Antibiotic Guidelines for Ophthalmology V1.8 290413 Issue Date Review Date Review Cycle May 2019 May 2022 Three Years Consulted with the Following Stakeholders
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Antiseptics and Disinfectants for the Treatment Of
Verstraelen et al. BMC Infectious Diseases 2012, 12:148 http://www.biomedcentral.com/1471-2334/12/148 RESEARCH ARTICLE Open Access Antiseptics and disinfectants for the treatment of bacterial vaginosis: A systematic review Hans Verstraelen1*, Rita Verhelst2, Kristien Roelens1 and Marleen Temmerman1,2 Abstract Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV). Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970- 2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin and if diagnosis of BV relied on standard criteria such as Amsel’s and Nugent’s criteria. Results: A total of 262 articles were found, of which 15 reports on clinical trials were assessed. Of these, four randomised controlled trials (RCTs) were withheld from analysis. Reasons for exclusion were primarily the lack of standard criteria to diagnose BV or to assess cure, and control treatment not involving placebo or standard antibiotic treatment. Risk of bias for the included studies was assessed with the Cochrane Collaboration’s tool for assessing risk of bias. Three studies showed non-inferiority of chlorhexidine and polyhexamethylene biguanide compared to metronidazole or clindamycin. One RCT found that a single vaginal douche with hydrogen peroxide was slightly, though significantly less effective than a single oral dose of metronidazole. -
Differentiate Red Eye Disorders
Introduction DIFFERENTIATE RED EYE DISORDERS • Needs immediate treatment • Needs treatment within a few days • Does not require treatment Introduction SUBJECTIVE EYE COMPLAINTS • Decreased vision • Pain • Redness Characterize the complaint through history and exam. Introduction TYPES OF RED EYE DISORDERS • Mechanical trauma • Chemical trauma • Inflammation/infection Introduction ETIOLOGIES OF RED EYE 1. Chemical injury 2. Angle-closure glaucoma 3. Ocular foreign body 4. Corneal abrasion 5. Uveitis 6. Conjunctivitis 7. Ocular surface disease 8. Subconjunctival hemorrhage Evaluation RED EYE: POSSIBLE CAUSES • Trauma • Chemicals • Infection • Allergy • Systemic conditions Evaluation RED EYE: CAUSE AND EFFECT Symptom Cause Itching Allergy Burning Lid disorders, dry eye Foreign body sensation Foreign body, corneal abrasion Localized lid tenderness Hordeolum, chalazion Evaluation RED EYE: CAUSE AND EFFECT (Continued) Symptom Cause Deep, intense pain Corneal abrasions, scleritis, iritis, acute glaucoma, sinusitis, etc. Photophobia Corneal abrasions, iritis, acute glaucoma Halo vision Corneal edema (acute glaucoma, uveitis) Evaluation Equipment needed to evaluate red eye Evaluation Refer red eye with vision loss to ophthalmologist for evaluation Evaluation RED EYE DISORDERS: AN ANATOMIC APPROACH • Face • Adnexa – Orbital area – Lids – Ocular movements • Globe – Conjunctiva, sclera – Anterior chamber (using slit lamp if possible) – Intraocular pressure Disorders of the Ocular Adnexa Disorders of the Ocular Adnexa Hordeolum Disorders of the Ocular -
Effect of Polyhexamethylene Biguanide in Combination with Undecylenamidopropyl Betaine Or Pslg on Biofilm Clearance
International Journal of Molecular Sciences Article Effect of Polyhexamethylene Biguanide in Combination with Undecylenamidopropyl Betaine or PslG on Biofilm Clearance Yaqian Zheng 1,2,†, Di Wang 1,† and Luyan Z. Ma 1,3,* 1 State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China; [email protected] (Y.Z.); [email protected] (D.W.) 2 College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China 3 Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China * Correspondence: [email protected]; Tel.: +86-10-64807437 † These authors have contributed equally to this work. Abstract: Hospital-acquired infection is a great challenge for clinical treatment due to pathogens’ biofilm formation and their antibiotic resistance. Here, we investigate the effect of antiseptic agent polyhexamethylene biguanide (PHMB) and undecylenamidopropyl betaine (UB) against biofilms of four pathogens