Eed Po

AAO READING
EXTERNAL DISEASE OF THE EYE
Oleh :

dr. Andi Ayu Lestari

PROGRAM PENDIDIKAN DOKTER SPESIALIS TERPADU BAGIAN ILMU KESEHATAN MATA

FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN MAKASSAR
2022
1 EPICSLIDE Presentation Template

01 Ophthalmia Neonatorum
Infectious
Conjunctivitis
02 Bacterial Conjunctivitis in Children and Adolescents
03 Viral Conjunctivitis in Infants and Children
01 Blepharitis
EXTERNAL Inflammatory
02 Ocular Allergy
DISEASE OF Disease
THE EYE 03 Ligneous Conjunctivitis
01 Papillomas
02 Conjunctival Epithelial Inclusion Cysts

Other Conjunctival
and Subconjunctival 03 Conjunctival Nevi
Disorders
04 Ocular Melanocytosis
05 Stevens- Johnson Syndrome and Toxic Epidermal Necrolysis

Infectious
Conjunctivitis

The character of the discharge is diagnostically helpful Infectious
and may be serous, mucopurulent, or purulent.
5 Conjunctivitis
Symptoms and signs may be
present unilaterally or bilaterally.
4 12
11 1
10 2 • Purulent discharge suggests a
polymorphonuclear response to a
Signs: conjunctival bacterial infection
hyperemia, ocular discharge,
and matting of the eyelids
3 9 3 • Mucopurulent discharge suggests a viral
or chlamydial infection
• Serous or watery discharge suggests a
8 4 viral or allergic reaction.
• Membrane or pseudomembrane
7 5
Symptoms: burning, stinging,
and foreign- body sensation 2 6
formation may occur in severe viral or
bacterial conjunctivitis, Stevens- Johnson
syndrome, ligneous conjunctivitis, and
chemical burns.
Bacterial and viral infections are the most common

causes of infectious conjunctivitis in children in
developed countries.
1
Table 20-1 lists common causes of conjunctival hyperemia, or red
eye, in infants and children.

Ophthalmia Neonatorum Epidemiology and etiology
Worldwide, the incidence is

greater in areas with high
rates of sexually transmitted
disease and poor health care.
The prevalence ranges from

0.1% in highly developed
• It refers to conjunctivitis occurring countries with effective
Neisseria Chlamydia prenatal and perinatal care to
in the first month of life.
• It caused by bacterial, viral, or gonorrhoeae trachomatis 10% in areas such as East
chemical agents. Africa.
• It remains a significant cause of
ocular infection, blindness, and Chemical Herpes simplex
virus The causative organism
even death in medically conjunctivitis infects the infant during
underserved areas around the passage through the birth
world. canal, and ascending to the
uterus (if there is prolonged
rupture of membranes)

Ophthalmia Neonatorum
Neisseria gonorrhoeae
Sign: mild conjunctival hyperemia

and ocular discharge. Severe
Presenting in the first 3–4 days of cases: marked chemosis, copious Systemic infection can cause
life. discharge, and potentially rapid sepsis, meningitis, and arthritis.
corneal ulceration and
perforation (Fig 20-1).
treatment should be started

immediately. systemic ceftriaxone
Gram stain of the conjunctival
and topical irrigation with saline.
exudate showing gram- negative
Topical antibiotics may also be
intracellular diplococci
indicated if there is corneal
involvement.
Figure 20-1 Neisseria gonorrhoeae conjunctivitis. (Courtesy of
Jane C. Edmond, MD.)

Chlamydia trachomatis
1 2 3 4 5
An obligate Onset: around 1 Signs: minimal to moderate Examiation: Systemic treatment is
intracellular week of age, it filmy discharge, mild culture of indicated because of
bacterium may be earlier in swelling of the eyelids, and conjunctival the risk of pneumonitis
cases with hyperemia with a papillary scrapings, PCR, and otitis media. Oral
premature reaction of the conjunctiva direct erythromycin, 50
rupture of (Fig 20-2). fluorescent mg/kg per day in 4
membranes. Severe cases: more copious antibody tests, divided doses for 14
discharge and and enzyme days. Topical
pseudomembrane immunoassays. erythromycin ointment
formation. may be used in
addition.
8 Figure 20-2 Chlamydial ophthalmia neonatorum. (Courtesy of EPICSLIDE Presentation Template

Jane C. Edmond, MD.)
Herpes simplex virus Chemical conjunctivitis Ophthalmia neonatorum

prophylaxis
It refers to a mild, self- limited
irritation and redness of the • 2% silver nitrate: prophylactic
Infection with HSV is usually
secondary to HSV type 2 and conjunctiva occurring in the first 24 treatment of gonorrheal
typically presents later than hours after instillation of silver ophthalmia neonatorum (not
infection with N gonorrhoeae or C nitrate, a preparation used for effective against C trachomatis)
ophthalmia neonatorum • Erythromycin and tetracycline
trachomatis, frequently in the
second week of life. prophylaxis. This condition ointments
improves spontaneously by the • 2.5% povidone- iodine solution.
second day of life.

