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A patient came to our clinic on a Monday morning after having visited the emergency department of a local hospital over the weekend with complaints of a red eye.
Clinically significant PEK (SPK) deserves treatment with a prophylactic antibiotic, regardless of the underlying cause. When a bacterial infection involves only the eyelashes, removing the antigen may be as simple as having the patient perform lid hygiene morning and night.
Many practitioners consider antibiotic treatment for blepharitis and bacterial conjunctivitis optional. One condition for which treatment is required to maximize visual outcome is bacterial keratitis, which includes bacterial corneal ulcers.
The two viral diseases that benefit from specific antiviral therapy are herpes simplex and herpes zoster. Topical antiviral medications are usually recommended for treatment of active herpes simplex keratitis. If you are tempted to prescribe an antibiotic or an antibiotic-steroid combination for viral eye disease, try to resist the temptation, except under certain circumstances. Many drugs have a dedicated Internet domain (usually the drug's name followed by dot com). Be sure your patient knows what to do if he experiences an allergic or other adverse reaction. Reinforce that there is 24-hour help available by calling your office or other appropriate designated resource. Unemployment and lack of healthcare benefits may mean your patient cannot afford a $90 bottle of drops. Become familiar with the local pharmacy's inventory and turnaround time for hard-to-find medications.
You will avoid delays in treatment if you know, for example, that your pharmacy carries brand X instead of brand Y antibiotics. This applies to initial treatment as well as any tapering schedule you may develop as the patient's condition improves. Despite the widely publicized outbreaks related to contact lens solution contamination in recent years, infections with fungi and parasites are rare.
Fungal eye disease is far more common in tropical regions than in colder climates, because the warm, moist conditions facilitate proliferation of the organism without a natural purge due to freezing. The acanthamoeba parasite exists in two forms: a free-living amoeba, which is fairly susceptible to antimicrobial therapy, and a hardy double-walled cyst, which is quite resistant.
The first step in managing any ocular infection is removing the antigen, which can be as simple as lid scrubs for a discrete bacterial infection or as complex as long-term therapy for a cystic acanthamoeba parasite. As optometrists, we have an important role not only to select the proper treatments for our patients' various conditions, but also to consider the patient as a person, not just an eye condition. Optometric Management is dedicated to helping optometrists improve their practice through relevant, actionable and practical columns and features that enhance patient outcomes and bolster the bottom line. Conjunctivitis is an inflammation of the mucous membrane of the eye known as the conjunctiva. Key to the treatment of conjunctivitis is that the infection clears up and also reduces the contagion together. When suffering from conjunctivitis, one can resort to warm compresses to eliminate the symptoms of conjunctivitis such as watery eyes, redness, and itching. Warm compresses helps in fight off the viral causing the condition by drawing the blood to the mucosal surfaces and dilating blood vessels.
Another effective conjunctivitis home treatment is to use chamomile teabags as eye compress that can reduce the inflammation and redness. In most cases conjunctivitis can cause mucous-like discharge that can be dried out with warm lemon juice compress. Known to contain lauric acid, coconut oil reduces the symptoms of pink eye or conjunctivitis effectively. Also known as baking soda, one can increase the intake of sodium bicarbonate supplements to treat conjunctivitis. Known for its anti-inflammatory properties, conjunctivitis can be treated with oregano oil application. Conjunctivitis is the inflammation of the thin layer of tissue that covers the front of theeye.
Coriander seeds have excellent antibacterial, antiviral and anti-inflammatory properties which do away with the infection quickly and provide relief from the distressing symptoms. Noodles are a favorite among many but it is associated with a lot of oil and fat content too! Tangerine essential oil is derived from citrus fruits and gets extracted through cold compression method. The remedy, so obtained, inactivates the causative element (virus) for some period thus enabling the enhanced host’s immune system to eradicate the infection early and in a better way. We have, with us, the testimonials, Case sheets, lab reports and certificates given by qualified doctors and veterinary surgeons in witness of the different cures and a video recording of the patients cured of their Chikungunya (in the year 2006) and Dengue fever.
