOPICAL THERAPY & DEPEND ON EYE COMPLICATION
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SPIROCHAETAL DISEASES AND THE EYE
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SYPHILIS
CAUSED : TREPONEMA PALLIDUM
(VENEREAL CONTACT OR MOTHER TO UNBORN CHILD)
EYE COMPLICATION
INFLAMED EYELID, DACRYOCYSTITIS, CONJUNCTIVITIS
EXTRAOCULAR MUSCLE PARESIS,INTERSTITIAL KERATITIS (SALMON PATCH
APPEARANCE),IRIDOCYCLITIS, PUPIL ABNORMALITIES,CHOROIDITIS (SALT AND PEPPER FUNDUS)
CORNEAL SCARRING ( GHOST VESSELS )
MANAGEMENT
TOPICAL CORTICOSTEROID, CYCLOPEGIC
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LEPTOSPIROSIS
CAUSED : SPIROCHAETES OF GENUS
LEPTOSPIRA
INFECTED BY CONTACT WITH DOMESTIC OR
WILD ANIMAL (RATS,PIGS,DOGS AND CATTLE)
EYE COMPLICATION
SUBCONJUNCTIVAL HAEMORRHAGES
IRIDOCYCLITIS
MANAGEMENT
SYSTEMIC TREATMENT
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RELAPSING FEVER
CAUSED : SPIROCHAETES BORRELIA DUTTONI
& BORRELIA RECURRENTIS
EYE COMPLICATION
ANTERIOR UVEITIS ( ACUTE & CHRONIC )
RETINA ( HEMORRHAGES AND EXUDATES )
MENINGITIS ( PTOSIS & EXTRAOCULAR MUSCLE
ABNORMALITIES )
MANAGEMENT
DEPEND ON EYE COMPLICATION
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YAWS
CAUSED : SPIROCHAETA TREPONEMA PERTENUE
EYE COMPLICATION
CICATRICAL ECTROPION
DESTROY BONE & CARTILAGE ( REGION OF EYE
& ORBIT )
MANAGEMENT
DEPEND ON EYE COMPLICATION
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CHLAMYDIAL INFECTIONS
AND THE EYE
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TRACHOMA
CAUSED : CHLAMYDIA TRACHOMATIS
EYE COMPLICATION
ENTROPION → TRICHIASIS → KERATITIS → SCAR
→ BLINDNESS
ENVIRONMENTAL RISK FACTOR FOR TRACHOMA
DRY
DUST DISCHARGE
DIRTY DUNG
DENSITY ( OVERCROWDING IN THE HOME )
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AGENT TRANSMISSION OF THE EYE DISSEASE
FLIES FAECES
FACES FINGERS
FOMITES
MANAGEMENT
EPILATION
DEPEND ON EYE COMPLICATION
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LYMPHOGRANULOMA VENEREUM
CAUSED : CHLAMYDIA ( BEDSONIA )
INITIAL LESSION ( GENITAL REGION )
EYE COMPLICATION
FOLLICULAR CONJUNCTIVITIS WITH
LYMPHADENOPATHY
KERATITIS, IRIDOCYCLITIS
DILATATION RETINAL VEINS,
RETINAL HAEMORRHAGES & OEDEMA
MANAGEMENT
DEPENT ON EYE COMPLICATION
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RICKETTSIAL INFECTIONS
AND THE EYE
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THYPUS
CAUSED : RICKETSIA PROWAZEKI (TICK,MITE OR FLEA BORNE)
EYE COMPLICATION
CONJUNCTIVITIS + PHOTOSENSITIVITY
SUBCONJUNCTIVAL HAEMORRHAGE
IRIDOCYCLITIS
RETINAL HAEMORRHAGES
OPTIC OEDEM OR ATROPHY
MANAGEMENT
DEPEND ON EYE COMPLICATION
SYSTEMIC THERAPY
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ROCKY MOUNTAIN SPOTTED FEVER
CAUSED : R RICKETTSII
THE VECTOR IS THE TICKCARRIED BY WILD RODENTS AND DOGS
EYE COMPLICATION
CONJUNCTIVITIS
PETECHIAL HAEMORRHAGES OF BULBAR AND TARSAL CONJUNCTIVA