Bacterial Conjunctivitis in Children and Adolescents
The most common causes are Streptococcus

01 pneumoniae, Haemophilus species, Staphylococcus
aureus, and Moraxella.
Diagnosed by clinical presentation.

02 Culture is usually not necessary in mild
cases
Symptoms are self- limited but may last up to 2

03 weeks. A broad- spectrum topical ophthalmic drop or
ointment should shorten the course to a few days .
Topical medications: polymyxin combinations, aminoglycosides,

04 erythromycin, bacitracin, fluoroquinolones, and azithromycin.
Patients with N meningitidis conjunctivitis, and others exposed to
these patients, require systemic treatment because of the high risk
of meningitis.
Parinaud oculoglandular syndrome (POS)
It manifests as unilateral granulomatous
1
conjunctivitis associated with preauricular
and submandibular lymphadenopathy (Fig
20-3).
Similar presentation with methicillin- resistant S
Bartonella henselae is endemic in cats and

causes cat- scratch disease (the most
2 aureus (MRSA) conjunctivitis
3
common cause of POS). Other causative
organisms: M tuberculosis, M leprae,
Francisella tularensis, Yersinia
pseudotuberculosis, Treponema pallidum, Cat- scratch disease is usually associated with a
and C trachomatis.
4 scratch from a kitten, but a cat bite or even
touching the eye with a hand that has been
licked by an infected kitten can cause the disease
Serologic testing: Presence of antibodies to
B henselae (detected by indirect fluorescent
antibody testing or enzyme immunoassay),
can confirm a diagnosis of cat- scratch
5
Treatment can be supportive in mild cases (self-
disease.
6 limited). In more severe cases systemic

treatment, usually with azithromycin, may be
indicated.
Parinaud oculoglandular syndrome (POS) Chlamydial infections
Two different diseases can be

caused by C trachomatis in
children and adolescents:
trachoma (serotypes A– C) and
adult inclusion conjunctivitis
(serotypes D– K).
Figure 20-3 Parinaud oculoglandular syndrome. A, Marked

follicular reaction in the lower fornix. B, Massive enlargement of
submandibular lymph node on the affected right side. (Courtesy
of David A. Plager, MD.)

Trachoma It is caused by poor hygiene and
Diagnosis is made by Giemsa stain,
cell culture, or PCR. Treatment
inadequate sanitation and is
includes both topical and systemic
spread from eye to eye or by flies
erythromycin. Tetracycline can be
or fomites.
used in children 8 years of age and
older.
1 2 3 4
The most common cause of Manifestations: acute purulent
preventable blindness in the conjunctivitis, a follicular reaction, papillary
world. hypertrophy, vascularization of the cornea,
and progressive cicatricial changes of the
cornea and conjunctiva.
Adult inclusion Conjunctivitis
Patients present with follicular conjunctivitis, scant

mucopurulent discharge, and preauricular
lymphadenopathy, no membrane formation.
Diagnose by culture of conjunctival

Nonsexual modes of transmission: scrapings, PCR, direct fluorescent
shared eye cosmetics, contaminated antibody tests, and enzyme
swimming pools. immunoassays.
a sexually transmitted disease, If untreated, inclusion

