Conjuctiva Project New

S.
SPECIFIC TEACHING
TIME CONTENT A.V. AIDS EVALUATION
NO OBJECTIVE ACTIVITY
1 1min To introduce SELF INTRODUCTION

my self
My self Ms. Sarla Devi student of M.Sc. Nursing First
Year (MSN) Shreyas college of nursing Bhilai
2 3 min To introduce INTRODUCTION Lecture & LCD Students are

the discussion getting the
conjunctiva Conjunctiva is an inflammation of the topic
inflammatio conjunctiva resulting in dilation of the in dilation of
n bleeding the conjunctiva blood vessels, causing the eye to
and cornea appear red. A history of infectious conjunctivitis and
inflammatio of itch both made the probability of current.
n and
infection. The term conjunctivitis refers to inflammation
of the conjunctival associated glaucoma check for
reduced visual acuity, hazy cornea, fixed pupil and
acute systemic malaise- severe purulent discharge,
eyelid swelling gonococcal infection.
Inflammation of the cornea causes the keratitis.
When the inflammation process involves botht eh
conjunctiva and the cornea the term kerato
conjunctivitis may be used. Keratitis amy be caused by
infection, hypersensitivity reaction , ischemia tearing
defects, trauma and impaired innervations of the
S. SPECIFIC TEACHING
cornea, they are most common eye problem.
3 4 min To define DEFINITION Lecture LCD Students are

the well
inflammatio 1) According to Brunner & Suddhart’s response.
n of Inflammation of the conjunctiva
conjuctiva “Pinkeye” that called conjunctivitis.
2) According to Lippincott
Inflammation or infection of the bubolbar
(covering the sclera and cornea) or palpetral
(covering inside lids) conjunctivitis may be
allergies, bacterial, streptococcus pneumonia
and viral infection or other chemical causes.
3) According to Nurses Dictionary

Keratitis inflammation of the cornea. The
cause may be physical (trauma, exposure to
dust, vapors or ultraviolet light) or due to
infectious condition such as corneal and
dendritic ulcer. Keratitis is characterized by
cornea odema cellular infiltration and associated
conjunctival reaction.
CONJUNCTIVA BLEEDING
Conjunctiva hemorrhage, also known as

subconjunctival hemorrhage and hypophagma, is
bleeding underneath the conjunctiva. The conjunctiva
contains many small fragile blood vessels that are
easily ruptured or broken. When this happens blood
leaks into the space between the conjunctiva and
sclera.
4 2 min To list down Etiology of Conjunctiva Lecture & LCD & Students are
the etiology 1) Bacterial and Viral Infection discussion Chart paper getting the
of 2) Allergic topic
conjunctiviti 3) Streptococcal Infection
s 4) Direct contact ( harm tissue and towels)
5) Chemical products
Types of Conjunctiva Inflammation Lecture LCD & Students are

5 4 min To Blackboard well respond
enumerate 1) Catarrhal
the types of 2) Granular
conjunctiviti 3) Phlycenular
s and 4) Purulent
pathophysiol
ogy
1) Catarrhar : A mild form usually due to

cold or irritation.
2) Granular : Containing small particles,

casts the degenerated cells from the lining of
renal tubules excreted in the urine in certain
kidney disorders.
3) Phlycleunular : Marked by small vessels or

ulcers on the membrane.
4) Purulent : Caused by virulent

organism with discharge of pus.
PATHOPHYSIOLOGY
Due to etiological factors
That may effects the eyes
Then cause redness, itching burning
Sometimes contact with genital secretion infected with

gonococcus can causes genococcal conjunctivitis
6 2 min To list down CLINICAL MANIFESTATION Lecture LCD & Students are
the clinical OHP well respond
manifestatio 1) Redness and tearing
n of 2) Edema
conjunctiviti 3) Hemorrhage
s 4) Itching
5) Burning
KERATITIS
7 2min To define Lecture & LCD Students are
the keratitis discussion getting the
and its Definition topic
etiology. Inflammation of Cornea.
Etiology
 Exogenous infection – e.g. staphylococcus,