MANAGEMENT
SYSTEMIC THERAPY
DEPEND ON EYE COMPLICATION
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VIRAL INFECTIONS
AND THE EYE
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MEASLES
CAUSED : MEASLES VIRUS
EYE COMPLICATION
PHOTOSENSITIVE, WATERING, RED EYE
PUNCTATE KERATITIS
MEASLES + VITAMIN DEFICIENT + DEHIDRATION →
FAIL TO CLOSE EYELID → KERATITIS EXPOSURE
→CORNEAL ULCER
MANAGEMENT
TOPICAL ANTIBIOTIK OINTMENT
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RUBELLA
CAUSED : RNA VIRUS OF THE ARBOVIRUS
GROUP
EYE COMPLICATION
CATARACT ( VIRUS REMAINS IN THE LENS FOR
SOME YEARS AFTER BIRTH ) AND
SURGICAL REMOVAL CATARACT RESULT UVEITIS
CONGENITAL GLAUCOMA ( BUPHTHALMOS )
RUBELLA RETINOPATHY, OPTIC ATROPY
SQUINT, NYSTAGMUS AND MICROPHTHALMUS
MANAGEMENT
DEPEND ON EYE COMPLICATION
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HERPES SIMPLEX
CAUSED : HERPES SIMPLEX VIRUS
HERPES SIMPLEX ULCERATION OF CORNEA
TENDENCY TO RECUR
RECURRENT MAY STIMULATED : FEVER, TRAUMA
EXPOSURE ULTRA VIOLET, MEASLES AND
PHSYCOLOGY FACTOR
EYE COMPLICATION
PAIN, PHOTOSENSITIVITY, WATERING, RED EYE
CORNEA HIPOANESTESIA
CORNEA ( DENDRITIC ULCER, GEOGRAPHIC ULCER
UVEITIS, NEOVASCULARAZATION, SCAR
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MANAGEMENT
SYSTEMIC THERAPHY
ANTIVIRAL EYE OINTMENT
CYCLOPEGIC
TOPICAL CORTICOSTEROID
CONJUNGTIVAL FLAP OR TARSORAPHY
CORNEAL GRAFT
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HERPES ZOSTER OPHTHALMICUS
CAUSED : THE VIRUS OF HERPES ZOSTER IS A
DNA VIRUS WHICH LIES DORMANT IN SENSORY
NERVE ROOT GANGLIA AFTER INFECTION WITH
VARICELLA
EYE COMPLICATION
IF NASOCILIARY BRANCH OF OPHTHALMIC
DIVISION OF THE FIFTH NERVE IS AFFECTED, WITH
VESICLES ON THE SIDE OF THE NOSE.
LID SCARRING, CONJUNCTIVITIS, EPISCLERITIS,
SCLERITIS, KERATITIS, NEUROPARALITIC KERATITIS
UVEITIS, SECONDARY GLAUCOMA, OPTIC NEURITIS
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HERPES ZOSTER KERATITIS TAKE FORMS :
PUNCTATE EPITHELIAL EROSION,
FILAMENTARY & DISCIFORM KERATITIS
MANAGEMENT
REST, ANALGETICS
TOPICAL ANTIVIRAL ( SKIN & EYE )
TOPICAL CYCLOPEGIC
TOPICAL CORTICOSTEROID
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VARICELLA
CAUSED : DNA VIRUS IDENTICAL TO HERPES
VIRUS GROUP
EYE COMPLICATION
VESICLE ON EYELIDS, CONJUNGTIVA &
CORNEOSCLERA MARGIN
KERATITIS, IRIDOCYCLITIS
EXTRAOCULAR MUSCLE, PUPIL ABNORMALITIES,
OPTIC NEURITIS & RETINA CAN BE INVOLVED
MANAGEMENT
DEPEND ON EYE COMPLICATION, ANTIBIOTIC
OINTMENT PREVENT SECUNDARY INFECTION
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MUMPS
ACUTE FEVER ASSOCIATED WITH PAROTITIS
INVOLVING ORCHITIS, OOPHORITIS, PANCREATITIS
EYE COMPLICATION
DACRYOADENITIS, CONJUNCTIVITIS, KERATITIS
SCLERITIS, RETINITIS & OPTIC NEURITIS
MANAGEMENT
DEPEND ON EYE COMPLICATION
ANALGETIC
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MOLLUSCUM CONTANGIOSUM
