EYE DISORDERS DUE TO
TROPICAL DISEASES
T SITI HARILZA ZUBAIDAH
Page 1
SYSTEMIC BACTERIAL
INFECTIONS AND THE EYE
Page 2
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)
Page 3
- 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
Page 4
TULARAEMIA
CAUSED : GRAM (-) BACILLUS,
PASTEURELLA TULARENSIS
(FRANCISELLA TULARENSIS)
SYSTEMIC DISEASE
TRANSMISSION : RABBIT
EYE COMPLICATIONS (ORGANISM PENETRATES
CONJUNCTIVA > 2 WEEKS
- ITCHING, PHOTOSENSITIVITY
- PAIN, REDNESS,CHEMOSIS
- PARINAUDS OCULOGLANDULAR SYNDROME
TREATMENT : SYSTEMIC TREATMENT
Page 5
TUBERCULOSIS
CAUSED : MYCOBACTERIUM TUBERCULOSIS
EYE COMPLICATION
- EYELID SCARRING AND CORNEAL
EXPOSURELUPUS VULGARIS
- PAPILLARY CONJUNCTIVITIS
- PHLYCTENULAR
KERATOCONJUNCTIVITISHYPERSENSITIVITY
REACTION TO THE TUBERCULOPROTEIN
(SMALLYELLOW/PINK NODULES ON THE
CORNEOSCLERAL MARGIN)
- INTERSTITIAL KERATITIS
- SCLERITIS (ANTERIOR) OR
(POSTERIOR)THICKENING OF SCLERA DUE TO
GRANULOMA FORMATION
Page 6
- 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 )
Page 7
MENINGOCOCCAL MENINGITIS
CAUSED : GRAM NEGATIVE N. MENINGITIDIS
EYE COMPLICATION
INVOLVED CRANIAL NERVE EXTRA OCULAR
IMBALANCE
ENCEPHALITIS + OPTIC NEURITISPOSTNEURITIC
ATROPHY
CONJUNCTIVITIS
ANTERIOR UVEITIS
LOSS VISION (CORTICAL BLINDNESS)
MANAGEMENT
LOCAL INFLAMATION SHOULD BE TREATED
APPROPRIATELY
Page 8
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
Page 9
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
Page 10
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
Page 11
ARTIFICIAL TEARS & DEPEND ON EYE COMPLICATION
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
Page 12
SPIROCHAETAL DISEASES
AND THE EYE
Page 13
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
Page 14
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
Page 15
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
Page 16
YAWS
CAUSED : SPIROCHAETA TREPONEMA PERTENUE
EYE COMPLICATION
CICATRICAL ECTROPION
DESTROY BONE & CARTILAGE ( REGION OF EYE
& ORBIT )
MANAGEMENT
DEPEND ON EYE COMPLICATION
Page 17
CHLAMYDIAL INFECTIONS
AND THE EYE
Page 18
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 )
Page 19
AGENT TRANSMISSION OF THE EYE DISSEASE
FLIES
FAECES
FACES
FINGERS
FOMITES
MANAGEMENT
EPILATION
DEPEND ON EYE COMPLICATION
Page 20
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
Page 21
RICKETTSIAL INFECTIONS
AND THE EYE
Page 22
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
Page 23
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
Page 24
VIRAL INFECTIONS
AND THE EYE
Page 25
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
Page 26
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
Page 27
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
Page 28
MANAGEMENT
SYSTEMIC THERAPHY
ANTIVIRAL EYE OINTMENT
CYCLOPEGIC
TOPICAL CORTICOSTEROID
CONJUNGTIVAL FLAP OR TARSORAPHY
CORNEAL GRAFT
Page 29
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
Page 30
HERPES ZOSTER KERATITIS TAKE FORMS :
PUNCTATE EPITHELIAL EROSION,
FILAMENTARY & DISCIFORM KERATITIS
MANAGEMENT
REST, ANALGETICS
TOPICAL ANTIVIRAL ( SKIN & EYE )
TOPICAL CYCLOPEGIC
TOPICAL CORTICOSTEROID
Page 31
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
Page 32
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
Page 33
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
Page 34
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
Page 35
BURKITTS LYMPHOMA
CAUSED : EPSTEIN- BARR VIRUS
EYE COMPLICATION
CRANIAL NERVE PALSY CAN INVOLVED EYELID
MANAGEMENT
SURGERY, RADIOTHERAPY, CHEMOTHERAPY
Page 36
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
Page 37
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