streptococcus, pneumonia, pneumonococcus.
 Conjuctival Ds.
 Scleral Ds.
 Uveal tract Ds.
 Endogenous infection – hypersensitivity
reaction
Structure of Cornea
Classification
8 8min To explain 1) Superficial Lecture and LCD & Students are
the 2) Deep Discussion OHP well
classification Keratitis response.
and its
clinical
manifestatio Superficial keratitis Deep keratitis
n.
Purulent Non purulent Non purulent Disciform

keratitis
1) Purulent keratitis or Corneal Ulcer
Definition
Corneal Ulcerative keratitis occurs secondary to
conjunctivitis, it is caused due to staphylococcus,
pneumonococcus and streptococcus infection.
Sources of Infection
 Aged person
 Alcoholic patient
 Keratomalacia (Vit. A deficiency)
 Acute infection
Causes
 Common causes of corneal ulcer are
1) Bacterial - Pneumonococcus
- Gonococcus
2) Fungi - Candida albican
- Aspergillas fumigates
Clinical Manifestations
 Pain, Redness
 Watering of the eyes
 Photophobia
 Headache
 Oedema of the eyelid
 Irritation of the eye
 Blurred vision
NONPURULENT
Nonpurulent Keratitis is caused by the viral and

other disease
Etiology
1) Herpes simplex
2) Herpes zoster
3) Thermal, chemical, burn
Clinical Manifestation
 Pain
 Redness of eye
 Headache
 Irritation of eye
DEEP KERATITIS
Definition
The deep forms of keratitis affect the stroma of cornea.
Etiology
 Congenital syphilis
 Tuberculosis
 Viral infection
 Sclera keratitis
NON ULCERATIVE KERATITIS
Non Ulcerative Keratitis is also known as

intestinal keratitis. In this condition opacity of the
stroma occurs but suffering tissue of the cornea has no
ulceration.
Causes
 Syphilis
 Tuberculosis
 Leprosy
Disciform Keratitis
Disciform keratitis is a viral infection
characterized by pain, redness, watering diminished
vision.
Etiology
 Herpex simples
 Herpex zoster
 Chicken pox
 Pain
 Watering of the eye
 Redness of eye
PATHOPHYSIOLOGY
Due to etiology
Infer in the eye
Corneal inflammation and corneal edema and anterior

segment inflammation are
Characterized keratitis
 Pain, redness
 Photophobia
 Blurred vision
 Headache
 Oedema of the eye lid
 Irritation of eye
 Watering discharge of eye
DIAGNOSTIC EVALUATION Lecture & LCD & Students are

9 5min To explain Discussion Black board getting the
the 1) Laboratory testing is necessary to prove topic.
diagnostic etiology, culture of exudates for bacteria or
evaluation of viruses.
Keratitis, 2) Screening vision exam may be done through
Conjunctiviti visual and ocular exam may be done if vision is
s & infection impaired or if internal involvement is suspected.
of cornea. 3) Fluorescent stain (Angiography) Flucrescein
stain with slip lam examination arrows
visualization of any cornea, ulc3ration found
and inflammation found in cornea. Abnormal
new blood vessels found
4) Conjuctival screenings : Conjuctival screening
are examined microscopically cultured to
identify the organism found from negative
bacteria.
5) Tonomety : Measures intraocular pressure by
determining the pressure necessary to indent a
small anterior area of the globe of the eye
decreased IOP.
6) Blood test
CBC test
Hb% - Decreased
TLC - Increased
DLC - Decreased
ESR - Increased
WBC - Increased
7) External eye examination : Bleeding and injury

found
10 1 min To list down COMPLICATION Lecture & LCD & Students are
the Keratitis : Corneal opacity discussion Chart Paper well
complication Conjunctivitis -septicemia response.
. Eye lids deformity
Visual impairment, hepatic infection
11 5 min To explain MANAGEMENT Lecture LCD Students are