CAUSED : DNA VIRUS
TYPICAL LESSION : PAPULE WITH CENTRAL
UMBILICULUS
EYE COMPLICATION
LESSION ON EYELID, CONJUNCTIVITIS, KERATITIS
MANAGEMENT
DEPEND ON EYE COMPLICATION
CURETTING LESSION, CHEMICAL CAUTERY
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CYTOMEGALO VIRUS
ASSOCIATED WITH AIDS / HIV
EYE COMPLICATION
UVEITIS, RETINAL OEDEM & NECROSIS
RETINITIS WITH HAEMORRHAGES, VITREOUS OPACITY
OPTIC ATROPY, CHOROIDORETINITIS
CATARACT, MICROPHTHALMOS
PREGNANCY WOMAN RESULT ABNORMALITY
OCULAR IN THE FETUS
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BURKITT’S LYMPHOMA
CAUSED : EPSTEIN- BARR VIRUS
EYE COMPLICATION
CRANIAL NERVE PALSY CAN INVOLVED EYELID
MANAGEMENT
SURGERY, RADIOTHERAPY, CHEMOTHERAPY
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HIV / AIDS
CAUSED : HUMAN IMMUNODEFICIENCY VIRUS
HERPES ZOSTER OPHTHALMICUS IS MARKER FOR HIV
CLINICAL STAGE OF DISSEASE AND
OCULAR COMPLICATION
GROUP 1
ASYMPTOMATIC / GENERALIZED LYMPHADENOPATHY
GROUP 2
HZO, PAPILOMATA, M CONTANGIOSUM
GROUP 3
HIV RELATED RETINOPATHY
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GROUP 4
AIDS, CMV RETINITIS,
CRYPTOCOCCAL MENINGITIS, KAPOSI SARCOMA
EYELIDS HAVE MULTIPLE WARTS OR UMBILICATED
PAPULES OF M CONTANGIOSUM, BOTH SUGGESTIVE
OF HIV / AIDS INFECTIONS
HIV RELATED RETINOPATHY
ABNORMALITIES OF SMALL VESSELS OF RETINA,
COTTON WOOL SPOT, SMALL HAEMORRHAGIC
MICROANEURYSM, TELANGIECTASIS
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AIDS AND CMV RETINITIS
HAEMORRHAGE RETINAL NECROSIS
DESCRIBED AS KETCHUP ( TOMATO SAUCE )
ON COTTAGE CHEESE
SEVERE PROGRESSIVE ( BILATERAL ) AND IF NO
TREATMENT IS PROVIDED THE WHOLE RETINA MAY
BE DESTROYED
PATIENT WITH SYPHILIS SHOULD BE TESTED FOR HIV
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HIV / AIDS AND TBC
TBC REACTIVATED
IN PRESENCE OF HIV INFECTION
MASSIVE CHOROIDAL INVASION MAY LEAD TO
SECONDARY RETINAL NECROSIS AND BLINDNESS
HIV / AIDS AND TUMORS
KAPOSI’ SARCOMA AND B CELL LYMPHOMA ARE
COMMON MALIGNANCIES REPORTED IN ASSOCIATED
WITH HIV AND CONSIDERED DIAGNOSTIC OF AIDS
THEY DEVELOP ON SKIN EYELID, EYELID MARGIN,
CONJUNCTIVA AND RARELY IN ORBIT
TUMOR CAN BE EXCISED FOCAL RADIATION THERAPY
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FUNGAL INFECTIONS
AND THE EYE
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FUNGI
FUNGI :
1. FILAMENTOUS FUNGI
2. YEAST
3. DIMORPHIC FUNGI
FUNGI CAUSING EYE INFECTIONS ARE COMMONLY
FILAMENTOUS FUNGI & YEAST
OCULOMYCOSES PARTICULARLY IN COUNTRY WITH
HOT AND HUMID CLIMATES
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DIFFICULTIES IN MANAGEMENT OF
OCULOMYCOSES RELATED TO PROBLEM
IN DIAGNOSIS AND INADEQUATE RESOURCE
OF ANTIFUNGAL AGENTS
EXAMPLE
FUNGAL CORNEAL ULCER IS SUGGESTED BY DRY,
SLOWLY WORSENING, STROMAL INFILTRATE AND
MULTIFOCAL LESIONS, PARTICULARLY IF THE ULCER
