Simon Taylor MA PhD FRCOphth Clinical Senior Lecturer & Consultant Ophthalmologist

 Conjunctiva  Cornea  Intraocular contents  Lids and orbit

SYMPTOMS  Pain  Watering  Redness  Photophobia  Diplopia  Poor vision SIGNS  Reduced visual acuity  Lid swelling/redness  Conjunctival swelling/injection  Corneal ulceration  Hypopyon  Restricted eye movements  Relative afferent pupillary defect  Fever

 Very common  Bilateral  Redness  Grittiness  Morning stickiness  Normal visual acuity  Staph & Streptococcus

HAEMORRHAGIC  Enterovirus 70  Highly contagious  Self-limiting GONOCOCCAL  Hyperacute onset  Profuse creamy pus  Periocular oedema

 Adenovirus  Acute onset  Bilateral in 60%  Watering, redness, discomfort, photophobia  Follicular response  Very contagious

 5-14 days after birth  Mainly chlamydial  Could be gonococcal  Purulent discharge  Papillary reaction  Sup. corneal pannus  Conjunctival scarring

 Contact lens wear  Bacterial  Acanthamoeba  Gardening injury or Organic FB  Bacterial  Fungal

scedosporium

 Elderly, diabetic, use of expired eyedrops  Use of contact lenses  History of foreign body/trauma  Ask about cold sores Marginal ulcer

 Viral in origin  Pain & Watering  Photophobia  Treat with Oc. Aciclovir

Dendritic ulceration AVOID STEROIDS!

 Viridans streptococci

 Following any intraocular procedure  Cataract surgery  Intravitreal injection  Pain, eyelid swelling, reduced vision and vitritis are all compelling signs

BACTERIALFUNGAL

 Lacrimal Sac Abscess  Acute or chronic  Secondary to blockage of nasolacrimal duct  Watering & discharge  Red, tense, painful swelling

 Systemically unwell  Restricted eye movements  Optic nerve compromise  Colour vision  RAPD  Distance acuity