Complications of sinusitis can be local, orbital, intracranial, or descending infections. Local complications include mucoceles and mucopyoceles of the paranasal sinuses which present as cystic swellings that can displace the eyeball. Orbital complications arise when infection spreads to the orbit through the thin bone separating the sinuses from the orbit, such as subperiosteal abscesses, orbital cellulitis, and orbital abscesses. Intracranial complications include meningitis, extradural abscesses, and cavernous sinus thrombosis which can cause paralysis of cranial nerves. Descending infections involve spread of infection from sinuses to areas like the ears, pharynx
www.ophthalclass.blogspot.com has the complete class on uveitis for undergraduate medical students. This presentation is the third in the series and deals with the sequelae and complications of uveitis.
This document discusses viral keratitis, specifically herpes simplex virus (HSV) keratitis. It describes that HSV is a common cause of corneal blindness. HSV can cause a variety of ocular manifestations including dendritic ulcers, geographic ulcers, neurotrophic keratitis, stromal keratitis, and endothelitis. Treatment involves topical antiviral medications like acyclovir. Recurrent infections may lead to complications such as stromal scarring.
Orbital cellulitis is an infection behind the orbital septum that can spread from adjacent sinuses or bloodstream. It is classified by Chandler into 5 groups based on location and severity. Group 1 is preseptal cellulitis anterior to the septum. Group 2 is orbital cellulitis within the orbit. Group 3 is a subperiosteal abscess between the bone and periosteum. Group 4 is an orbital abscess within orbital contents. Group 5 is cavernous sinus thrombosis spreading bilaterally. Symptoms include eyelid swelling, pain, and vision issues. Imaging helps locate the infection and guide treatment which involves intravenous antibiotics, analgesics, and sometimes surgery.
This document discusses fungal corneal ulcers. It begins by describing the signs and symptoms of fungal ulcers, including pain, redness, defective vision, lid edema, and corneal opacity staining with fluorescein. Diagnosis involves smears, cultures and microscopy to identify causative fungi. Common fungi include Fusarium, Aspergillus, and Candida. Treatment involves topical natamycin or voriconazole drops. Prognosis includes potential complications like scar formation, astigmatism, perforation and fistula formation. Close monitoring is needed due to the difficulty treating fungal infections.
Fungal corneal ulcers are common, caused mainly by Aspergillus in India. Risk factors include ocular trauma, contact lens use, pre-existing eye conditions, and systemic immunosuppression. Diagnosis involves corneal scrapings, cultures, and stains showing fungal hyphae or spores. Treatment consists of topical natamycin or amphotericin B, sometimes with adjunctive debridement, intracameral/intracorneal injections, or therapeutic keratoplasty for severe cases. Systemic antifungals may also be used for extensive infections.
1. Chronic dacryocystitis is inflammation of the lacrimal sac often caused by blockage of the nasolacrimal duct leading to tearing and discharge.
2. Diagnosis is confirmed by syringing which demonstrates blockage either in the canaliculi or nasolacrimal duct.
3. Treatment options include repeated syringing, balloon dilation, or dacryocystorhinostomy which surgically reestablishes drainage by connecting the lacrimal sac to the nasal cavity.
Sympathetic ophthalmia is a rare bilateral granulomatous panuveitis that occurs after trauma or surgery to one eye. It results from an immune response against ocular antigens that spreads from the injured eye to the other eye. The main symptoms are blurred vision, pain, and photophobia in the uninjured eye. Treatment involves high-dose oral corticosteroids and immunosuppressants to prevent vision loss in both eyes. Prompt diagnosis and treatment usually leads to a good visual prognosis.
This document defines and describes interstitial keratitis, a non-ulcerative inflammation of the corneal stroma that is often allergic or infectious in origin. It discusses the various causes including congenital syphilis, tuberculosis, and Cogan's syndrome. The stages of syphilitic interstitial keratitis are described including initial progressive, florid, and regression stages. Symptoms, clinical features, diagnosis, and treatment are outlined with a focus on systemic penicillin and corticosteroids to prevent further lesions and vision loss. Tuberculous interstitial keratitis is also briefly discussed.
www.ophthalclass.blogspot.com has the complete class on uveitis for undergraduate medical students. This presentation is the third in the series and deals with the sequelae and complications of uveitis.
This document discusses viral keratitis, specifically herpes simplex virus (HSV) keratitis. It describes that HSV is a common cause of corneal blindness. HSV can cause a variety of ocular manifestations including dendritic ulcers, geographic ulcers, neurotrophic keratitis, stromal keratitis, and endothelitis. Treatment involves topical antiviral medications like acyclovir. Recurrent infections may lead to complications such as stromal scarring.
Orbital cellulitis is an infection behind the orbital septum that can spread from adjacent sinuses or bloodstream. It is classified by Chandler into 5 groups based on location and severity. Group 1 is preseptal cellulitis anterior to the septum. Group 2 is orbital cellulitis within the orbit. Group 3 is a subperiosteal abscess between the bone and periosteum. Group 4 is an orbital abscess within orbital contents. Group 5 is cavernous sinus thrombosis spreading bilaterally. Symptoms include eyelid swelling, pain, and vision issues. Imaging helps locate the infection and guide treatment which involves intravenous antibiotics, analgesics, and sometimes surgery.