FAILS TO RESPON TO ANTIBIOTIC TREATMENT
THESE SIGNS ARE NOT CONSISTENTLY PRESENT
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ASPERGILLOSIS
GENUS ASPERGILLUS IS COMMON IN WARM
AND HUMID CLIMATES WHICH CAN LEAD ON
TO OCULAR INVOLVMENT WITH EXTRAOCULAR
MUSCLE PALSIES
INTRACEREBRAL ABCES FORMATION CAN CAUSE
EYE COMPLICATION DUE TO SPACE OCCUPYING
LESION
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FUSARIOSIS
MAY CAUSE SUPURATIVE KERATITIS
WITH OR WITHOUT HYPOPION
CORNEAL SCAR WHEN AREA INFECTION HEALS
LATER CORNEAL GRAFTING MAY BE INDICATED
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CANDIDIASIS
AN ORGANISM COMMONLY FOUND IN
MOUTH, THROAT AND VULVA
MAY AFFECT THE EYELID, LACRIMAL SYSTEM,
CONJUNCTIVA AND CORNEA
OFTEN INFECTED FOLLOW INJURY TO THE EYE,
WHETHER ACCIDENTAL OR SURGICAL
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CRYPTOCOCCIS
CRYPTOCOCCIS NEOFORMANS IS A YEAST
LIKE FUNGUS WHICH MAY HAVE SYSTEMIC EFFECT
IT CAUSED MYCOTIC CORNEAL ULCERATION AND
HYPOPION
ENDOGEN SPREADTHROUGH BLOODSTREAM RESULT
IN INVOLMENT ANTERIOR AND POSTERIOR UVEA
INFECTION OF MENINGES MAY RAISED INTRA
CEREBRAL PRESSURE WITH OCULAR SIGN PAPIL
OEDEMA OR ATROPY
CRANIAL NERVE ABNORMALITIES ALSO OCCUR
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BLASTOMICOSIS
BLASTOMYCOSIS DERAMATIDIS IS FOUND IN
AS AND AFRICA
AND AFFECT THE SKIN, LUNG, MENINGES
CHARACTERIZED BY SUPPURATIVE GRANULOMATOUS
WHICH MAY BE FOUND IN EYELID
THE ORBIT, LACRIMAL CANALICULI, CONJUNGTIVA
AND CORNEA AFFECTED
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COCCIDIOIMYCOSIS
COCCIDIOIMYCOSIS IMMITIS BEGIN WITH
INHALATION OF ORGANISM CAUSING PNEUMONITIS
EYE INVOLVEMENT CAN INCLUDE HYPERSENSITIVE
RESPON MANIFEST AS PHLYCTENULARIS CONJUNCTIVITIS
EYELIDS AND INTRAOCULAR INVOLVEMENT HAS
BEEN RECORDED, CAUSING POSTERIOR UVEITIS
ENDOPHTHALMITIS CAN OCCUR
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HISTOPLASMOSIS
CAUSED : FUNGUS HISTOPLASMOSIS
CAPSULATUM
HISTOPLASMOSIS PREDILECTION FOR THE POSTERIOR UVEA AND CHARACTERIZED LESIONS ARE MULTIFOCAL ATROPIC CHOROIDAL AND DISCIFORMIS MACULAR CHANGES
IF SUBRETINAL NEOVASKULAR MEMBRAN FORM, TREATMENT WITH ARGON LASER
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TREATMENT OF FUNGAL INFECTION
ANTIFUNGAL AGENT SHOULD BE USED, IF ANTIBACTERIAL UNRESPONSIVE
AFTER 48 HOURS
NATAMYCIN 5 % EYE DROPS MOST EFFECTIVE AGAINST FILAMENS FUNGI INCLUDING ASPERGILLUS AND FUSARIUM
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DISEASES CAUSED BY PROTOZOA
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TOXOPLASMOSIS
CAUSE BY TOXOPLASMA GONDII
CONGENITAL TOXOPLASMOSIS WITH INFECTION
OF FETUS DURING PREGNANCY
EYE COMPLICATION
BLUR, PHOTOSENSITIVITY, FLOATERS
TOXOPLASMOSIS RETINOCHOROIDITIS
SQUINT & NYSTAGMUS
THE LESIONS MAY BE MULTIFOCAL, ALTHOUGH THE
FINAL PUNCHED OUT SCAR MAY BE SEEN.
