What is Ocular infection?
– Ocular infections are illnesses that occur when harmful microorganisms, such as bacteria, viruses, or fungi, invade the eye and cause inflammation or infection.
Common Ocular Infection & Treatment –
A. Bacterial Infection
1. Bacterial Conjunctivitis –
Bacterial conjunctivitis is an infection of the conjunctiva (the thin membrane covering the white part of the eye and inner eyelids) caused by bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae. It leads to redness, swelling, eye
discharge (often yellow or green), and irritation.
Treatment of Bacterial Conjunctivitis
1. Antibiotic Eye Drops or Ointments (First-Line Treatment)
– Fluoroquinolones (e.g., moxifloxacin, ciprofloxacin) – Commonly used for severe infections
– Aminoglycosides (e.g., tobramycin, gentamicin) – Effective for many bacterial strains
– Macrolides (e.g., erythromycin ointment, azithromycin drops) – Preferred for children and mild cases
2. Supportive Care
– Warm compress – Helps relieve irritation and remove crusting
– Artificial tears – Reduces discomfort and dryness
– Eyelid hygiene – Clean with warm water and avoid rubbing
3. Prevention Tips
– Wash hands frequently
– Avoid touching/rubbing eyes
– Do not share towels, pillows, or eye makeup
– Replace contact lenses and cases after infection clears
Most cases improve within 5–7 days with treatment. If symptoms persist or worsen, consult an eye specialist.
2. Blepharitis –
Blepharitis is a chronic inflammation of the eyelids, typically affecting the base of the eyelashes. It can be caused by:
-Bacterial infection (e.g., Staphylococcus aureus)
-Blocked oil glands (Meibomian gland dysfunction – MGD)
-Skin conditions (e.g., seborrheic dermatitis, rosacea)
Treatment of Blepharitis
1. Eyelid Hygiene (Main Treatment for All Types)
– Warm compress (for 5–10 minutes) to soften debris and unclog oil glands
– Eyelid cleansing with diluted baby shampoo or commercial lid wipes
– Gentle massage of the eyelids to express blocked oil glands
2. Medications (For Moderate to Severe Cases)-
– Antibiotic ointments (e.g., erythromycin, bacitracin) for bacterial infections.
– Oral antibiotics (e.g., doxycycline, azithromycin) for persistent or Meibomian gland dysfunction (MGD) cases
– Steroid eye drops (short-term use) to reduce inflammation
– Artificial tears to relieve dryness
3. Managing Underlying Conditions
-Treat seborrheic dermatitis (anti-dandruff shampoo).
Blepharitis is chronic and may need long-term eyelid care to prevent flare-ups.
3 . Bacterial Keratitis –
Bacterial keratitis is a serious infection of the cornea (the clear, front part of the eye) caused by bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, or Streptococcus pneumoniae. It is commonly associated with contact lens misuse, eye trauma, or weakened immune defenses.
Treatment of Bacterial Keratitis-
1. Antibiotic Eye Drops (First-Line Treatment)
-Fluoroquinolones (e.g., moxifloxacin, ciprofloxacin, levofloxacin) – Broad-spectrum coverage
-Fortified antibiotics (e.g., vancomycin + tobramycin) for severe or resistant cases
➡️ Frequent dosing (every 30 minutes to 1 hour initially) is required for severe infections.
2. Supportive Treatments
-Cycloplegic eye drops (e.g., atropine) – Reduce pain and prevent complications
-Artificial tears – Relieve dryness and irritation
-Discontinue contact lenses immediately
3. Advanced Cases (If Severe or Not Improving)
– Corneal debridement – Removal of infected tissue.
– Corneal transplant – For severe scarring or perforation.
– Hospitalization – Needed in vision-threatening cases.
B. Viral Infection.
1.Viral Conjunctivitis –
Viral conjunctivitis (pink eye) is a highly contagious acute conjunctival infection usually caused by an adenovirus. Symptoms include irritation, photophobia, and watery discharge.
Treatment –
→ Self Care –
– Cold compress.
– Use Lubricating eye drops.
– To Avoid touching/rubbing eyes.
– Replace pillowcases and towels daily.
– Don't Use wearing contact lenses.
→ Medical Treatment-
If severe conditions go to the Eye hospital.
– Antihistamines or anti-inflammatory eye drops.
– Antiviral Drops.
Most cases improve without treatment in about 7 to 14 days.
2.Herpes Simplex Keratitis –
Herpes simplex keratitis (HSK) is a viral infection of the cornea caused by the herpes simplex virus (HSV).
Treatment –
→ Epithelial Keratitis (Superficial Infection).
Main treatment: Antiviral medications Drugs used:
– Topical antiviral eye drops/ointment:
– Ganciclovir (0.15%) gel – preferred option
– Trifluridine (1%) eye drops – effective but can be toxic with prolonged use
– Idoxuridine (not commonly used now)
– Oral antivirals (for more severe cases or recurrence):
– Acyclovir (400 mg, 5 times/day for 7–10 days)
– Valacyclovir (500 mg, 2–3 times/day for 7–10 days)
– Avoid corticosteroids – they can worsen the infection.
→ Stromal Keratitis (Deeper Involvement)
More serious form that can lead to scarring and vision loss
Treatment:
-Oral antivirals (acyclovir or valacyclovir) for at least 3 weeks.
-Topical corticosteroids (low dose, e.g., prednisolone 1%) – ONLY under strict doctor
supervision to control inflammation.
– Lubricating eye drops to prevent dryness and discomfort.
3. Herpes Zoster Ophthalmicus
Herpes Zoster Ophthalmicus (HZO) is an infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox and shingles.
Treatment –
→ Antiviral Therapy (Start Within 72 Hours)
-Acyclovir (800 mg, 5 times/day for 7–10 days).
-Valacyclovir (1,000 mg, 3 times/day for 7 days)
– Famciclovir (500 mg, 3 times/day for 7 days)
→ Pain Management
-NSAIDs (ibuprofen, naproxen) or acetaminophen for mild pain.
-Gabapentin, pregabalin, or amitriptyline for postherpetic neuralgia.
-Opioids (in severe cases only).
3. Eye-Specific Treatment (if ocular involvement)
-Lubricating eye drops (artificial tears) to prevent dryness.
-Topical corticosteroids (prednisolone 1%) – ONLY if prescribed by an ophthalmologist to reduce inflammation (used cautiously).
-Antibiotic eye drops (e.g., erythromycin) if there is a secondary bacterial infection.
C. Fungal Infection.
1.Fungal Keratitis-
Fungal keratitis is a serious corneal infection caused by fungi, typically following trauma, prolonged contact lens use, or an immune system problem.
Treatment –
→ Antifungal Medications –
-Topical antifungal eye drops.
– Natamycin 5% (first-line for Fusarium)
-Amphotericin B 0.15% (for Candida and other yeasts)
-Voriconazole 1% (broad-spectrum, used if resistant to other treatments)
→ Oral antifungal medication (for severe or deep infections)
-Voriconazole (200 mg twice daily) – preferred
-Fluconazole (for Candida infections)
→ Supportive Care
-Cycloplegic drops (e.g., atropine 1%) – relieve pain and prevent scarring
-Artificial tears – for comfort and to prevent dryness