This document discusses fungal corneal ulcers. It begins by describing the signs and symptoms of fungal ulcers, including pain, redness, defective vision, lid edema, and corneal opacity staining with fluorescein. Diagnosis involves smears, cultures and microscopy to identify causative fungi. Common fungi include Fusarium, Aspergillus, and Candida. Treatment involves topical natamycin or voriconazole drops. Prognosis includes potential complications like scar formation, astigmatism, perforation and fistula formation. Close monitoring is needed due to the difficulty treating fungal infections.
Fungal corneal ulcers are common, caused mainly by Aspergillus in India. Risk factors include ocular trauma, contact lens use, pre-existing eye conditions, and systemic immunosuppression. Diagnosis involves corneal scrapings, cultures, and stains showing fungal hyphae or spores. Treatment consists of topical natamycin or amphotericin B, sometimes with adjunctive debridement, intracameral/intracorneal injections, or therapeutic keratoplasty for severe cases. Systemic antifungals may also be used for extensive infections.
1. Chronic dacryocystitis is inflammation of the lacrimal sac often caused by blockage of the nasolacrimal duct leading to tearing and discharge.
2. Diagnosis is confirmed by syringing which demonstrates blockage either in the canaliculi or nasolacrimal duct.
3. Treatment options include repeated syringing, balloon dilation, or dacryocystorhinostomy which surgically reestablishes drainage by connecting the lacrimal sac to the nasal cavity.
Sympathetic ophthalmia is a rare bilateral granulomatous panuveitis that occurs after trauma or surgery to one eye. It results from an immune response against ocular antigens that spreads from the injured eye to the other eye. The main symptoms are blurred vision, pain, and photophobia in the uninjured eye. Treatment involves high-dose oral corticosteroids and immunosuppressants to prevent vision loss in both eyes. Prompt diagnosis and treatment usually leads to a good visual prognosis.
This document defines and describes interstitial keratitis, a non-ulcerative inflammation of the corneal stroma that is often allergic or infectious in origin. It discusses the various causes including congenital syphilis, tuberculosis, and Cogan's syndrome. The stages of syphilitic interstitial keratitis are described including initial progressive, florid, and regression stages. Symptoms, clinical features, diagnosis, and treatment are outlined with a focus on systemic penicillin and corticosteroids to prevent further lesions and vision loss. Tuberculous interstitial keratitis is also briefly discussed.
Vernal keratoconjunctivitis ophthalmology TONY SCARIA
This document discusses vernal keratoconjunctivitis (VKC), a recurrent, seasonal eye condition seen primarily in children and young adults. VKC involves inflammation of the conjunctiva and cornea and is caused by an allergic reaction, often to pollen allergens. Symptoms include itching, tearing, and thick discharge. Signs include raised papillae on the conjunctiva that resemble cobblestones. Treatment focuses on reducing inflammation and symptoms using topical steroids, mast cell stabilizers, and antihistamines. The condition typically resolves spontaneously by adulthood.
This document discusses microbial keratitis, specifically bacterial keratitis. It defines bacterial corneal ulcer as tissue destruction within the corneal layers due to bacterial infection and proliferation. The four main bacterial causes are discussed. Risk factors include trauma, eyelid abnormalities, dry eye, contact lens use, and systemic diseases. Bacterial keratitis progresses through stages including necrosis, line of demarcation, and healing. Diagnosis involves clinical examination, corneal scraping for culture/sensitivity, and treatment involves topical and sometimes systemic antibiotics based on culture results with the goal of preventing complications like perforation and scarring.
This document discusses corneal ulcers, including their definition, causes, microbiology, pathogenesis, stages, grading, symptoms, clinical examination, investigations, treatment, and complications. Key points include:
- Corneal ulcers are tissue excavations associated with epithelial defects, edema, infiltration and necrosis. They are usually caused by injury or foreign materials that allow microbial infection.
- Common microbes include bacteria (e.g. streptococcus, pseudomonas), fungi (e.g. candida, fusarium), protozoa (e.g. acanthamoeba), and viruses (e.g. herpes).
- Treatment involves local and systemic antibiotics, antifungals, or antiv
Uveitis is an interesting disease of the with such a varied and diverse pathogenesis, various systemic causes and Dangerous complications in relation to the eye which makes it difficult and challenging to treat in a proper way. I hope this share will help.
This document defines and classifies proptosis (abnormal forward displacement of the eyeball), discusses its causes and types, and outlines the clinical evaluation of patients presenting with proptosis. Proptosis can be pseudoproptosis (apparent protrusion) or true proptosis, and unilateral or bilateral. Common causes include thyroid eye disease, orbital tumors, infections, trauma, vascular lesions, and craniofacial anomalies. The clinical evaluation of proptosis involves history, examination of the eye and orbit, imaging studies, and laboratory/biopsy if indicated to determine the underlying cause.
Sclera is the opaque outer fibrous tunic of the eyeball. Diseases of the sclera include episcleritis, which involves inflammation of the outer episcleral layer, and scleritis, which is a deeper inflammation of the sclera proper. Scleritis can be non-necrotizing or necrotizing, and is often associated with autoimmune disorders. Other scleral conditions include blue sclera seen in certain genetic disorders, and staphylomas which are localized bulgings of a weakened sclera lined by inner ocular layers.
This document discusses the various ocular manifestations of HIV infection, which are categorized into adnexal, anterior segment, posterior segment, neuro-ophthalmic, orbital, and drug-related manifestations. Some of the key manifestations discussed include cytomegalovirus retinitis, which presents as a hemorrhagic necrotizing retinitis that spreads in a "brushfire" pattern and is the most common cause of intraocular infection in patients with CD4 counts below 50. Kaposi sarcoma and herpes zoster ophthalmicus are also discussed as common adnexal manifestations. Treatment options are provided for many of the ocular conditions.