the getting the
management Nursing Management topic.
of
conjunctiviti Assessment
s, keratitis, 1) Assess nature and extent of symptoms and their
infection of effect on child activities
cornea. 2) Assess visual activity
3) Assess the health history
4) Assess and check the eye part internal and
external parts of eye
5) Data are collected about the duration and
intensity of the problem its previous treatment.
Diagnosis
1) Risk for infection (transmission r/t hand to hand
or hand to object contact.
2) Acute pain and discomfort t r/t tissue swelling,
information and light sensitivity.
3) Alteration in thermo regulation due to
hospitalization
4) Eye pain r/t injury as evidence by swelling in
eye
5) Weakness related to injury in eye as evidence by
irritation of eye.
Goal
 Improving the patient condition
 Improving the injury part in the ye reduce the
fever
Intervention
1) Perform or teach proper cleansing of olrum
a) Use warm water or disposable applicator
such as cotton balls or gauze.
b) Use a separate applicator for each ye.
2) Information about the surgical procedure.

 The patient discussed about the anesthesia
the location of incision.
3) Teach to avoid touching and rubbing the eye.

4) Instruct to use clean cotton tipped cotton balls
for cleaning each eye.
5) Perform or tech proper cleansing of eardrum….
6) Time to time take medicine properly
7) Reduce steroid use.
Medical Management
1) Drug Name : Inj Azithromycin
Drug Class : Broad spectrum
antibiotic
Drug Route : IV/IM
Strength : 500mg in inj IV/IM
Tab: 500mg (PO)
Action: a microlide antibiotic that binds to

ribosomal receptor sites of susceptible
organisms inhibiting RNA dependent protein
synthesis
Side effect: Nausea, Vomiting, Dizziness
Nurses Responsibility
a) Assess the patient sign and symptoms
b) Check the side effect of drugs
2) Drug Name : Chloramphenicol

Eye Drops
Drug Class : Antibiotic, Dose BD
Drug Route : drop in eye
Strength : 2% in liquid form
Action: Antibiotic eye drops inhibits the

bacterial synthesis in cell wall membranes
Side effects: Headache, Nausea, reaction,

irritation
a) Check any side effects of the drugs
b) Time to time take medicine properly
c) Assess the general condition of the patient.
3) Drug Name : Levofloxacin

ophthalmic eye drop
Drug class : Third generation
antibiotic
Drug route : drop in eye
Strength : 0.5% solution in drop
Dose : 4 time daily on day 3-
7
Action: It inhibits DNS gyrase in susceptible

organisms, there by inhibiting relaxation of
supercoiled DNA and promoting breakage of
DNA strands
Side effects:
a) Check the side effects of the drugs
b) Time to time take medicine properly as
prescribed the physician
Surgical Management
Management of Keratitis
Purulent Keratitis
1) Laser eye surgery : Permanently lens size
change.
2) Corneal transplantation : Change the cornea
12 8 min To explain HEALTH EDUCATION Lecture & LCD Students are

the health Discussion well
educations. 1) Advice of ways to prevent transmission to other response.
a) Don’t share wash clothes or towel or
handkerchief.
b) Avoid swimming until infection is resolved
2) Advice parents of indication for revaluation by
the health care provider
a) Check antibiotic response
b) Eye pain
3) Encourage routine follow up visits
4) Advice about proper detection and early r/t of
sinus dental and infection
5) Instruct to use clean the cotton
6) Instruct he patient for into putting any thing in
eye
7) Explain the normal protective function of eye.
8) Teach proper eye care this condition.
9) Take Vit A diet properly
10) Time to time take medicine properly and take
rest properly for improving the health of patient.
SUMMARY
13 5 min To 1) Inflammation of the conjunctiva “Pinkeye” that
summarize called conjunctivitis. Keratitis inflammation of the
the topic. cornea. The cause may be physical (trauma, exposure
to dust, vapors or ultraviolet light) or due to
infectious condition. Etiology of bacterial infection,
allergy and streptococcal infection. Types of
conjunctiva inflammation catarrhal, granular,
classification – Superficial & Deep keratitis,
Symptoms of pain redness, photophobia, headache.
Diagnostic evaluation of laboratory tests, screening
test of vision and management Assess nature and
extent of symptoms and their effect on child
activities. Activities and provide inj. Azithromycin
and Levofloxacin Opthalamic eye drop to the patient.
Advice of ways to prevent transmission to other
person.
RECAPTULIZATION
1) What is keratitis?
2) What is conjunctiva and its etiology & clinical
features?
3) What is diagnostic evaluation of conjunctiva
inflammation?
4) Management of conjunctivitis and keratitis?
Date of submission: _____________________