ACUTE PHASE THE FOCI OF INFLAMATION ARE
FLUFFY WHITE WITH HAZY MARGINS.
VITRITIS, MACULAR OEDEMA, IRIDOCYCLITIS
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Fundus picture showing a typical punched-out macular scar
of a healed congenital toxoplasmosis
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LEISMANIASIS
CAUSED : PARASITIES GENUS LEISHMANIA
TRANSMITTED BY INSECT (SANDFLY )
EYE COMPLICATION
1. VISCERAL LEISHMANIASIS
VISCERAL FORM OF LEISHMANIASIS KNOWN AS
KALA AZAR
RETINAL HAEMORRHAGIC, BILATERAL
IRIDOCYCLITIS
KERATITIS
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2. CUTANEOUS LEISHMANIASIS
HAS BEEN DESCRIBED AS TROPICAL SORE,
MUCOCUTANEUS LEISHMANIASIS AND
DISSEMINATED CUTANEUS LEISHMANIASIS
COMMONLY AFFECT EYELIDS, OCCASIONAL
INVOLVEMENT LACRIMAL / CONJUNCTIVA
CUTANEUS LESION : ULCER, PAPULES, NODULES
SKIN INVOLVEMENT LEAVES SCAR
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AMOEBIASIS
CAUSED : ENTAMOEBA HISTOLYCA
EYE COMPLICATION
CYST IN REGION OF MACULA WITH ASSOCIATED
SMALL RETINA HAEMORRHAGIC AND DISTURBANCE
OF RETINAL PIGMEN EPITELIUM
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GIARDIASIS
CAUSED : GIARDIA LAMBLIA
EYE COMPLICATION
ANTERIOR AND POSTERIOR UVEITIS
IRIDOCYCLITIS, CHOROIDITIS
RETINA DAN SUBRETINAL HAEMORRHAGIC
MACULAR DISTURBANCE
MANAGEMENT
PATIENT RESPONS TO SYSTEMIC TREATMENT
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AFRICAN TRYPANOSOMIASIS (SLEEPING SICKNESS)
CAUSED : TRYPANOSOMA BRUCEI GAMBIENSE &
T B RHODESIENSE
EYE COMPLICATION
EYELID OEDEMA, CONJUNCTIVAL REDNESS,
PHOTOSENSITIVITY, INTERSTITIAL KERATITIS, IRIDOCYCLITIS
MENINGOENCEPHALOPATHY ( PTOSIS, OPTIC NEURITIS, PAPILOEDEMA, EXTRAOCULAR MUCLE INVOLVEMENT )
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AMERICAN TRYPANOMIASIS CHAGAS DISEASE)
CAUSED : T CRUZI ( INSECT BITE )
EYE COMPLICATION
EYELID OEDEM, UNILATERAL ( ROMANA’S SIGN )
LACRIMAL GLAND INVOLVEMENT (INFLAMMATION)
GRANULOMATOUS UVEITIS (IN A PREMATURE CHILD)
MANAGEMENT
DEPENDS ON EYE COMPLICATION
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MALARIA
CAUSED : PLASMODIUM FALCIFARUM, VIVAX
OVALE AND MALARIAE
EYE COMPLICATION
RETINAL HAEMORRHAGIC / EXUDATE
EXTRAOCULAR MUSCLE PARESE, OPTIC NEURITIS,
CORTICAL BLINDNESS (DUE TO BRAIN DAMAGE)
CHLOROQUIN EFFECT ( DAMAGE CENTRAL RETINA) →BULLS EYE MACULOPATHY.