This document discusses various corneal diseases, including dystrophies and degenerations. It provides classifications for corneal dystrophies and degenerations, noting key distinguishing features such as laterality, symmetry, age of onset, heritability, site of involvement, and presence of vascularization. Specific corneal dystrophies and degenerations are defined, with descriptions of clinical presentation, histopathological features, treatment approaches, and differentials.
This document discusses various diseases and conditions of the orbit, including proptosis, Grave's ophthalmopathy, enophthalmos, developmental anomalies, orbital inflammations, and more. It defines key terms, describes causes, clinical features, treatment, and related pathologies for each topic. Images and diagrams are included to illustrate some conditions like craniosynostosis and its types.
The document provides an overview of proptosis (forward displacement of the eye) including its causes, clinical approach, and investigations. Some key points:
- Proptosis can be caused by inflammatory conditions like thyroid eye disease, infections like orbital cellulitis, trauma, vascular lesions, cysts, and tumors.
- The clinical approach involves taking a medical history, examining the eye and orbit, and performing investigations like CT scan and MRI to determine the underlying cause.
- Thyroid eye disease is a common inflammatory cause of proptosis and features include soft tissue involvement, lid retraction, proptosis, restrictive myopathy, and potential optic neuropathy. Orbital cellulitis is a serious
Congenital glaucomas are a group of disorders where abnormal high intraocular pressure results from developmental abnormalities of the anterior chamber angle that obstruct aqueous humor drainage. They can be primary, caused by trabecular meshwork maldevelopment, or secondary, associated with other ocular or systemic anomalies. Surgical treatment via goniotomy or trabeculotomy aims to create a drainage pathway and lower pressure. Medications may be used before or after surgery to control pressure. Early diagnosis and treatment leads to the best visual prognosis.
[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
[3] Risk factors include ultraviolet light, HIV, and human papillomavirus. While rare, metastasis can occur to local lymph nodes or distant sites like lungs. Recurrence after treatment ranges from 15-52% depending
Bacterial keratitis is a sight-threatening condition caused by various bacteria that leads to progressive corneal destruction if left untreated. It is characterized by corneal inflammation and ulceration. Common risk factors include contact lens wear, trauma, and ocular surface diseases. Clinical features may include a purulent corneal ulcer without hypopyon or a hypopyon corneal ulcer, the latter seen more often with more virulent organisms and in immunocompromised patients. Prompt treatment is necessary to prevent corneal perforation or extension of infection.
1. Viral corneal ulcers have increased due to antibiotics reducing bacterial flora. Herpes simplex virus is a common cause, initially infecting epithelium and potentially becoming neurotropic. Primary infection involves non-immune individuals while recurrent infections reactivate dormant virus.
2. Herpes simplex keratitis manifestations include punctate epithelial keratitis, dendritic ulcers, and stromal keratitis treated with antivirals like acyclovir along with supportive measures. Herpes zoster ophthalmicus affects the trigeminal nerve causing vesicular skin lesions and ocular complications in 50% of cases like keratitis, treated with antivirals and steroids.
This document discusses various types of secondary glaucoma caused by underlying ocular diseases and conditions. It describes the mechanisms of increased intraocular pressure, clinical features, and treatment approaches for different forms of secondary glaucoma including lens-induced glaucoma, inflammatory glaucoma, pigmentary glaucoma, neovascular glaucoma, and steroid-induced glaucoma among others. Management involves treating the underlying condition causing secondary glaucoma as well as lowering intraocular pressure through medical, laser, or surgical means.
This document discusses various types of metabolic optic neuropathies including toxic, nutritional, and hereditodegenerative optic neuropathies. It provides details on the clinical presentation, pathogenesis, and treatment of different conditions that can cause metabolic optic neuropathies including various toxic medications, nutritional deficiencies, hereditary disorders like Leber's hereditary optic neuropathy, and more. Examples of specific toxic medications that can cause optic neuropathies discussed include ethambutol, methanol, chloroquine, and statins.
Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
This document discusses bacterial keratitis and corneal ulcers. It defines bacterial keratitis as any corneal inflammation caused by bacteria, and a corneal ulcer as bacterial keratitis accompanied by a loss of epithelium. It then lists common bacterial causes and describes characteristics of infections caused by different bacteria. The document provides guidance on diagnosing, treating, and managing bacterial keratitis and corneal ulcers.
This document discusses various viral and protozoal causes of corneal ulcers, including herpes simplex virus (HSV), herpes zoster virus, and acanthamoeba. It describes the etiology, clinical features, diagnosis, and treatment of these conditions. Primary and recurrent HSV keratitis present with punctate epithelial lesions and dendritic ulcers. Herpes zoster ophthalmicus causes vesicular skin lesions following reactivation of varicella zoster virus in the trigeminal ganglion. Acanthamoeba keratitis is an opportunistic infection associated with contact lens use that presents with epithelial lesions and stromal infiltrates. Treatment involves antiviral medications for viruses and anti-am
Osteomyelitis is a bone infection, more common in children than adults, that can start in the dental sac and spread to the maxilla. Symptoms include cheek swelling, eyelid edema, nasal discharge, and fever. Treatment involves high doses of antibiotics, drainage of any abscesses, and removal of infected bone fragments. Orbital complications are a common result of sinusitis, especially from the ethmoid sinus in children. This can lead to subperiosteal abscesses that displace the eyeball, orbital cellulitis spreading infection between orbital structures, or intraorbital abscesses seen on imaging. Left untreated, vision loss, meningitis, or cavernous sinus thrombosis can occur.
