0071643192.pdf

HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

■ Frequent ocular irrigation with saline

■ Ophthalmology consult and admission

■ Evaluate and treat sexual partners.

COMPLICATIONS

Corneal ulceration and perforation

Chlamydia Conjunctivitis

■ Leading cause of preventable blindness in young people

■ Obligate intracellular parasite

■ Occurs in newborns 5–7 days after delivery

■ In endemic areas, transmission occurs through direct contact among young

children.

■ Adults with genital Chlamydia (also known as inclusion conjunctivitis)

SYMPTOMS/EXAM

■ Watery discharge

■ Pseudomembrane and corneal opacification may occur.

TREATMENT

■ Gram stain and culture

■ Topical erythromycin is given to all newborns in the United States for

prophylaxis.

■ Treatment includes topical erythromycin and either systemic erythromycin

or tetracycline depending on age.

FIGURE 14.30. Neisseria gonorrheaconjunctivitis.

(Courtesy of L. Schwab as published in Schwab L. Eye Care in Developing Nations, 4th ed.

London: Blackwell Publishers, 2008:128.)

If a neonate presents with

chlamydia conjunctivitis, the

next appropriate test is a CXR

to rule out chlamydia

pneumonitis.