TREATMENT : MALARIA TREATMENT
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PNEUMOCYSTOSIS
CAUSED : PNEUMOCYSTIS CARINII
EYE COMPLICATION
COTTON- WOOL SPOT WHICH APPEAR AS FLUFFY WHITISH FOCI IN THE RETINA
CHOROIDITIS
MANAGEMENT
A DESCRIPTION OF SYSTEMIC TREATMENT
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DISEASES CAUSED
BY NEMATODES
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ONCHOCERCIASIS
MOST COMMON CAUSE OF BLINDNESS
CAUSED : FILARIAL WORM, ONCHOCERCA VOLVULUS
WORM TRANSMITTED SIMULLIUM BLACKFLY
( BLACK BITING FLY )
AFRICA ( RIVERS )
AGE : CHILDHOOD AND YOUNG ADULTHOOD ( BITTEN MANY TIMES ) WILL BE INFECTED AND REINFECTED
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TRANSMISSION
♀ SIMULLIUM HUMAN BLOOD DAWN AND DUSK
LIFE CYCLE
INFECTED PERSON BITTEN BY SIMULLIUM FLY
MICROFILARIAE ENTER THE BODY OF FLY GUT WALL
THORACIC MUSCLE HEAD ( 7 DAYS ) READY
TO BE TRANSMITTED ADULT WORM ( 1-3 YEARS )
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EYE COMPLICATION
BILATERAL ( SEGMEN ANTERIOR AND POSTERIOR )
MIKCROFILARIA SEEN AT COA
SNOWFLAKE ( WHITE GREY SPOT IN CORNEA )
SCLEROSING KERATITIS ( COMMON CAUSE OF
BLINDNESS ) SCAR
IRIDOCYCLITIS ( REDUCED VISION , CATARACT )
OPTIC NEURITIS
MANAGEMENT
SYSTEMIC THERAPY
NODULECTOMY ( NODULES NEARS EYES )
TOPICAL CORTICOSTEROID
TOPICAL CYCLOPEGIC
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THELAZIASIS
CAUSED : THELAZIA CALLIPAEDA (TRANSMISSION BY FLIES)
EYE COMPLICATION
IRRITATION, WATERING, PAIN
THE WORM MAY BE SEEN IN CONJUNCTIVA SAC
MANAGEMENT
WORM PRESENT ON THE SURFACE CONJUNCTIVA
CAN BE REMOVED WITH LOCAL ANESTHESIA
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TOXOCARIASIS
CAUSED : TOXOCARA CANIS
EYE COMPLICATION
OCULAR LARVA MIGRAN PRESENT EYE PROBLEM
( SQUINT / LEUCOCORIA )
INTRARETINAL LARVA MAY BE SEEN ON FUNDUSCOPY
KERATITIS, IRIDOCYCLITIS, ENDOPHTHALMITIS
RETINAL DETACHMENT & OPTIC NEURITIS
MANAGEMENT
EYE INFLAMATION → TOPICAL CORTICOSTEROID
DEPEND ON EYE COMPLICATION
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LOIASIS
CAUSED : FILARIAL HELMINTH LOA LOA
EYE COMPLICATION
PRESENT WORM UNDER CONJUNCTIVA
REDNESS, DISCOMFORT
EYELID OEDEM ( CALABAR SWELLING )
PRESENT WORM IN ANTERIOR CHAMBER
UVEITIS, RETINOPATHY
MANAGEMENT
SURGICAL REMOVAL
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BRANCROFTIAN AND BRUGIAN FILARIASIS
CAUSED : WUCHERERIA BANCROFTI
( TRANSMITTED BY MOSQUITO )
EYE COMPLICATION
PAIN, REDNESS
ADULT WORM ISOLATED IN CONJUNCTIVA
ADULT WORM HAS BEEN FOUND AT
SUBRETINAL, CONJUNCTIVA, LACRIMAL GLAND
LARVA CAN INFILTRATE TO ANTERIOR CHAMBER,
IRIS, LENS, CAPSULE, RETINA AND CHOROID
MANAGEMENT : SURGICAL
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DRANCUNCULIASIS
CAUSED : DRACUNCULUS MEDINENSIS
EYE COMPLICATION
IRRITABLE, WATERING EYE, SWELLING OF CONJUNCTIVA
INVOLVEMENT OF ORBIT
WORM OFTEN EMERGE THROUGH THE SKIN
MANAGEMENT
REMOVED SURGICALLY
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TRICHINOSIS