1) Sinusitis complications arise when infection spreads beyond the sinus mucosa into surrounding areas like the orbit or skull. Common local complications include mucoceles/pyocles, osteomyelitis of the frontal bone or maxilla, and orbital issues like preseptal cellulitis, subperiosteal abscesses, or orbital cellulitis.
2) Intracranial complications from sinusitis spreading can cause meningitis, extradural or subdural abscesses, brain abscesses, or cavernous sinus thrombosis. Descending infections from sinus discharge can also lead to otitis media, pharyngitis, or laryngitis.
3) Orbital cell
Vernal keratoconjunctivitis ophthalmology TONY SCARIA
This document discusses vernal keratoconjunctivitis (VKC), a recurrent, seasonal eye condition seen primarily in children and young adults. VKC involves inflammation of the conjunctiva and cornea and is caused by an allergic reaction, often to pollen allergens. Symptoms include itching, tearing, and thick discharge. Signs include raised papillae on the conjunctiva that resemble cobblestones. Treatment focuses on reducing inflammation and symptoms using topical steroids, mast cell stabilizers, and antihistamines. The condition typically resolves spontaneously by adulthood.
This document discusses microbial keratitis, specifically bacterial keratitis. It defines bacterial corneal ulcer as tissue destruction within the corneal layers due to bacterial infection and proliferation. The four main bacterial causes are discussed. Risk factors include trauma, eyelid abnormalities, dry eye, contact lens use, and systemic diseases. Bacterial keratitis progresses through stages including necrosis, line of demarcation, and healing. Diagnosis involves clinical examination, corneal scraping for culture/sensitivity, and treatment involves topical and sometimes systemic antibiotics based on culture results with the goal of preventing complications like perforation and scarring.
This document discusses corneal ulcers, including their definition, causes, microbiology, pathogenesis, stages, grading, symptoms, clinical examination, investigations, treatment, and complications. Key points include:
- Corneal ulcers are tissue excavations associated with epithelial defects, edema, infiltration and necrosis. They are usually caused by injury or foreign materials that allow microbial infection.
- Common microbes include bacteria (e.g. streptococcus, pseudomonas), fungi (e.g. candida, fusarium), protozoa (e.g. acanthamoeba), and viruses (e.g. herpes).
- Treatment involves local and systemic antibiotics, antifungals, or antiv
Uveitis is an interesting disease of the with such a varied and diverse pathogenesis, various systemic causes and Dangerous complications in relation to the eye which makes it difficult and challenging to treat in a proper way. I hope this share will help.
This document defines and classifies proptosis (abnormal forward displacement of the eyeball), discusses its causes and types, and outlines the clinical evaluation of patients presenting with proptosis. Proptosis can be pseudoproptosis (apparent protrusion) or true proptosis, and unilateral or bilateral. Common causes include thyroid eye disease, orbital tumors, infections, trauma, vascular lesions, and craniofacial anomalies. The clinical evaluation of proptosis involves history, examination of the eye and orbit, imaging studies, and laboratory/biopsy if indicated to determine the underlying cause.
Sclera is the opaque outer fibrous tunic of the eyeball. Diseases of the sclera include episcleritis, which involves inflammation of the outer episcleral layer, and scleritis, which is a deeper inflammation of the sclera proper. Scleritis can be non-necrotizing or necrotizing, and is often associated with autoimmune disorders. Other scleral conditions include blue sclera seen in certain genetic disorders, and staphylomas which are localized bulgings of a weakened sclera lined by inner ocular layers.
This document discusses the various ocular manifestations of HIV infection, which are categorized into adnexal, anterior segment, posterior segment, neuro-ophthalmic, orbital, and drug-related manifestations. Some of the key manifestations discussed include cytomegalovirus retinitis, which presents as a hemorrhagic necrotizing retinitis that spreads in a "brushfire" pattern and is the most common cause of intraocular infection in patients with CD4 counts below 50. Kaposi sarcoma and herpes zoster ophthalmicus are also discussed as common adnexal manifestations. Treatment options are provided for many of the ocular conditions.
This document discusses various corneal diseases, including dystrophies and degenerations. It provides classifications for corneal dystrophies and degenerations, noting key distinguishing features such as laterality, symmetry, age of onset, heritability, site of involvement, and presence of vascularization. Specific corneal dystrophies and degenerations are defined, with descriptions of clinical presentation, histopathological features, treatment approaches, and differentials.
This document discusses various diseases and conditions of the orbit, including proptosis, Grave's ophthalmopathy, enophthalmos, developmental anomalies, orbital inflammations, and more. It defines key terms, describes causes, clinical features, treatment, and related pathologies for each topic. Images and diagrams are included to illustrate some conditions like craniosynostosis and its types.
The document provides an overview of proptosis (forward displacement of the eye) including its causes, clinical approach, and investigations. Some key points:
- Proptosis can be caused by inflammatory conditions like thyroid eye disease, infections like orbital cellulitis, trauma, vascular lesions, cysts, and tumors.
- The clinical approach involves taking a medical history, examining the eye and orbit, and performing investigations like CT scan and MRI to determine the underlying cause.