The process involves the preparation and administration of potentised substances with patient's own infected natural fluids like blood, as a basic substance making use of certain potentisers available in the market. The potentised substance, so obtained, is a real dynamic equivalent to all the components of blood, the basic substance, but upon therapeutic administration, the living organism, responds favorably and finally to only that part of the curative vital reaction that relates to the pathogenetic constituent of foreign origin present in the basic substance. The results are good in diseases in which the causal factor is a foreign chemical or a tiny organism like a virus. The concept has been disclosed to all concerned through news media, through my presentations in scientific seminars in the year 2000 and through articles carried by homoeopathic magazines in the year 2002.
Indian Systems of Medicine and Homoeopathy (Ministry of Health & Family Welfare) was approached for evaluation of DAHT in the year 2003.
Presently, there is no satisfactory treatment for many viral diseases in any recognized system of medicine. Epidemic diseases like Chikungunya, Poliomyelitis, Conjunctivitis are known for their severe morbidity.
There are many viral diseases that affect the domestic animals in the form of viral epidemics, leading to lot of morbidity and mortality, causing great financial loss to the society and countries. The development of antiviral compounds for chemotherapy and chemoprophylaxis of viral diseases is a difficult task because of peculiar biologic properties of viruses.
The therapeutic results are good in diseases in which the causal factor is a foreign chemical or a tiny organism like a virus.

It is safe, easy, fast, highly useful, and practicable and saves the lives of majority of sick individuals and animals and helps in avoiding huge expenditure. The process is of eternal benefit as there is no risk of viruses developing resistance against nosodes which are always new and specific for the virus. It is an improved and modified version with clear understanding of olden, vague concept called Isopathy. Isopathy was conceived about 200 years ago, Which states that “All the contagions carry in their substance even the means of their cure.” Although good, it was a vague idea as the germ theory and disease causation were not known. My novel therapeutic process was already intimated to Patent dept, ICMR and Central council for Research in Homeopathy. In the news the Diseases like Hepatitis, Measles, Chickenpox and Conjunctivitis only were reported to be cured by me although I disclosed that I could successfully cure and prevent “3” viral epidemics among animals and “9’’ viral diseases among Human beings. The novel method invented by me was the preparation and application of nosodes from patients own infected fluids like blood and found curative in certain diseases.
News reported by Vartha on 21-1-2004 about the successful cure of Dengue Fever by Delhi scientists( 40 months after my disclosure). There was no claim of curing other viral diseases ( Whereas I disclosed the cure of 12 diseases “4” years ago.). The concept adopted by them was similar to that employed by me,but the practical application could be different. They were convinced of the effectivenessof the innovative concept which they adopted in the year 2004 and whichI could demonstrate in the year 2000 only. If you manage this site and have a question about why the site is not available, please contact us directly. This will loosen and remove the debris that harbors the bacteria and often is sufficient to alleviate all symptoms. For instance, bacterial infections are far more common in urban areas than in rural areas, where viral infections predominate.
Lid hygiene is often sufficient therapy, but an antibiotic ointment or viscous gel applied to the lash margin will help eradicate the bacteria. A patient who is likely to forget doses or whose work or school schedule makes frequent instillation of drops inconvenient would benefit from a less-frequent dosing regimen. That way of thinking may change, however, because several agents are being studied for use in all types of viral eye disease, including simple adenoviral conjunctivitis.
When ocular involvement is seen with either of these diseases, it means that the patient has, at some time in the past, been infected with the virus, usually transferred through direct contact of the skin, mouth or other mucus membrane. When prescribing, bear in mind that the differences in cost between the older drugs and the newer ones, as well as between generic and brand names, can be staggering. Many of the older drops and ointments used for this purpose, for example, tri-fluridine 1% drops, are fairly toxic to the cornea.