found in sexually active conjunctivitis resolves
adolescents, associated with spontaneously in 6–18 months.
chlamydial urethritis or cervicitis. The recommended treatment is
oral tetracycline, doxycycline,
azithromycin, or erythromycin.
Mcaused by an adenovirus
Viral Conjunctivitis in Infants and Children
Viral Conjunctivitis in Infants and Children are most often caused by an Adenovirus:
Acute follicular
Pharyngoconjunctival conjunctivitis
fever (serotypes 3 and 7) (serotypes 1, 2, 3, 4, 7,
and 10)
1 3
2 4
Epidemic Acaute hemorrhagic
keratoconjunctivitis conjunctivitis
(adenovirus serotypes (serotypes 11 and 21)
8, 19, and 37,
subgroup D)
Highly contagious conjunctivitis
Adenovirus
The organism can be recovered that tends to occur in epidemic
for 2 weeks after onset. outbreaks.
Treatment: supportive, artificial
tears, cold compresses.
a Bilateral follicular conjunctivitis,
(unilateral at onset) , associated
Topical corticosteroids to with preauricular
decrease symptoms in severe f b lymphadenopathy.
cases and in cases of decreased Initial symptoms : foreign- body
vision secondary to subepithelial sensation, periorbital pain.
Epidemic
opacities.
keratoconjunctivitis A diffuse superficial keratitis →
Contact precautions must be (EKC) focal epithelial lesions. After 11–
maintained, Isolation areas 15 days, subepithelial opacities
designated for examination. e c begin to form beneath the focal
Diagnosis is based on clinical epithelial infiltrates. In severe
presentation, confirmed by a infections: a conjunctival
rapid immunodetection assay. d membrane forms and marked
swelling of the eyelids occurs
Complications: persistent
subepithelial opacities and Mcaused by an adenovirus
conjunctival scar formation.
Viral Conjunctivitis in Infants and Children Adenovirus
Adenovirus
A follicular
Pharyngo- conjunctival
reaction,
conjunctival Clinical
preauricular
Symptoms >= Treatment is
Presentation 2 weeks. supportive
fever lymphadenop
athy can
develop.
Conjunctival hyperemia, subconjunctival hemorrhage,

conjunctival edema, epiphora, and eyelid swelling,
accompanied by sore throat and fever.

Varicella- zoster
2 virus
Varicella- zoster virus (VZV) is

Herpes simplex
virus 1 a herpesvirus that can cause
varicella and herpes zoster
Conjunctivitis caused
by HSV type 1

Varicella- zoster virus
• Reactivation of latent VZV in dorsal root and

• a contagious viral exanthem cranial nerve ganglia
• caused by primary infection with VZV. • Vesicular lesions on the periorbital skin, localized
• Clinical manifestations: fever, vesicular lesions of to a single dermatome, with subsequent ocular
the skin and mucous membranes. Except for involvement (Fig 20-4). Keratitis and anterior
eyelid vesicles and follicular conjunctivitis, ocular uveitis are most likely to occur if the nasociliary
involvement is uncommon. branch of cranial nerve V is affected.
• Treatment of conjunctival disease is usually not • Oral acyclovir to shorten the course of the
necessary. illness, decrease the risk of bacterial
• Intravenous or oral acyclovir is recommended by superinfection. IV antiviral agents in
AAP in the treatment of immunocomprothe immunocompromised patients. Antiviral
mised children with varicella. medications should be started within 72 hours
of onset of symptoms.
Varicella Herpes zoster

(chickenpox)
Epstein- Barr virus
 Infectious mononucleosis, a benign and self- limited disease that occurs most commonly
between ages 15 and 30 years.
 Findings include fever, widespread lymphadenopathy, pharyngitis, hepatic involvement, and
the presence of atypical lymphocytes in the circulating blood.
 Conjunctivitis, nummular keratitis.
 The diagnosis is confirmed with detection of immunoglobulin M antibodies to viral capsid
antigens or with a positive result on the heterophile antibody test.
 Ocular treatment is cool compresses to the eyes.

Epstein- Barr virus
Findings include fever, widespread

lymphadenopathy, pharyngitis, hepatic
involvement, and the presence of atypical The diagnosis is confirmed with detection of
lymphocytes in the circulating blood. immunoglobulin M antibodies to viral capsid
Conjunctivitis, nummular keratitis. antigens or with a positive result on the
heterophile antibody test.
Infectious mononucleosis,
a benign and self- limited
Ocular treatment is cool
disease that occurs most
compresses to the eyes.
commonly between ages
15 and 30 years.

Molluscum contagiosum
Caused by a DNA poxvirus
Presents as numerous umbilicated skin lesions (Fig 20-5A).
Lesions on or near the eyelid margin can release viral particles onto
the conjunctival surface, resulting in a follicular conjunctivitis (Fig 20-
5B).
Most lesions do not require treatment because they tend to
resolve spontaneously; however, resolution can take months or
years.
Figure 20-5 Molluscum contagiosum. A,
Lesions causing conjunctivitis can be treated by incising each lesion and Eyelid lesions. B, Secondary follicular
debriding the central core; in young children, such treatment usually requires conjunctivitis. (Part A courtesy of Edward L.
general anesthesia. Raab, MD; part B courtesy of Gregg T.
Lueder, MD.)

