Common ocular infections - A prescriber's guide
Common ocular infections - A prescriber's guide
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DOI：
10.2165/00003495-199652040-00006
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发表时间：
1996-10-01
期刊：
影响因子：
11.5
通讯作者：
Kowalski, RP
中科院分区：
文献类型：
--
作者：
Donahue, SP;Khoury, JM;Kowalski, RP
虽然大多数眼部感染是良性的，但其他感染可能与破坏性的视觉后果有关。大多数患者表现为眼分泌物、视觉症状或眼睛发红或疼痛。初级保健医生通常是评估这些患者的最佳人选。我们将眼部感染分为3组。感染影响角膜和结膜通常表现为眼痛和红眼;非感染性病因可能有类似的表现。眼内感染（眼内炎）通常会造成毁灭性的后果。它们通常发生在穿透性眼外伤或眼内手术后。及时转诊到眼科医生是至关重要的。眼周围软组织（眼附属器和眼眶）的感染可间接累及眼，并可从眼眶扩散至脑，本文旨在综述眼感染和目前关于治疗的观点。一般的指导方针应该是，治疗方法应取决于症状的严重程度和可能后果的严重程度。轻微的外部感染通常可以凭经验治疗。严重的结膜炎和任何角膜感染都需要积极的治疗，通常包括培养和广谱抗生素;培养通常用于指导治疗。即使进行积极的治疗，也可能发生破坏性的视力丧失。成人和年龄较大的儿童的隔前蜂窝织炎，如果眼眶和视神经不受影响，并且患者其他方面健康，则可以采用口服抗生素保守治疗。另一方面，眼眶或视神经受累需要眼眶成像和更积极的干预。最近做过手术的患者有发生眼内炎的风险。疼痛或红眼的投诉必须认真对待。这些患者必须被认为有眼内感染，直到它可以被排除，并应积极管理的医生在眼科疾病和手术培训。
While most ocular infections are benign, others can be associated with devastating Visual consequences. Most patients present with either ocular discharge, visual symptoms or a red or painful eye. The primary care physician is usually the ill-st to evaluate these patients.We have separated ocular infections into 3 groups. Infections affecting the cornea and conjunctiva often present with eye pain and a red eye; noninfectious aetiologies can have a similar presentation. Infections inside the eye (endophthalmitis) often have devastating consequences. They usually occur following penetrating ocular trauma or after intraocular surgery. Prompt referral to an ophthalmologist is crucial. Infections in the soft tissue surrounding the eye (ocular adnexa and orbit) can involve the eye indirectly and can spread from the orbit into the brain,The purpose of this article is to review ocular infections and current opinion regarding treatment. A general guideline should be that the approach to treatment be governed by the severity of symptoms and the magnitude of possible consequences. Mild external infections can be typically treated empirically. Severe conjunctivitis, and any corneal infection, require aggressive management, often including cultures and broad spectrum antibiotics; cultures are often used to guide treatment. Devastating vision loss can occur, even with aggressive management. Preseptal cellulitis in adults and older children can be managed conservatively 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 aggressive intervention. Patients who have had recent surgery are at risk for developing endophthalmitis. Complaints of pain or a red eye must be taken very seriously. These patients must be considered to have an intraocular infection until it can be ruled out, and should be aggressively managed by a physician trained in eye diseases and surgery.