BIBLIOGRAPHY
1) Baillere’s Nurse’s Dictonary, 24th edition, Page no 92, 221
2) Brunner and Suddharths, Medical Surgical Nursing, 12th edition, Vol 2,

Page No- 1786, 1784-1789
3) Mosby, 2006, Drug consult for Nurses, Page no 164-166, 284
4) Hipps Monaha, Binds – Marek, Medical Surgical Nursing, Health and

Illness Perspectives, 7th edition, Page no 1874-1877
5) Lippincott- Manual of Nursing Practice, 9th edition, page no 580-600
6) Modern medicine, the red eye in childhood, conjunctivitis, Vol 37

Page no 121-123
7) American Academy of Allergy Asthma and Immunology Medical

Surgical Nursing, Page no 1201, 1206
8) www.google.com
9) www.wikipedia.com
10) www.encyclopedia.com

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S.

1 1min To introduce SELF INTRODUCTION

2 3 min To introduce INTRODUCTION Lecture & LCD Students are

3 4 min To define DEFINITION Lecture LCD Students are

3) According to Nurses Dictionary

Conjunctiva hemorrhage, also known as

Types of Conjunctiva Inflammation Lecture LCD & Students are

1) Catarrhar : A mild form usually due to

2) Granular : Containing small particles,

3) Phlycleunular : Marked by small vessels or

4) Purulent : Caused by virulent

Due to etiological factors

That may effects the eyes

Then cause redness, itching burning

Sometimes contact with genital secretion infected with

 Exogenous infection – e.g. staphylococcus,

Purulent Non purulent Non purulent Disciform

1) Purulent keratitis or Corneal Ulcer

Nonpurulent Keratitis is caused by the viral and

NON ULCERATIVE KERATITIS

Non Ulcerative Keratitis is also known as

Infer in the eye

Corneal inflammation and corneal edema and anterior

DIAGNOSTIC EVALUATION Lecture & LCD & Students are

7) External eye examination : Bleeding and injury

11 5 min To explain MANAGEMENT Lecture LCD Students are

2) Information about the surgical procedure.

3) Teach to avoid touching and rubbing the eye.

Action: a microlide antibiotic that binds to

2) Drug Name : Chloramphenicol

Action: Antibiotic eye drops inhibits the

Side effects: Headache, Nausea, reaction,

3) Drug Name : Levofloxacin

Action: It inhibits DNS gyrase in susceptible

12 8 min To explain HEALTH EDUCATION Lecture & LCD Students are

Date of submission: _____________________

1) Baillere’s Nurse’s Dictonary, 24th edition, Page no 92, 221

2) Brunner and Suddharths, Medical Surgical Nursing, 12th edition, Vol 2,

3) Mosby, 2006, Drug consult for Nurses, Page no 164-166, 284

4) Hipps Monaha, Binds – Marek, Medical Surgical Nursing, Health and

5) Lippincott- Manual of Nursing Practice, 9th edition, page no 580-600

6) Modern medicine, the red eye in childhood, conjunctivitis, Vol 37

7) American Academy of Allergy Asthma and Immunology Medical

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