that are often found in hospitals, including Gram-negative bacteria Pseudomonas aeruginosa and Escherichia coli, Gram-positive bacteria Staphylococcus aureus, and pathogenic fungus, Candida albicans. We show that 0.02% PHMB, which is 10-fold lower than the concentration of commercial products, has a strong inhibitory effect on the growth, initial attachment, and biofilm formation of all tested pathogens. PHMB can also disrupt the preformed biofilms of these pathogens. In contrast, 0.1% UB exhibits a mild inhibitory effect on biofilm formation of the four pathogens. This concentration inhibits the growth of S. aureus and C. albicans yet has no growth effect on P. aeruginosa or E. coli. UB only slightly enhances the anti-biofilm efficacy of PHMB on P. -
Eyelid Conjunctival Tumors
EYELID &CONJUNCTIVAL TUMORS PHOTOGRAPHIC ATLAS Dr. Olivier Galatoire Dr. Christine Levy-Gabriel Dr. Mathieu Zmuda EYELID & CONJUNCTIVAL TUMORS 4 EYELID & CONJUNCTIVAL TUMORS Dear readers, All rights of translation, adaptation, or reproduction by any means are reserved in all countries. The reproduction or representation, in whole or in part and by any means, of any of the pages published in the present book without the prior written consent of the publisher, is prohibited and illegal and would constitute an infringement. Only reproductions strictly reserved for the private use of the copier and not intended for collective use, and short analyses and quotations justified by the illustrative or scientific nature of the work in which they are incorporated, are authorized (Law of March 11, 1957 art. 40 and 41 and Criminal Code art. 425). EYELID & CONJUNCTIVAL TUMORS EYELID & CONJUNCTIVAL TUMORS 5 6 EYELID & CONJUNCTIVAL TUMORS Foreword Dr. Serge Morax I am honored to introduce this Photographic Atlas of palpebral and conjunctival tumors,which is the culmination of the close collaboration between Drs. Olivier Galatoire and Mathieu Zmuda of the A. de Rothschild Ophthalmological Foundation and Dr. Christine Levy-Gabriel of the Curie Institute. The subject is now of unquestionable importance and evidently of great interest to Ophthalmologists, whether they are orbital- palpebral specialists or not. Indeed, errors or delays in the diagnosis of tumor pathologies are relatively common and the consequences can be serious in the case of malignant tumors, especially carcinomas. Swift diagnosis and anatomopathological confirmation will lead to a treatment, discussed in multidisciplinary team meetings, ranging from surgery to radiotherapy. -
Chronic Conjunctivitis
9/8/2017 Allergan Pharmaceuticals Speaker’s Bureau Bio-Tissue BioDLogics, LLC Katena/IOP Seed Biotech COA Monterey Symposium 2017 Johnson and Johnson Vision Care, Inc. Shire Pharmaceuticals Nicholas Colatrella, OD, FAAO, Dipl AAO, ABO, ABCMO Jeffrey R. Varanelli, OD, FAAO, Dipl ABO, ABCMO Text NICHOLASCOLA090 to 22333 to join Live Text Poll Nicholas Colatrella, OD, FAAO, Dipl AAO, Jeffrey Varanelli, OD, FAAO, Dipl ABO, ABO, ABCMO ABCMO Text NICHOLASCOLA090 to 22333 once to join Then text A, B, C, D, E or write in your answer Live Immediate Accurate Chronic conjunctivitis is one of the most frustrating reasons that patients present to the office (1) Time course Often times patients will seek multiple providers searching for a solution The chronicity of their symptoms is extremely frustrating to the (2) Morphology patient and treating physician alike Some conditions can seriously affect vision and create ocular morbidity (3) Localization of disease process Many of these diseases do not respond to commonly used topical antibiotics, topical steroids, artificial tears, and other treatments for external ocular disease (4) Type of discharge or exudate Our hope during this one-hour lecture is to present a process to help aid in the diagnosis of chronic conjunctivitis help you determine the most likely etiology 1 9/8/2017 Three weeks is the dividing point as it is the upper limit for cases of viral infection and most bacterial infections to resolve without treatment. Acute Conjunctivitis Conjunctivitis that has been present for less than 3 weeks -
Quality of Vision in Eyes with Epiphora Undergoing Lacrimal Passage Intubation