This advice does not apply, for example, when there is clinically significant corneal epithelial staining with a more severe viral infection, which would put the patient at risk for secondary bacterial infection.
Have the patient try to instill a drop himself, so you can assess his likelihood for success. If you approach the subject with compassion and honesty, you may discover that a generic drug is a better option for the patient. Corneal infections with these types of organisms generally carry a poor prognosis, with a significant number of patients ultimately requiring corneal transplantation due to permanent corneal scarring. Fungal keratitis is frequently misdiagnosed initially as bacterial keratitis because the early clinical characteristics are similar. Acanthamoeba are parasites that can be found in water, air, soil, cooling systems, HVAC systems and elsewhere. In the absence of corneal staining, these patients should not be treated with an antibiotic. Moreover, the organism can remain in the cystic form for months to years, so treatment must continue long-term to ensure eradication. Regardless of the infection, our guiding principle throughout the treatment process is to protect the cornea.
Doing so will not only result in good clinical outcomes, but it is also the single most important factor in cultivating a long-lasting relationship with patients. Why do general practitioners prescribe antibiotics for acute infective conjunctivitis in children?
Efficacy of topical azithromycin ophthalmic solution 1% in the treatment of posterior blepharitis.
A randomized controlled trial of management strategies for acute infective conjunctivitis in general practice. Reed is an associate professor of Optometry at Nova Southeastern University College of Optometry in Ft.
Optometric Management is the leading how-to guide for optometrists interested in growing their practice, improving their standard of care, and achieving financial and professional success.
The following conjunctivitis home remedies helps in meeting the condition and helps you get back a clear eye as soon as possible. Like viral conditions, conjunctivitis can be caused by viral organisms and can last up to seven days. For best results, place wet and warm teabags for approximately three minutes on a daily basis. For best results, make a lemon juice solution by diluting into warm water and using it as a compress. The natural pH in the shampoo makes it non-irritant and helps in wiping off the viral secretions from the eye and eliminates the condition effectively. To treat the condition, all you need to do is to apply the oil directly onto the affected eye. Alternatively, one can also use it an eye cleanser and it can provide the best treatment for the eye infection. You accept that you are following any advice at your own risk and will properly research or consult healthcare professional. This tissue known as the conjunctiva becomes red and irritated and causes an intense burning sensation in the eyes. Sometimes the vision is blurred and there is sensitivity to light. A thick yellowish coating too forms on the eyelashes. Put to boil one liter of water.When the water starts boiling add three teaspoons of coriander seeds to it.
Boil a glass of water and steep one tablespoon of chamomile flowers into it for fifteen minutes.

Delhi researchers (one of them employed in ISM&H ) have treated Dengue fever on similar lines in 2004 –a news copy is enclosed. It replicates rapidly inside the host cell employing hosts enzymes and organelles for its multiplication.. There are many types of viral diseases.To mention a few, Dengue, Influenza, Swineflu, Birdflu, Sars, Encephalitis etc.
They are lingering, incurable chronic diseases affecting important organs like liver and sometimes leading to many complications and ultimately death. One has to helplessly depend on the less useful symptomatic and supportive treatment only, waiting for the final verdict of the nature.
It is a therapeutic process involving the preparation and administration of potentised substances with patient's own infected natural fluids like blood, CSF, urine,saliva etc., as a basic substance. In this article, I discuss I the four categories of ocular infection: bacterial, viral, fungal and parasitic.
For stubborn cases, applying an antibiotic ointment to the lid margins with a clean fingertip or clean cotton swab twice a day is advisable to prevent more serious infection, such as conjunctivitis or ulceration of the lid margins.
This is important to recognize, so that appropriate anti-infective therapy can be selected. Some drugs are approved for children one-year and older, while others are approved for use in patients six years and older. Consider also that no matter how efficacious the antibiotic you prescribe may be, if the patient doesn't buy it because it is too expensive, the efficacy of that drug is zero. This often takes the form of superficial punctate keratitis (SPK) or punctate epithelial keratitis, either in focal areas or diffusely distributed across the cornea. The characteristic conjunctivitis, keratitis, uveitis and blepharitis with simplex and zoster infections signal a reactivation of virus organisms that have remained dormant in the nerve ganglion for cranial nerve V supplying the eye and adnexa.