Inflammatory
Disease

Inflammatory Disease
Blepharitis
Blepharitis is a Intermittent
common cause of blurred vision may
chronic occur because of
conjunctivitis in tear film instability.
children. Inferior keratitis
The signs and may develop in
symptoms: include more severe cases,
ocular irritation, leading to
conjunctival Figure 20-8 Severe corneal epithelial
Figure 20-6 Blepharitis with
hyperemia, meibomian gland
scarring secondary to keratitis
disruption and
morning eyelid caused by blepharitis.
dysfunction, scurf, and fluorescein
crusting, eyelid telangiectasias.
staining, corneal
margin erythema, scarring, and
and meibomian Figure 20-7 A, Inferior keratitis permanent vision
gland obstruction secondary to severe blepharitis.
B, Fluorescein staining of loss (Figs 20-7, 20-
(Fig 20-6). keratitis 8).

Blepharitis
Acne rosacea in Demodex (human

children: manifested mites) may play a role
Recurrent chalazia in in the pathogenesis Demodicosis may
by chronic blepharitis
children may indicate of blepharitis. It respond to dilute tea
and facial
underlying present a waxy, tree oil applied to lash
telangiectasias,
blepharitis. sleevelike buildup at bases.
papules, and
pustules. the base of
eyelashes.
Treatment: warm compresses, eyelid scrubs with baby shampoo, and erythromycin or bacitracin ophthalmic
ointment or azithromycin ophthalmic solution, 1%. Severe cases: oral antibiotic use. Tetracyclines, macrolides.
Judicious use of topical corticosteroids (corneal disease), supplementation with omega-3 fatty acids.

Ocular Allergy
• Marked itching and Four specific types of

bilateral conjunctival ocular allergy:
inflammation of a chronic,
All have some element of
recurrent, and possibly
Seasonal and perennial a type I hypersensitivity
seasonal nature are
allergic conjunctivitis reaction (interaction
hallmarks of external
between an allergen and
ocular disease of allergic
specific immunoglobulin E
origin.
• antibodies on the surface
Other signs and Vernal keratoconjunctivitis (VKC) of mast cells in the
symptoms include tearing,
conjunctiva)
stinging, burning, and
photophobia.
Atopic
keratoconjunctivitis (AKC)

Ocular Allergy
Seasonal and perennial allergic conjunctivitis
Patients typically present with red and The presentation of perennial allergic
watery eyes, boggy- appearing conjunctivitis are similar to those of
conjunctiva, and ocular itching (Fig 20-9). seasonal allergic conjunctivitis. Perennial
It is triggered by environmental contact
Blue- gray to purple discoloration of the allergic conjunctivitis is a reaction after
with specific airborne allergens (pollens)
lower eyelids, termed allergic shiners contact with ubiquitous house hold
(secondary to venous stasis from nasal allergens, such as dust mites and
congestion) dander from domestic pets.
Treatment: to avoid offending allergens.

Oral antihistamines (less effective, better
tolerated in children). Topical
This condition is diagnosed based on the medications include mast-cell stabilizers,
history and clinical presentation. H1- receptor antagonists,
antihistamines, vasoconstrictors,
corticosteroids, or combinations of
these drugs ( Table 20-2).

Ocular Allergy
Seasonal and perennial allergic conjunctivitis
Figure 20-9 Seasonal allergic

conjunctivitis.

Ocular Allergy
Vernal keratoconjunctivitis (VKC)
01 02 03 04 05
The limbal The limbal

Caused by There are 2 Both types form is more form is more
type I and forms of VKC: manifest common in prevalent in
type IV palpebral with patients of warm,
hypersensitiv and limbal severe African or subtropical
ity reactions. (or bulbar). itching. Asian climates.
descent
Treatment of VKC is usually less effective than that of seasonal allergic conjunctivitis. Eyedrops combining a mast-
cell stabilizer and an H1- receptor antagonist may be used initially. In addition, treatment of VKC often requires
topical steroids or topical cyclosporine. Supratarsal injection of corticosteroids may be used in patients with
refractory palpebral VKC
Ocular Allergy
At early, the eye may be A thick, ropy, whitish

diffusely injected, with discharge may be
The palpebral form of
little discharge. present.
VKC:
01 03 05
02 04 06
Preferentially affects the Papillae may multiply, Figure 20-10 Palpebral vernal
tarsal conjunctiva of the covering the tarsal area keratoconjunctivitis (VKC), upper eyelid.
upper eyelid. with a mosaic of flat
papules (Fig 20-10).

