3-3.
GONOCOCCAL CONJUNCTIVITIS
a. Description. This disease is evidenced by a large purulent discharge. A
stained smear and culture of the discharge can confirm the diagnosis. The disease
occurs as a self-inoculation from gonorrheal genital infection, or the disease can be
acquired from contact with someone with gonorrhea. Twenty-four to 48 hours after
exposure, the disease develops.
b. Signs/Symptoms. This disease has two basic signs and symptoms. The
eyelids and conjunctiva may become swollen with the eye having a beefy-red
appearance. A second sign is a serosanguineous discharge (serum and blood) that
quickly becomes purulent.
c. Treatment. Basic treatment includes parenteral antimicrobial therapy
(penicillin) and ten percent to thirty percent sodium sulfacetamide (sodium Sulamyd
ophthalmic), one to two drops every two hours. This is done after gram staining of
conjunctival scraping and discharge to confirm assessment. If untreated, this disease
remains acute for about five days and subsides in four to six weeks. Complications
which may occur if treatment is delayed include corneal ulceration and perforation,
abscess, and blindness.
CAUTION:
Parenteral antimicrobial therapy is contraindicated when sensitivity to
sulfa drugs is known or suspected.
3-4.
INCLUSION CONJUNCTIVITIS
a. Description. Inclusion conjunctivitis is associated with swimming pools. The
disease source is exposure to infected genital secretions and/or chlamydiae in poorly
chlorinated swimming pools. The disease can also be transmitted by intercourse.
Adenovirus can also produce conjunctivitis.
b. Signs/Symptoms. Initially, acute redness, discharge, and irritation of the eye
occur. Eye findings consist of conjunctivitis with mild corneal inflammation. A
nontender preauricular lymph node can often be palpated, and the front of the ear must
be palpated to assess a preauricular lymph node.
c. Treatment. To prevent bilateral infection, the drug of choice is tetracycline
one percent.
3-5.
HERPES SIMPLEX KERATITIS
a. Description. Herpes simplex keratitis is a common corneal ulceration
caused by the herpes simplex virus (HSV).
MD0582
3-3