Eye bacterial infections include conjunctivitis,keratitis, endophthalmitis,preseptal cellulitis,orbital cellulitis, and dacryocystitis.Broad spectrum antibiotics are the choice of treatment.These are effective against the most common bacteria associated with these ocular infections. However, the widespread use of broad-spectrum systemic antibiotics has resulted in resistance among both Gram-positive and Gram-negative bacteria to a number of the older antibiotics used to treat ophthalmic infections.
A recently published study from India has shown a link between in vitro resistance and clinical failure to respond in patients with keratitis caused by Pseudomonas isolates. Garg et al(Ophthalmology 1999;106:1319-2)reported that of 141 culture-proven cases of Pseudomonas keratitis, 22 cases were caused by isolates resistant to ciprofloxacin (mean MIC 43mg/ml). Of the 19 (of 22) cases treated initially with ciprofloxacin, 15 (76.7 per cent) worsened or showed no clinical improvement after three days of intensive therapy and required modification of antibiotic therapy, corneal grafting or evisceration (surgical removal of the contents of the eyeball).
Broad-spectrum, bactericidal antibiotics and its resistance is becoming a greater problem in managing ocular bacterial infections.The fourth-generation fluoroquinolones with broader gram-positive coverage and greater effectiveness against emerging resistant isolates are now available for ophthalmic use.
Tuesday, July 27, 2010
Sunday, July 25, 2010
EMERGENCY EYE CARE:CHEMICAL INJURIES
If a chemical gets in your eye,we generally close our eyes or rub it. However, this could cause more irritation. Immediately rinse your eye under a steady stream of clean warm water for 15 minutes
Randleman et al (2009) Emory Eye centre states that chemical injuries account for around 7% of work-related eye injuries treated at US hospital emergency departments. Furthermore, they said that over 60% of chemical injuries occur in the workplace, 30% at home and 10% as a result of assault.
Acids are chemicals that aren't extremely dangerous, even though they may initially sting and cause redness. Alkalis, like oven cleaners or toilet bowl cleaners, although they may not hurt at first, can cause serious damage, including vision loss and blindness
Common sources of alkali are as follows:Cleaning products,Fertilizers,Drain cleaners,Cement, plaster, mortar (eg, lime),Airbag rupture (eg, sodium hydroxide)Fireworks (eg, magnesium hydroxide),Potash (eg, potassium hydroxide)
Common sources of acids are Battery acid (eg, sulfuric acid),Bleach (eg, sulfurous acid),Glass polish,Vinegar (eg, acetic acid),Chromic acid,Nitric acid,Hydrochloric
If available, the eye should be anesthetized prior to irrigation.
Ideally, the eye should be irrigated with a sterile balanced buffered solution, such as normal saline solution or Ringer's lactate solution. However, immediate irrigation with even plain tap water is preferred without waiting for the ideal fluid.
The irrigation solution must contact the ocular surface.Irrigation should be continued until the pH of the ocular surface is neutralized, usually requiring 1-2 liters of fluid
Chemically injured eyes have a tendency to poorly produce adequate tears; therefore, artificial tear supplements play an important role in healing.
A therapeutic bandage contact lens until the epithelium has regenerated can be helpful in some patients.
Refer the patient to the Ophthalmologist (Eye Specialist) at the earliest.
Randleman et al (2009) Emory Eye centre states that chemical injuries account for around 7% of work-related eye injuries treated at US hospital emergency departments. Furthermore, they said that over 60% of chemical injuries occur in the workplace, 30% at home and 10% as a result of assault.
Acids are chemicals that aren't extremely dangerous, even though they may initially sting and cause redness. Alkalis, like oven cleaners or toilet bowl cleaners, although they may not hurt at first, can cause serious damage, including vision loss and blindness
Common sources of alkali are as follows:Cleaning products,Fertilizers,Drain cleaners,Cement, plaster, mortar (eg, lime),Airbag rupture (eg, sodium hydroxide)Fireworks (eg, magnesium hydroxide),Potash (eg, potassium hydroxide)
Common sources of acids are Battery acid (eg, sulfuric acid),Bleach (eg, sulfurous acid),Glass polish,Vinegar (eg, acetic acid),Chromic acid,Nitric acid,Hydrochloric
If available, the eye should be anesthetized prior to irrigation.
Ideally, the eye should be irrigated with a sterile balanced buffered solution, such as normal saline solution or Ringer's lactate solution. However, immediate irrigation with even plain tap water is preferred without waiting for the ideal fluid.
The irrigation solution must contact the ocular surface.Irrigation should be continued until the pH of the ocular surface is neutralized, usually requiring 1-2 liters of fluid
Chemically injured eyes have a tendency to poorly produce adequate tears; therefore, artificial tear supplements play an important role in healing.
A therapeutic bandage contact lens until the epithelium has regenerated can be helpful in some patients.
Refer the patient to the Ophthalmologist (Eye Specialist) at the earliest.
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