Page 38
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
Page 39
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
Page 40
FUNGAL INFECTIONS
AND THE EYE
Page 41
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
Page 42
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
Page 43
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
Page 44
FUSARIOSIS
MAY CAUSE SUPURATIVE KERATITIS
WITH OR WITHOUT HYPOPION
CORNEAL SCAR WHEN AREA INFECTION HEALS
LATER CORNEAL GRAFTING MAY BE INDICATED
Page 45
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
Page 46
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
Page 47
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
Page 48
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
Page 49
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
Page 50
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
Page 51
DISEASES CAUSED BY PROTOZOA
Page 52
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
Page 53
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
Page 54
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
Page 55
AMOEBIASIS
CAUSED : ENTAMOEBA HISTOLYCA
EYE COMPLICATION
CYST IN REGION OF MACULA WITH ASSOCIATED
SMALL RETINA HAEMORRHAGIC AND DISTURBANCE
OF RETINAL PIGMEN EPITELIUM
Page 56
GIARDIASIS
CAUSED : GIARDIA LAMBLIA
EYE COMPLICATION
ANTERIOR AND POSTERIOR UVEITIS
IRIDOCYCLITIS, CHOROIDITIS
RETINA DAN SUBRETINAL HAEMORRHAGIC
MACULAR DISTURBANCE
MANAGEMENT
PATIENT RESPONS TO SYSTEMIC TREATMENT
Page 57
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 )
Page 58
AMERICAN TRYPANOMIASIS CHAGAS DISEASE)
CAUSED : T CRUZI ( INSECT BITE )
EYE COMPLICATION
EYELID OEDEM, UNILATERAL ( ROMANAS SIGN )
LACRIMAL GLAND INVOLVEMENT (INFLAMMATION)
GRANULOMATOUS UVEITIS (IN A PREMATURE
CHILD)
MANAGEMENT
DEPENDS ON EYE COMPLICATION
Page 59
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
Page 60
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
Page 61
DISEASES CAUSED
BY NEMATODES
Page 62
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
Page 63
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 )
Page 64
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
Page 65
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
Page 66
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
Page 67
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
Page 68
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
Page 69
DRANCUNCULIASIS
CAUSED : DRACUNCULUS MEDINENSIS
EYE COMPLICATION
IRRITABLE, WATERING EYE, SWELLING OF
CONJUNCTIVA
INVOLVEMENT OF ORBIT
WORM OFTEN EMERGE THROUGH THE SKIN
MANAGEMENT
REMOVED SURGICALLY
Page 70
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
Page 71
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 ( CATARACT, GLAUKOMA,
RETINA )
MANAGEMENT
REMOVAL SURGERY
Page 72
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
Page 73
DISEASE CAUSED
BY CESTODES
Page 74
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
Page 75
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
Page 76
SPARGANOSIS
CAUSED : LARVA GENUS SPIROMETRA
EYE COMPLICATION
PAIN, EYELID OEDEM, WATERING, IRRITATION
WORM FOUND SUBCONJUNCTIVALLY / RETROBULBAR
LARVA FOUND AT ANTERIOR CHAMBER
MANAGEMENT
REMOVAL SURGICAL
Page 77
DISEASE CAUSED
BY TREMATODES
Page 78
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
Page 79
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
Page 80
DISEASE CAUSED
BY ARTHROPODS
Page 81
MYIASIS
LARVA MAY CAUSE OCULAR MYIASIS
EYE COMPLICATION
REDNESS WITH IRRITATION, DISCHARGE
UVEITIS
MANAGEMENT
REMOVAL SURGERY
TOPICAL CORTICOSTEROID (INTERNAL OCULAR
MYASIS)
Page 82
TERIMA KASIH
Page 83