- Thyroid eye disease is a common inflammatory cause of proptosis and features include soft tissue involvement, lid retraction, proptosis, restrictive myopathy, and potential optic neuropathy. Orbital cellulitis is a serious
Congenital glaucomas are a group of disorders where abnormal high intraocular pressure results from developmental abnormalities of the anterior chamber angle that obstruct aqueous humor drainage. They can be primary, caused by trabecular meshwork maldevelopment, or secondary, associated with other ocular or systemic anomalies. Surgical treatment via goniotomy or trabeculotomy aims to create a drainage pathway and lower pressure. Medications may be used before or after surgery to control pressure. Early diagnosis and treatment leads to the best visual prognosis.
[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
[3] Risk factors include ultraviolet light, HIV, and human papillomavirus. While rare, metastasis can occur to local lymph nodes or distant sites like lungs. Recurrence after treatment ranges from 15-52% depending
Bacterial keratitis is a sight-threatening condition caused by various bacteria that leads to progressive corneal destruction if left untreated. It is characterized by corneal inflammation and ulceration. Common risk factors include contact lens wear, trauma, and ocular surface diseases. Clinical features may include a purulent corneal ulcer without hypopyon or a hypopyon corneal ulcer, the latter seen more often with more virulent organisms and in immunocompromised patients. Prompt treatment is necessary to prevent corneal perforation or extension of infection.
1. Viral corneal ulcers have increased due to antibiotics reducing bacterial flora. Herpes simplex virus is a common cause, initially infecting epithelium and potentially becoming neurotropic. Primary infection involves non-immune individuals while recurrent infections reactivate dormant virus.
2. Herpes simplex keratitis manifestations include punctate epithelial keratitis, dendritic ulcers, and stromal keratitis treated with antivirals like acyclovir along with supportive measures. Herpes zoster ophthalmicus affects the trigeminal nerve causing vesicular skin lesions and ocular complications in 50% of cases like keratitis, treated with antivirals and steroids.
This document discusses various types of secondary glaucoma caused by underlying ocular diseases and conditions. It describes the mechanisms of increased intraocular pressure, clinical features, and treatment approaches for different forms of secondary glaucoma including lens-induced glaucoma, inflammatory glaucoma, pigmentary glaucoma, neovascular glaucoma, and steroid-induced glaucoma among others. Management involves treating the underlying condition causing secondary glaucoma as well as lowering intraocular pressure through medical, laser, or surgical means.
This document discusses various types of metabolic optic neuropathies including toxic, nutritional, and hereditodegenerative optic neuropathies. It provides details on the clinical presentation, pathogenesis, and treatment of different conditions that can cause metabolic optic neuropathies including various toxic medications, nutritional deficiencies, hereditary disorders like Leber's hereditary optic neuropathy, and more. Examples of specific toxic medications that can cause optic neuropathies discussed include ethambutol, methanol, chloroquine, and statins.
Bullous keratopathy refers to corneal swelling caused by insufficient pumping of fluid out of the cornea. It results in the formation of fluid-filled blisters beneath the surface of the eye. It can occur secondary to endothelial dysfunction from trauma, inflammation, dystrophies or other conditions that damage the corneal endothelial pump. Symptoms include blurred vision, glare, pain from ruptured blisters, and potentially scarring. Management involves reducing fluid buildup through hypertonic drops or lenses, lowering eye pressure if high, and corneal transplantation if vision is significantly decreased or pain becomes intolerable.
This document discusses bacterial keratitis and corneal ulcers. It defines bacterial keratitis as any corneal inflammation caused by bacteria, and a corneal ulcer as bacterial keratitis accompanied by a loss of epithelium. It then lists common bacterial causes and describes characteristics of infections caused by different bacteria. The document provides guidance on diagnosing, treating, and managing bacterial keratitis and corneal ulcers.
This document discusses various viral and protozoal causes of corneal ulcers, including herpes simplex virus (HSV), herpes zoster virus, and acanthamoeba. It describes the etiology, clinical features, diagnosis, and treatment of these conditions. Primary and recurrent HSV keratitis present with punctate epithelial lesions and dendritic ulcers. Herpes zoster ophthalmicus causes vesicular skin lesions following reactivation of varicella zoster virus in the trigeminal ganglion. Acanthamoeba keratitis is an opportunistic infection associated with contact lens use that presents with epithelial lesions and stromal infiltrates. Treatment involves antiviral medications for viruses and anti-am
Osteomyelitis is a bone infection, more common in children than adults, that can start in the dental sac and spread to the maxilla. Symptoms include cheek swelling, eyelid edema, nasal discharge, and fever. Treatment involves high doses of antibiotics, drainage of any abscesses, and removal of infected bone fragments. Orbital complications are a common result of sinusitis, especially from the ethmoid sinus in children. This can lead to subperiosteal abscesses that displace the eyeball, orbital cellulitis spreading infection between orbital structures, or intraorbital abscesses seen on imaging. Left untreated, vision loss, meningitis, or cavernous sinus thrombosis can occur.
1) Sinusitis complications arise when infection spreads beyond the sinus mucosa into surrounding areas like the orbit or skull. Common local complications include mucoceles/pyocles, osteomyelitis of the frontal bone or maxilla, and orbital issues like preseptal cellulitis, subperiosteal abscesses, or orbital cellulitis.
2) Intracranial complications from sinusitis spreading can cause meningitis, extradural or subdural abscesses, brain abscesses, or cavernous sinus thrombosis. Descending infections from sinus discharge can also lead to otitis media, pharyngitis, or laryngitis.