CAUSED : LARVAE OF TRICHINELLA SPIRALIS
( UNCOOKED MEAT : PORK )
EYE COMPLICATION
BILATERAL EYELID OEDEM, PAIN, BLUR
PHOTOSENSITIVITY
RETINAL HAEMORRHAGES, OPTIC NEURITIS / OEDEM
MANAGEMENT
SYSTEMIC TREATMENT
TOPICAL CYCLOPEGIC. TOPICAL CORTICOSTEROID
SWELING REDUCED WITH COLD COMPRESSES
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GNATHOSTOMIASIS
CAUSED : GNATHOSTOMA SPINIGERUM
INFLAMATORY CAUSED BY LARVA
( HIPERSENSITIV REACTION WITH TISSUE )
EYE COMPLICATION
EYELID, ANTERIOR / INTRA OCULAR TISSUE
CORNEAL ULCER, UVEITIS ( WORM ANTERIOR )
WORM POSTERIOR ( CARARACT, GLAUKOMA, RETINA )
MANAGEMENT
REMOVAL SURGERY
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ANGIOSTRONGYLIASIS
CAUSED : ANGIOSTRONGYLUS CANTONENSIS
EYE COMPLICATION
ADULT WORM ( ANTERIOR CHAMBER, VITREOUS,
RETINA )
PAIN, BLEPHAROSPASME, IRIDOCYCLITIS
RETINAL PIGMEN DISTURBANCE / R DETACHMENT
OPTIC NEURITIS
MANAGEMENT
SURGICAL REMOVAL
TOPICAL CORTICOSTEROID, TOPICAL ATROPIN
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DISEASE CAUSED
BY CESTODES
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CYSTICERCOSIS
CAUSED : TAENIA SOLIUM CYSTICERCI
EYE COMPLICATION
PAIN, DOUBLE VISION, BLUR, FLASH OF LIGHT
CYSTICERCI OCCUR IN ANTERIOR SEGMENT AND
OTHER EYE TISSUE
FOUND IN POSTERIOR SEGMENT ( VITREUS,
SUBRETINAL )
MANAGEMENT
REMOVAL SURGERY
SYSTEMIC TERAPY
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ECHINOCOCCOSIS
CAUSED : ECHINOCOCCUS GRANULOSIS
EYE COMPLICATION
PROPTOSIS
TYPICALLY OCULAR IS FOUND WITHIN BONY ORBIT
CONJUNCTIVALCHEMOSIS, KERATITIS EXPOSURE
MANAGEMENT
TREATMENT OF ORBITAL CYST IS SURGICAL REMOVAL
SYSTEMIC THERAPY
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SPARGANOSIS
CAUSED : LARVA GENUS SPIROMETRA
EYE COMPLICATION
PAIN, EYELID OEDEM, WATERING, IRRITATION
WORM FOUND SUBCONJUNCTIVALLY / RETROBULBAR
LARVA FOUND AT ANTERIOR CHAMBER
MANAGEMENT
REMOVAL SURGICAL
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DISEASE CAUSED
BY TREMATODES
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PARAGONOMIASIS
CAUSED : GENUS PARAGONIMUS
EYE COMPLICATION
SEVERE PAIN
UVEITIS, VITREUS AND RETINAL HAEMORRHAGIC
IMMATURE WORM CAUSED ANTERIOR SEGMENT
INFLAMATIONS WITH HYPOPION
MANAGEMENT
IN OCULAR : REMOVAL SUGERY
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SCHISTOSOMIASIS
CAUSED : S JAPONICUM, S MANSONI,
S HAEMATOBIUM (MOST FREQUENT)
EYE COMPLICATION
EGG GRANULOMAS FOUND ON CONJUNCTIVA, CHOROID, LACRIMAL GLAND
S MANSONI ADULT HAS BEEN FOUND ANT CHAMBER
UVEITIS, RETINAL HAEMORRHAGES
MANAGEMENT
DEPEND ON EYE COMPLICATION
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DISEASE CAUSED
BY ARTHROPODS
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MYIASIS
LARVA MAY CAUSE OCULAR MYIASIS
EYE COMPLICATION
REDNESS WITH IRRITATION, DISCHARGE
UVEITIS
MANAGEMENT
REMOVAL SURGERY
TOPICAL CORTICOSTEROID (INTERNAL OCULAR MYASIS)
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TERIMA KASIH