Ocular Allergy
The limbal form of VKC:
Corneal
A whitish center involvement may
The discrete
Early, thickening filled with progress to a
limbal nodules Limbal nodules The cornea may
and opacification eosinophils and large, confluent
that appear are may increase in become involved,
of the conjunctiva epithelioid cells epithelial defect,
gray, jelly- like, number and with punctate
at the limbus (at may appear in the typically in the
elevated lumps become confluent epithelial
the upper margin raised lesion upper half of the
with vascular (Fig 20-11). erosions.
of the cornea) (Horner- Trantas cornea, called a
cores.
dot) shield ulcer. (Fig
20-12).

Ocular Allergy
Figure 20-11 Limbal VKC with Horner-Trantas Figure 20-12 VKC with shield ulcer. (Courtesy of
dots. (Courtesy of Stephen P. Christiansen, MD.) Stephen P. Christiansen, MD.)

Ocular Allergy Ligneous Conjunctivitis
Atopic keratoconjunctivitis
A rare bilateral chronic disorder
Atopic keratoconjunctivitis is a
characterized by firm (“woody”), yellowish,
nonseasonal disorder that occurs in
fibrinous pseudomembranes on the
patients with atopic disease
palpebral conjunctiva
It is thought to be secondary to severe

deficiency in type I plasminogen and can
affect persons of all ages. No single
. It is relatively rare in children. treatment is consistently effective. Surgical
removal, amniotic membrane
transplantation, fresh frozen plasma, and
heparin have been used.

Other Conjunctival
and Subconjunctival
Disorders

Other Conjunctival and Subconjunctival Disorders
Papillomas Conjunctival Epithelial

Inclusion Cysts
• benign epithelial proliferations
• Conjunctival inclusion cysts are clear, fluid- filled cysts on the

• appear as sessile masses at the limbus or as
conjunctiva.
pedunculated lesions of the caruncle, fornix, or
palpebral conjunctiva.
• These cysts are often noted in patients who had ocular
surgery or trauma. Excision is indicated if the cyst causes
• They may be transparent, pale yellow, or salmon irritation.
colored and are sometimes speckled with red dots.
• Papillomas in children usually result from viral infection.

They often resolve spontaneously.
• Oral cimetidine can induce papilloma regression. Carbon dioxide

laser or surgical incision is indicated when symptoms are severe
or if new lesions continue to appear. Seeding may follow excision,
leading to recurrence.

Conjunctival Nevi
Relatively common in childhood. 1

Nevocellular nevi of the conjunctiva consist
Histologically, most of these nevi are 2 of nests or more diffuse infiltrations of

benign melanocytes.
compound (nevus cells found in both
epithelium and substantia propria);
others are junctional (nevus cells
confined to the interface between
3
The lesions are occasionally noted at birth.
epithelium and substantia propria).
4 More commonly, they develop during later
childhood or adolescence.
The lesions may be flat or elevated. Nevi are
typically brown, but approximately one-
third are nonpigmented and have a pinkish
appearance (Fig 20-13).
5
Removal may be indicated if significant
6 growth occurs, although transformation to

malignant melanoma is extremely rare in
childhood.
A congenital focal proliferation of

subepithelial melanocytes
Melanosis of skin and sclera is a Unilateral patchy but extensive

occasionally associated with Sturge-
slate- gray or bluish
Weber syndrome and Klippel-
Trénaunay- Weber syndrome f b discoloration of the episclera
(Fig 20-14).
Ocular Melanocytosis
Small patches of slate- gray Intraocular pigmentation is

scleral pigmentation, typically
bilateral and without clinical
e c increased, associated with a
higher incidence of glaucoma
significance, are common in and risk of malignant
Black and Asian children.
d melanoma.
Persons of Asian ancestry may have associated involvement of eyelid and adjacent
skin with dermal hyperpigmentation that produces brown, bluish,Mcaused
or black
by an adenovirus
37
discoloration without thickening (oculodermal melanocytosis, nevus of Ota).
EPICSLIDE Presentation Template
Figure 20-13 Pigmented nevus of the bulbar Figure 20-14 Ocular melanocytosis.
conjunctiva, right eye.
Stevens- Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
The hypersensitivity reactions that affect skin and mucous membranes.
The most common etiologies in are medications (usually anticonvulsants and sulfonamides)
and infections (usually Mycoplasma species or herpes simplex virus).
Systemic manifestations range from mild to severe.
A prodrome of fever, malaise, and upper respiratory tract infection is followed by bullous
mucosal and skin lesions.
These lesions rupture, ulcerate, and become covered by gray- white membranes and a
hemorrhagic crust.
Ocular involvement (50% of patients), varies from mild