Quality of Vision in Eyes With Epiphora Undergoing Lacrimal Passage Intubation SHIZUKA KOH, YASUSHI INOUE, SHINTARO OCHI, YOSHIHIRO TAKAI, NAOYUKI MAEDA, AND KOHJI NISHIDA PURPOSE: To investigate visual function and optical PIPHORA, THE MAIN COMPLAINT OF PATIENTS WITH quality in eyes with epiphora undergoing lacrimal passage lacrimal passage obstruction, causes blurred vision, intubation. discomfort, and skin eczema, and may even cause so- E DESIGN: Prospective case series. cial embarrassment. Several studies have assessed the qual- METHODS: Thirty-four eyes of 30 patients with ity of life (QoL) or vision-related QoL of patients suffering lacrimal passage obstruction were enrolled. Before and from lacrimal disorders and the impact of surgical treat- 1 month after lacrimal passage intubation, functional vi- ments on QoL, using a variety of symptom-based question- sual acuity (FVA), higher-order aberrations (HOAs), naires.1–8 According to these studies, epiphora negatively lower tear meniscus, and tear clearance were assessed. affects QoL physically and socially; however, surgical An FVA measurement system was used to examine treatment can improve QoL. Increased tear meniscus changes in continuous visual acuity (VA) over time, owing to inadequate drainage contributes to blurry and visual function parameters such as FVA, visual main- vision.9 However, quality of vision (QoV) has not been tenance ratio, and blink frequency were obtained. fully quantified in eyes with epiphora, and the effects of Sequential ocular HOAs were measured for 10 seconds lacrimal surgery on such eyes are unknown. after the blink using a wavefront sensor. Aberration Dry eye, a clinically significant multifactorial disorder of data were analyzed in the central 4 mm for coma-like, the ocular surface and tear film, may cause visual distur- spherical-like, and total HOAs. -
(COVID-19) Outbreak: an Experience from Daegu, Korea
Infect Chemother. 2020 Jun;52(2):226-230 https://doi.org/10.3947/ic.2020.52.2.226 pISSN 2093-2340·eISSN 2092-6448 Editorial Changes in the Clinical Practice of Ophthalmology during the Coronavirus Disease 2019 (COVID-19) Outbreak: an Experience from Daegu, Korea Areum Jeong 1,2 and Min Sagong 1,2 1Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea 2Yeungnam Eye Center, Yeungnam University Hospital, Daegu, Korea Received: May 24, 2020 The world has been hit hard by the coronavirus disease 2019 (COVID-19) pandemic. Korea Accepted: May 25, 2020 experienced a surge of patients because of a mass infection in an obscure religious group Corresponding Author: in Daegu. With our experience from hospitals in Daegu, the epicenter of the COVID-19 Min Sagong, MD outbreak in Korea, we suggest the strategies that should be followed in order to reduce the Department of Ophthalmology, Yeungnam transmission and assess the risk in the field of ophthalmology. University College of Medicine, 170 Hyunchungro, Nam-gu, Daegu 42415, Korea. Tel: +82-53-620-3443 Fax: +82-53-626-5936 TRANSMISSION OF SEVERE ACUTE RESPIRATORY E-mail: [email protected] SYNDROME CORONAVIRUS 2 (SARS-CoV-2) Copyright © 2020 by The Korean Society We are still learning about how SARS-CoV-2 spreads. The virus is mainly transmitted of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society person-to-person, particularly among those who are in close contact with one another for AIDS within approximately 6 feet. Moreover, it may be possible that a person contract COVID-19 This is an Open Access article distributed by touching a surface that has the virus on it and then touching their own mouth, nose, or under the terms of the Creative Commons possibly their eyes. -
Eye Infections