A recent price check at one national web-based drugstore showed a price difference of just over $300 when comparing an older generic oral anti-viral to a newer brand-name anti-viral. You also may find copies of the published studies that led to the drug's approval as well as clinical photographs and case discussions. Generally, the organism is not a threat to humans under normal circumstances; however, patients who have poor contact lens care habits, those who swim in contaminated pools, spas or natural water reservoirs, or those who are immunocompromised or who have a compromised corneal epithelium are susceptible to infection. Topical anti-fungal and antibiotic agents are often used as adjunctive management to kill the food source for the acanthamoeba organisms. Though the condition can be treated with over-the-counter eye solutions, one can also resort to home remedies for conjunctivitis that helps in speeding up the clearance of the infection without any side effects. For best results, soak a cotton ball into a solution made of baby shampoo and warm water and use it on a daily basis to clean the affected area. Consult a doctor if the condition worsens and also to understand the appropriate dosage required to treat the condition. Though this condition is not a serious health problem it is very contagious and causes uncommon discomfort and one is unable to work in the routine manner.
For all of these conditions, the overarching premise is to identify what's causing the problem, eradicate that problem, and then clean up the consequences, all while protecting the cornea. While there may be advantages to newer drugs with respect to a reduced dosing frequency and possibly slightly higher efficacy, the cost of the newer drug may be prohibitive to the patient. In these cases, a prophylactic antibiotic is advisable in the dosage approved for conjunctivitis therapy. She teaches courses in ocular disease and ocular pharmacology, and lectures and writes frequently in the areas of anterior segment ocular disease and nutrition. Home remedies can do much to alleviate the itching and burning and heal the inflamed tissue. This eye wash will soothe the inflamed tissue and bring considerable relief in the burning and itching. The moisture from the slices will soothe the inflammation and provide great comfort in the distressing symptoms. The cool sap will soothe and calm the inflamed lining and will alleviate the itching and burning. The medicine is not a direct derivative of the basic material, hence there is no risk of spreading the infection.
The patient was understandably confused and also unhappy that she'd had to pay for three medications. This is especially important if you're not taking cultures to determine the specific bacterium present, which is rarely done in routine cases. Although severe SPK can be treated with an appropriate antibiotic in the dosing schedule recommended for conjunctivitis, the standard of care in treating true corneal ulcers dictates that a fourth-generation fluoroquinolone be prescribed. Again, in general, new medications are usually more costly than older medications that may have gone off patent and are now available in generic form. Use steroid-antibiotic combination therapy only when significant staining and moderate to severe inflammation exist. The patient may report a history of trauma 3 to 5 days prior to the appearance of clinical symptoms. Sometimes an allergic reaction to dust and pollen and contact with chlorinated water, shampoo or an eyelash rubbing against the eye can also inflame the conjunctiva. Use the eye wash three times regularly until your eyes stop hurting and are healed completely. To make matters worse, she had a simple viral conjunctivitis and didn't even need an antibiotic. Usually, a loading dose of frequent drops for the first hour or two is recommended, followed by a schedule of 1 drop every 30 minutes to 2 hours for the first day during waking hours.
Some conditions, such as epidemic keratoconjunctivitis, have peculiarities that make steroid use far more complex than in ordinary circumstances, requiring careful monitoring and a protracted tapering schedule. Often the trauma involved yard work, horseback riding, outdoor sports or other activities associated with injuries from plant-based objects. An antibiotic ointment can be applied at night, or the patient can be instructed to wake up during the night to instill drops two or more times. In most cases of fungal keratitis, it is advisable to comanage with an infectious disease specialist, because cultures using specialty media are often required to direct treatment.

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