COMMON OCULAR INFECTIONS - A PRESCRIBERS GUIDE

While most ocular infections are benign, others can be associated with devastating Visual consequences. Most patients present with either oc ular discharge, visual symptoms or a red or painful eye. The primary c are physician is usually the ill-st to evaluate these patients. We hav e separated ocular infections into 3 groups. Infections affecting the cornea and conjunctiva often present with eye pain and a red eye; noni nfectious aetiologies can have a similar presentation. Infections insi de the eye (endophthalmitis) often have devastating consequences. They usually occur following penetrating ocular trauma or after intraocula r surgery. Prompt referral to an ophthalmologist is crucial. Infection s in the soft tissue surrounding the eye (ocular adnexa and orbit) can involve the eye indirectly and can spread from the orbit into the bra in, The purpose of this article is to review ocular infections and cur rent opinion regarding treatment. A general guideline should be that t he approach to treatment be governed by the severity of symptoms and t he magnitude of possible consequences. Mild external infections can be typically treated empirically. Severe conjunctivitis, and any corneal infection, require aggressive management, often including cultures an d broad spectrum antibiotics; cultures are often used to guide treatme nt. Devastating vision loss can occur, even with aggressive management . Preseptal cellulitis in adults and older children can be managed con servatively with oral antibiotics if the orbit and optic nerve are not involved and the patient is otherwise healthy. Orbital or optic nerve involvement, on the other hand, demands orbital imaging and more aggr essive intervention. Patients who have had recent surgery are at risk for developing endophthalmitis. Complaints of pain or a red eye must b e taken very seriously. These patients must be considered to have an i ntraocular infection until it can be ruled out, and should be aggressi vely managed by a physician trained in eye diseases and surgery.