CLINICAL Approach Taking a Look at Common Eye Infections John T. Huang, MD, FRCSC and Peter T. Huang, MD, FRCSC he acutely red eye is often seen first by the primary-care physician. The exact Tcause may be difficult to determine and may cause some concern that a serious ocular condition has been missed. Thorough history and clinical examination will help delineate the final diagnosis. When there are doubts, prompt referral to an oph- thalmologist can prevent serious consequences. Often, the most likely diagnosis of an acutely red eye is acute conjunctivitis. In the first day, an acute bacterial infection may be hard to differentiate from viral, chlamydial and noninfectious conjunctivitis and from episcleritis or scleritis. Below is a review of the most commonly seen forms of eye infections and treat- ments. Failure to improve after three to five days should lead to a re-evaluation of the patient and appropriate referral where necessary. CHRONIC BLEPHARITIS Clinical: Gritty burning sensation, mattering, lid margin swelling and/or scaly, flaky debris, mild hyperemia of conjunctiva; may have acne rosacea or hyperkeratotic dermatitis (Figure 1). Anterior: Staphylococcus aureus (follicles, accessory glands); posterior (meibomian glands). Treatment: • Lid scrubs (baby shampoo, lid-care towellettes, warm compresses). Figure 1. Chronic blepharitis. There may be localized sensitivity to the shampoo or the components of the solution in the towellettes (e.g., benzyl alcohol). • Hygiene is important for the treatment and management of chronic blepharitis. Topical antibiotic-corticosteroid combinations (e.g., tobramycin drops, tobramycin/dexamethasone or sulfacetamide sodium-prednisolone acetate). Usage of these medications is effective in providing symptomatic relief, as the inflammatory component of the problem is more effectively dealt with. -
Congenital Ocular Anomalies in Newborns: a Practical Atlas
www.jpnim.com Open Access eISSN: 2281-0692 Journal of Pediatric and Neonatal Individualized Medicine 2020;9(2):e090207 doi: 10.7363/090207 Received: 2019 Jul 19; revised: 2019 Jul 23; accepted: 2019 Jul 24; published online: 2020 Sept 04 Mini Atlas Congenital ocular anomalies in newborns: a practical atlas Federico Mecarini1, Vassilios Fanos1,2, Giangiorgio Crisponi1 1Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Cagliari, Italy 2Department of Surgery, University of Cagliari, Cagliari, Italy Abstract All newborns should be examined for ocular structural abnormalities, an essential part of the newborn assessment. Early detection of congenital ocular disorders is important to begin appropriate medical or surgical therapy and to prevent visual problems and blindness, which could deeply affect a child’s life. The present review aims to describe the main congenital ocular anomalies in newborns and provide images in order to help the physician in current clinical practice. Keywords Congenital ocular anomalies, newborn, anophthalmia, microphthalmia, aniridia, iris coloboma, glaucoma, blepharoptosis, epibulbar dermoids, eyelid haemangioma, hypertelorism, hypotelorism, ankyloblepharon filiforme adnatum, dacryocystitis, dacryostenosis, blepharophimosis, chemosis, blue sclera, corneal opacity. Corresponding author Federico Mecarini, MD, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Cagliari, Italy; tel.: (+39) 3298343193; e-mail: [email protected]. -
Freedman Eyelid Abnormalities
1/16/2018 1 1/16/2018 Upper Lid Lower Lid Protractors Retractors: Levator m. 3rd nerve function Muller’s m. Cranial Nerve VII function Sympathetic Function Inferior Tarsal Muscle Things to Note Lid Apposition to Globe Position of Lid Margins MRD = 3‐5 mm Canthal Insertions Brow Positions 2 1/16/2018 Ptosis Usually age related levator dehiscence, but sometimes a sign of neurologic, mechanical orbital or inflammatory disease Blepharospasm Sign of External Irritation or Neurologic Disease 3 1/16/2018 First Consider Underlying Orbital Disease Orbital Cellulitis, Pseudotumor, Wegener’s Graves Ophthalmopathy, Orbital Varix Orbital Tumors that can mimic inflammatory process: Lacrimal Gland CA, Lymphoma, Lymphangioma, etc. Lacrimal Gland – Dacryoadenitis or tumor Sinus Mucocele Without Inflammatory Appearance, consider above but also… Allergic Eyelid Edema Hormonal Shifts Systemic Disorder – Cardiac, Renal, Hepatic, Thyroid with edema Cutaneous Lymphoma Graves Ophthalmopathy –can just have lid edema w/o inflammatory appearance Lymphedema after trauma, surgery to lids or orbit (e.g. lymphatics in lateral canthus) Traumatic Leak of CSF into upper eyelid (JAMA Oph 2014;312:1485) Blepharochalasis Not True Edema, but might mimic it: Dermatochalasis, Hidden Eyelid or Sub‐Conjunctival Mass, Prolapsed Orbital Fat When your concerned about: Orbital Cellulitis Orbital Pseudotumor Orbital Malignancy Vascular – e.g. CC fistula Proptosis Chemosis Poor Motility Poor Vision Pupil abnormality – e.g. RAPD Orbital Pseudotumor 4 1/16/2018 Good Vision Good Motility -