3) Orbital cell
This document discusses various local and orbital complications that can arise from sinusitis as well as potential intracranial complications. Local complications include mucoceles of the paranasal sinuses, mucus retention cysts, and osteomyelitis of the maxilla or frontal bone. Orbital complications range from preseptal inflammatory edema to subperiosteal abscesses, orbital cellulitis, and orbital apex syndrome. Sinus infections can also potentially spread and cause meningitis, encephalitis, or brain abscesses. Descending infections from sinusitis may lead to otitis media, pharyngitis, laryngitis or tracheobronchitis.
The document discusses various conditions that can affect the orbit including orbital periostitis, orbital cellulitis, cavernous sinus thrombosis, chronic orbital inflammations, and parasitic orbital infection. It describes the anatomy of the orbit and eyeball, clinical features, causes, complications, and treatment approaches for these different orbital conditions.
Complications of suppurative otitis mediaSidra Nawaz
This document discusses complications that can arise from suppurative otitis media, including mastoiditis, petrositis, facial paralysis, and others. It outlines factors that influence the development of complications such as age, socioeconomic status, and immune status. It also describes various pathways of infection spread and classifications of intracranial complications. Specific complications are then discussed in more detail including their causes, symptoms, treatments and more.
This document discusses complications that can arise from chronic otitis media (COM), including both extracranial and intracranial complications. Extracranial complications include postauricular abscess, facial palsy, and sensorineural hearing loss. Intracranial complications include meningitis, brain abscess, lateral sinus thrombosis, and otitic hydrocephalus. Management of complications involves intravenous antibiotics, drainage or excision of abscesses, and surgical treatment of the ear infection. Early and effective treatment of both the complication and the underlying ear disease is important.
Rhinosinusitis can lead to serious orbital, intracranial, and bony complications if not properly treated. The document describes the various classifications of orbital complications including preseptal cellulitis, orbital cellulitis, subperiosteal abscess, and orbital abscess. It also details intracranial complications such as meningitis, epidural/subdural empyema, brain abscess, and cavernous sinus thrombosis. Treatment involves antibiotics, surgical drainage if needed, and management of the underlying sinusitis. Failure to improve or clinical deterioration despite treatment indicates the need for more aggressive management.
The orbit is separated from the eyelid by the orbital septum, which prevents spread of infection from the eyelids to the orbit. Preseptal cellulitis involves infection of tissues anterior to the septum, causing eyelid swelling and pain but no orbital involvement. Orbital cellulitis is infection behind the septum in the orbit, which can lead to complications like abscesses, cavernous sinus thrombosis, or meningitis if not treated promptly with IV antibiotics. Cavernous sinus thrombosis involves septic thrombosis of the cavernous sinus veins and can cause bilateral proptosis, cranial nerve palsies, and systemic symptoms. Facial trauma can cause fractures of the orbital walls which may require surgical
The document discusses various topics related to clinical nasal slides and dental students including:
1. The anatomy of the external nasal skeleton, nasal septum, nasal turbinates, and paranasal sinuses.
2. Conditions affecting the nose, palate, and paranasal sinuses including cleft lip and palate, sinusitis, nasal fractures, and nasal tumors.
3. Radiographic images showing dental and jaw fractures, cysts, tumors, and infections affecting the maxillary sinus and their relationship to dental issues.
The document discusses various diseases and conditions that can affect the external nose and nasal vestibule. It describes cellulitis, nasal deformities like saddle nose and hump nose, and various types of tumors including dermoid cysts, encephaloceles, and basal cell carcinoma. It also discusses injuries to the nose including nasal fractures and injuries to the paranasal sinuses. Other conditions mentioned include furuncles, vestibulitis, stenosis of the nares, and epistaxis (nosebleeds). The treatments involve antibiotics, steroids, surgery, and procedures to repair nasal fractures and deformities.
This document outlines various potential complications of chronic rhinosinusitis that can affect the orbit, intracranial cavity, and bones. It describes orbital complications such as preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, and cavernous sinus thrombosis. Intracranial complications discussed include meningitis, epidural abscess, subdural abscess, intracerebral abscess, cavernous sinus thrombosis, and sagittal sinus thrombosis. Bone complications include osteomyelitis (Pott's puffy tumor). Chronic complications include mucocoeles.
Sinusitis is defined as inflammation of the mucosal lining of the sinus passages. Frequent attacks of sinusitis for over three months, also known as chronic sinusitis, result in the thickening of the mucosal membranes and an excess production of nasal and sinus secretions. These secretions are usually thick and sticky and frequently predispose the sinuses to bacterial infection.
https://www.icliniq.com/articles/ent-health/sinusitis-causes-symptoms-and-treatment
This document discusses the complications that can arise from rhinosinusitis infections. It begins by defining complications and providing epidemiological data. It then classifies complications as orbital, intracranial, bony or chronic. Specific complications are discussed such as orbital cellulitis, brain abscess, subdural empyema, and cavernous sinus thrombosis. Treatment involves both medical and surgical approaches depending on the complication. Prognosis is generally good if complications are promptly treated and monitored.
This document discusses various intracranial complications that can arise from chronic otitis media, including:
1. Meningitis, which is the most common complication and occurs when infection spreads from the middle ear to the membranes covering the brain.
2. Extradural and subdural abscesses, which develop when infection spreads through the bone and collects between the skull and brain or between the brain's membranes.