mucopurulent conjunctivitis to severe perforating corneal ulcers .
Ocular involvement begins with edema, erythema, and crusting of the eyelids. The palpebral
conjunctiva becomes hyperemic, and distinct vesicles or bullae may occur. In many instances,
epithelial defects or ulcers involving the tarsus and fornices develop. In severe cases, membranous
or pseudomembranous conjunctivitis may occur (Fig 20-15) and lead to symblepharon formation.
Superinfection may develop (most common is

Figure 20-15 Stevens-Johnson syndrome.
Early, severe involvement of the Staphylococcus species).
conjunctiva,
right eye.
Late ocular complications: decrease in vision (in 27% of pediatric patients), anomalies of eyelid
position (ectropion and entropion), dry eye disease, trichiasis, chronic conjunctivitis, corneal
defects, corneal vascularization, and symblepharon formation.
Initial management: treatment of any

The diagnose based on clinical underlying infection, discontinuation
presentation and skin biopsy of any inciting drug. Systemic therapy
results. with corticosteroids or intravenous
immunoglobulin is controversial.
Ocular lubrication with

artificial tears and ointments The fornices may be swept to
(preferably preservative- free) lyse adhesions
should be applied frequently.
In patients with significant ocular

In severe cases, a disease, a corneal bandage device
using amniotic membrane or amniotic
symblepharon ring may be membrane grafting should be
useful in cooperative patients. considered early to decrease the risk of
late ocular complications.
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AAO READING

EXTERNAL DISEASE OF THE EYE

PROGRAM PENDIDIKAN DOKTER SPESIALIS TERPADU BAGIAN ILMU KESEHATAN MATA

1 EPICSLIDE Presentation Template

03 Viral Conjunctivitis in Infants and Children

02 Conjunctival Epithelial Inclusion Cysts

05 Stevens- Johnson Syndrome and Toxic Epidermal Necrolysis

3 EPICSLIDE Presentation Template

Bacterial and viral infections are the most common

5 EPICSLIDE Presentation Template

Worldwide, the incidence is

The prevalence ranges from

6 EPICSLIDE Presentation Template

Sign: mild conjunctival hyperemia

treatment should be started

7 EPICSLIDE Presentation Template

8 Figure 20-2 Chlamydial ophthalmia neonatorum. (Courtesy of EPICSLIDE Presentation Template

Herpes simplex virus Chemical conjunctivitis Ophthalmia neonatorum

9 EPICSLIDE Presentation Template

The most common causes are Streptococcus

Diagnosed by clinical presentation.

Symptoms are self- limited but may last up to 2

Topical medications: polymyxin combinations, aminoglycosides,

Bartonella henselae is endemic in cats and

6 limited). In more severe cases systemic

Parinaud oculoglandular syndrome (POS) Chlamydial infections

Two different diseases can be

Figure 20-3 Parinaud oculoglandular syndrome. A, Marked

12 EPICSLIDE Presentation Template

Patients present with follicular conjunctivitis, scant

Diagnose by culture of conjunctival

a sexually transmitted disease, If untreated, inclusion

Conjunctival hyperemia, subconjunctival hemorrhage,

17 EPICSLIDE Presentation Template

Varicella- zoster virus (VZV) is

18 EPICSLIDE Presentation Template

• Reactivation of latent VZV in dorsal root and

Varicella Herpes zoster

20 EPICSLIDE Presentation Template

Findings include fever, widespread

21 EPICSLIDE Presentation Template

Caused by a DNA poxvirus

Presents as numerous umbilicated skin lesions (Fig 20-5A).

22 EPICSLIDE Presentation Template

23 EPICSLIDE Presentation Template

24 EPICSLIDE Presentation Template

Acne rosacea in Demodex (human

25 EPICSLIDE Presentation Template

• Marked itching and Four specific types of

26 EPICSLIDE Presentation Template

Seasonal and perennial allergic conjunctivitis

Treatment: to avoid offending allergens.

27 EPICSLIDE Presentation Template

Seasonal and perennial allergic conjunctivitis

Figure 20-9 Seasonal allergic

28 EPICSLIDE Presentation Template

Vernal keratoconjunctivitis (VKC)

The limbal The limbal

Vernal keratoconjunctivitis (VKC)