Carotid-Cavernous Sinus Fistulas and Venous Thrombosis
141 Carotid-Cavernous Sinus Fistulas and Venous Thrombosis Joachim F. Seeger1 Radiographic signs of cavernous sinus thrombosis were found in eight consecutive Trygve 0. Gabrielsen 1 patients with an angiographic diagnosis of carotid-cavernous sinus fistula; six were of 1 2 the dural type and the ninth case was of a shunt from a cerebral hemisphere vascular Steven L. Giannotta · Preston R. Lotz ,_ 3 malformation. Diagnostic features consisted of filling defects within the cavernous sinus and its tributaries, an abnormal shape of the cavernous sinus, an atypical pattern of venous drainage, and venous stasis. Progression of thrombosis was demonstrated in five patients who underwent follow-up angiography. Because of a high incidence of spontaneous resolution, patients with dural- cavernous sinus fistulas who show signs of venous thrombosis at angiography should be followed conservatively. Spontaneous closure of dural arteriovenous fistulas involving branches of the internal and/ or external carotid arteries and the cavernous sinus has been reported by several investigators (1-4). The cause of such closure has been speculative, although venous thrombosis recently has been suggested as a possible mechanism (3]. This report demonstrates the high incidence of progres sive thrombosis of the cavernous sinus associated with dural carotid- cavernous shunts, proposes a possible mechanism of the thrombosis, and emphasizes certain characteristic angiographic features which are clues to thrombosis in evolution, with an associated high incidence of spontaneous " cure. " Materials and Methods We reviewed the radiographic and medical records of eight consecutive patients studied at our hospital in 1977 who had an angiographic diagnosis of carotid- cavernous sinus Received September 24, 1979; accepted after fistula. -
Diagnosis and Management of Common Eye Problems
Diagnosis and Management of Common Eye Problems Review of Ocular Anatomy Picture taken from Basic Ophthalmology for Medical Students and Primary Care Residents published by the American Academy of Ophthalmology Diagnosis and Management of Common Eye Problems Fernando Vega, MD Lacrimal system and eye musculature Eyelid anatomy Picture taken from Basic Ophthalmology for Medical Students and Primary Care Residents published by the American Academy of Ophthalmology n Red Eye Disorders: An Anatomical Approach n Lids n Orbit n Lacrimal System n Conjunctivitis n Cornea n Anterior Chamber Fernando Vega, MD 1 Diagnosis and Management of Common Eye Problems Red Eye Disorders: What is not in the scope of Red Eye Possible Causes of a Red Eye n Loss of Vision n Trauma n Vitreous Floaters n Chemicals n Vitreous detatchment n Infection n Retinal detachment n Allergy n Chronic Irritation n Systemic Infections Symptoms can help determine the Symptoms Continued diagnosis Symptom Cause Symptom Cause Itching allergy Deep, intense pain Corneal abrasions, scleritis Scratchiness/ burning lid, conjunctival, corneal Iritis, acute glaucoma, sinusitis disorders, including Photophobia Corneal abrasions, iritis, acute foreign body, trichiasis, glaucoma dry eye Halo Vision corneal edema (acute glaucoma, Localized lid tenderness Hordeolum, Chalazion contact lens overwear) Diagnostic steps to evaluate the patient with Diagnostic steps continued the red eye n Check visual acuity n Estimate depth of anterior chamber n Inspect pattern of redness n Look for irregularities in pupil size or n Detect presence or absence of conjunctival reaction discharge: purulent vs serous n Look for proptosis (protrusion of the globe), n Inspect cornea for opacities or irregularities lid malfunction or limitations of eye n Stain cornea with fluorescein movement Fernando Vega, MD 2 Diagnosis and Management of Common Eye Problems How to interpret findings n Decreased visual acuity suggests a serious ocular disease.