3. Brain abscesses, which usually form when infection extends from the middle ear into the brain tissue, commonly through areas of bone dehiscence. Lateral sinus thrombophlebitis involves infection and clot formation within the venous sinus near the ear.
This document discusses acute sinusitis, providing details on the types and causes. It begins by explaining that the maxillary sinus is most commonly infected, followed by the ethmoid, frontal and sphenoid sinuses. Acute sinusitis is usually caused by viral infections that are later invaded by bacteria like streptococcus pneumoniae. Each type of acute sinusitis is then described in more detail, outlining signs and symptoms, treatments, and potential complications for maxillary, frontal, ethmoid and sphenoid infections.
1) The frontal sinus and surrounding anatomy can vary significantly between individuals. Abnormal structures like agger nasi cells can obstruct the frontal sinus and contribute to sinusitis.
2) Surgical approaches to the frontal sinus include trephination, endoscopy, and various external and endonasal procedures. The goal is to establish drainage while preserving surrounding structures.
3) Common pathologies of the frontal sinus discussed include osteomas, fibrous dysplasia, and inverted papillomas. Surgical techniques aim to completely remove tumors while preserving function and minimizing recurrence risk.
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2. Complications are said to arise when infection
spreads into or beyond the bony wall of the
sinus
Mainly divided into
1. Local
2. Orbital
3. Intracranial
4. Descending infections
5. Focal infections
3. I . LOCAL COMPLICATIONS
A. MUCOCELE OF PARANASAL SINUSES
AND MUCOUS RETENTION CYST
There are two views in the genesis of a mucocele:
1. Chronic obstruction to sinus ostium resulting in
accumulation of secretions which slowly expand the
sinus and destroy its bony walls.
2. Cystic dilatation of mucous gland of the sinus mucosa
due to obstruction of its duct. In this case, wall of
mucocele is surrounded by normal sinus mucosa. The
contents of mucocele are sterile.
4. Mucoceleofthefrontalsinus
Usually presents in the superomedial quadrant
of the orbit (90%) and displaces the eyeball
forward, downward and laterally.
The swelling is cystic and non tender; egg-
shell crackling may be elicited.
Sometimes, it presents as a cystic swelling in
the forehead(10%).
Patient’s complaints are usually mild and may
include headache, diplopia and proptosis.
5. Mucocele of frontal sinus.
Imaging of the frontal sinus usually reveals
clouding of the sinus with loss of scalloped
outline.
6. Treatment is frontoethmoidectomy with
free drainage of frontal sinus into the middle
meatus
7. Mucoceleofethmoidsinuses
Seen as expansion of the medial wall of the orbit,
displacing the eyeball forward and laterally.
It may also cause a bulge in the middle meatus of
nose.
A mucocele of the ethmoid can be drained by an
intranasal operation, uncapping the ethmoidal
bulge and establishing free drainage.
Sometimes, it may require external ethmoid
operation.
8. Mucousretentioncystofthemaxillary
sinus
Presents as a retention cyst due to obstruction
of the duct of seromucinous gland and usually
does not cause bone erosion.
It is asymptomatic and is observed as an
incidental finding on radiographs.
No treatment is generally required for
asymptomatic retention cysts as most of them
regress spontaneously over a period of time.
9. Mucoceleofthemaxillarysinus
Can occur as a complication of chronic sinusitis
when the ostium is blocked.
The sinus fills with mucus and its bony walls
get expanded due to expansile process.
CT scan and MRI can help in the diagnosis.
A polyp, tumour or trauma in the middle
meatus may also obstruct the sinus ostium to
cause a mucocele.
10. Mucoceleofsphenoidsinusor
sphenoethmoidalmucocele
Arises from slow expansion and destruction of sphenoid and
posterior ethmoid sinuses.
Clinical features are those of superior orbital fissure
syndrome (involvement of CN III, IV, VI and ophthalmic
division of V) or orbital apex syndrome which is superior
orbital fissure syndrome with additional involvement of
optic and maxillary division of trigeminal nerve.
Exophthalmos is always present and the pain is localized to
the orbit or forehead.
Some may complain of headache in the occiput or vertex.
Treatment is external ethmoidectomy with sphenoidotomy.
Anterior wall of the sphenoid sinus is removed, cyst wall
uncapped and its fluid contents evacuated.
11. Pyoceleormucopyocele
Is similar to mucocele but its contents are
purulent.
It can result from infection of a mucocele of
any of the sinuses
Endoscopic surgery has replaced external
operation of the sinuses for treatment of all
mucocele or mucopyoceles of various sinuses.
12. B.OSTEOMYELITIS
Osteomyelitis is infection of bone marrow.
Osteomyelitis, following sinus infection, involves
either the maxilla or the frontal bone.
1. Osteomyelitis of the maxilla.
It is more often seen in infants and children than
adults because of the presence of spongy bone in the
anterior wall of the maxilla.
Infection may start in the dental sac and then spread
to the maxilla, but sometimes, it is primary infection
of the maxillary sinus.
Clinical features are erythema, swelling of cheek,
oedema of lower lid, purulent nasal discharge and
fever.
13. Subperiosteal abscess followed by fistulae may
form in infraorbital region, alveolus or palate, or in
zygoma.
Sequestration of bone may occur.
Treatment consists of large doses of antibiotics,
drainage of any abscess and removal of the
sequestra.
Osteomyelitis of maxilla may cause damage to
temporary or permanent tooth-buds,
maldevelopment of maxilla, oroantral fistula,
persistently draining sinus or epiphora
15. 2.Osteomyelitis of frontal bone
It is more often seen in adults as frontal sinus is not developed
in infants and children.
Osteomyelitis of frontal bone results from acute infection of
frontal sinus either directly or through the venous spread.
It can also follow trauma or surgery of frontal sinus in the
presence of acute infection.
Pus may form externally under the periosteum as soft doughy
swelling (Pott’s puffy tumour), or internally as an extradural
abscess.
Treatment consists of large doses of antibiotics, drainage of
abscess and trephining of frontal sinus through its floor.
Sometimes, it requires removal of sequestra and necrotic bone
by raising a scalp flap through a coronal incision
16. Case of chronic frontal sinusitis presenting with a fistula in
the floor of the sinus.
17. II.ORBITALCOMPLICATIONS
Orbit and its contents are closely related to the ethmoid,
frontal and maxillary sinuses, but most of the complications,
however, follow infection of ethmoids as they are separated from the
orbit only by a thin lamina of bone — lamina papyracea.
Infection travels from these sinuses either by osteitis or as
thrombophlebitic process of ethmoidal veins.
Orbital complications include:
1. Inflammatory oedema of lids.
This is only reactionary.
There is no erythema or tenderness of the lids which characterises lid
abscess.
It involves only preseptal space, i.e. lies in front of orbital septum.
Eyeball movements and vision are normal.
Generally, upper lid is swollen in frontal, lower lid in maxillary, and
both upper and lower lids in ethmoid sinusitis.
18. 2. Subperiosteal abscess.
Pus collects outside the bone under the periosteum.
A subperiosteal abscess from ethmoids forms on
the medial wall of orbit and displaces the eyeball
forward, downward and laterally;
from the frontal sinus, abscess is situated just above
and behind the medial canthus and displaces the
eyeball downwards and laterally;
from the maxillary sinus, abscess forms in the floor
of the orbit and displaces the eyeball upwards and
forwards.
19. 3. Orbital cellulitis.
The pus on breaking through the periosteum finds its
way into the orbit, it spreads between the orbital fat,
extraocular muscles, vessels and nerves.
Clinical features will include oedema of lids,
exophthalmos , chemosis of conjunctiva and restricted
movements of the eye ball.
Vision is affected causing partial or total loss which is
sometimes permanent.
Patient may run high fever.
Orbital cellulitis is potentially dangerous because
of the risk of meningitis and cavernous sinus
thrombosis.
20. 4. Orbital abscess
Intraorbital abscess usually forms along
lamina papyracea or the floor of frontal sinus.
Clinical picture is similar to that of orbital
cellulitis.
Diagnosis can be easily made by CT scan or
ultrasound of the orbit.
Treatment is i.v. antibiotics and drainage of the
abscess and sinus (ethmoidectomy or trephination
of frontal sinus).
22. 5. Superior orbital fissure syndrome
Infection of sphenoid sinus can rarely affect structures of
superior orbital fissure.
Symptoms consist of deep orbital pain, frontal
headache and progressive paralysis of CN VI, III and IV
in that order.
6. Orbital apex syndrome.
It is superior orbital fissure syndrome with
additional involvement of the optic nerve and
maxillary division of the trigeminal (V2)
23. III. INTRACRANIAL COMPLICATIONS
Frontal, ethmoid and sphenoid sinuses are
closely related to anterior cranial fossa and
infection from these can cause:
1. Meningitis and encephalitis
2. Extradural abscess
3. Subdural abscess
4. Brain abscess
5. Cavernous sinus thrombosis
24. CAVERNOUSSINUSTHROMBOSIS
Aetiology
Infection of paranasal sinuses, particularly those
of ethmoid and sphenoid and less commonly the
frontal, and orbital complications from these sinus
infections can cause thrombophlebitis of the
cavernous sinus.
The valveless nature of the veins connecting the
cavernous sinus causeseasy spread of infection.
25. Clinical features.
Onset of cavernous sinus thrombophlebitis is abrupt
with chills and rigors.
Patient is acutely ill.
Eyelids get swollen with chemosis and proptosis of
eyeball.
Cranial nerves III, IV and VI causing total
ophthalmoplegia which are related to the sinus get
involved individually and sequentially
Pupil becomes dilated and fixed, optic disc shows
congestion and oedema with diminution of vision.
Sensation in the distribution of V1 (ophthalmic
division of CN V) is diminished.
CSF is usually normal.
Diagnosis : CT scan .
26. Treatment.
It consists of i.v. antibiotics and attention
to the focus of infection, drainage of infected
ethmoid or sphenoid sinus.
Blood culture should be taken before
starting antibiotic therapy.
27. IV.DESCENDINGINFECTIONS
In suppurative sinusitis, discharge constantly flows
into the pharynx and can cause or aggravate:
1. Otitis media (acute or chronic).
2. Pharyngitis and tonsillitis.
Hypertrophy of lateral lymphoid bands behind the
posterior pillars (lateral pharyngitis) is indicative of
chronic sinusitis.
It may be unilateral and affect the side of the involved
sinus.
Chronic sinusitis may also cause recurrent tonsillitis or
granular pharyngitis.
3. Persistent laryngitis and tracheobronchitis.
28. V. FOCAL INFECTIONS
Doubtful condition
Due to dissemination of microorganisms or
toxic products .
Eg :Polyarthritis, tenosynovitis, fibrositis and
certain skin diseases.