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Measles and the eye.pptx

  1. 1. MEASLES AND THE EYES. Presented by Victoria Ikechukwu
  2. 2. MEASLES
  3. 3. Definition Measles:- Is a childhood infection caused by a virus (i.e a single stranded, enveloped RNA virus with 1 serotype- it is classified as a member of the genus Morbillivirus in the Paramyxoviridac Family. Humans are the only natural hosts of measles virus. Once quite common, measles can now almost be prevented
  4. 4. Mode of Transmission Person to person transmission. This virus lives in the nose and throat (i.e mucus of an infected person it can spread to others through coughing and sneezing. Transmitted by direct contact with infectious droplets or by Airbonne spread. Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area. Its highly Contagious
  5. 5. It is so contagious that if one person has it, up to 90% of the people close to that person who are not immune to it will also become infected. Infected people can spread measles to others from four days before and through four days before the rash appears.
  6. 6. Mortality/Morbidity Rate Jan 2022, 254 cases of measles were confirmed in Nigeria 2022 9,000 cases, (March – August 2022 – 9,373 cares as at 12 Oct, 2022) WHO 2018 140, 000 died from measles worldwide. High mortality is common in eventures with low income and weak health facilities. One of the most contagious disease.
  7. 7. Clinical Manifestation There takes around 10 -14 days after exposure to the virus 1. Fever 40.5° - 41.5° = 105° F 2. Coryza 3. Malaise 4. Dry cough (hyperpyrexia) 5. Koplik’s spots: tiny white spot with bluish acute 6. Sore throat centers on a red background found inside the mouth. 7. The 3C’s = Cough, Coryza and conjunctivitis
  8. 8. The infection occurs in stages over 2 to 3 weeks 1. Infection and Incubation:- For the first 10-14 days after infection the measles virus spreads in the body. There are no signs or measles during this time. 2. Non-specific signs and symptoms:- measles typically begins a mild to moderate fever, after with a persistent cough, a running nose. (Coryza) inflamed (Conjuctivitis) and a sure throat. This relatively mild illness may last 2 to 3 days.
  9. 9. Its Effects on the Eyes A study estimated that measles causes to 60,000 cases of blindness a year. Through measles is just re- emerging as a threat in developed countries. The disease has long been leading cause of childhood blindness worldwide. Poor access to measles vaccination and malnutrition often correlates with higher rates of blindness in the most affected countries.
  10. 10. There are some ways the virus can harm the eyes and affect vision. 1. Conjunctivitis 2. Corneal scaring 3. Keratitis 4. Rehnopathy 5. Optic neuritis 6. Blindness
  11. 11. Conjunctivitis (infective) The commonest cause of red eye is one of the early and common symptoms of measles is inflamed eyes (conjunctivitis). This type of “pink eye” usually develops along fever, cough and coryza before the rashes appears. The inflammation of the conjunctiva, which can be extremely contagious when small blood vessels in the conjunctiva becomes inflamed, there are more visible. Cause: Commonly by a bacteria or viral infection, an allergic reaction.
  12. 12. Clinical manifestation 1. Redness in one or both eyes 2. Itching in one or both eyes 3. A gritty feeling in one or both eyes 4. Discharge in one or both eyes 5. Tearing
  13. 13. Treatment Nursing management  History taking: timing of onset  Prodromal symptoms i.e. unilateral or bilateral  Past episodes, type of discharge  Obtain visual acquity  Apply cool compress  Educate patient on the disease
  14. 14.  Do not share personal belongings/ care items  Administer medication as prescribed  Encourage hand hygiene  Use of sun glasses white out
  15. 15. Treatment Treatment of both viral and bacterial conjunctivitis should include patient education to decrease the rate of transmission. - Antibiotic options are available as liquid so intious and topical ointment - Anti-Viral medication (Therapy)
  16. 16. Realities: - inflammation of the cornea, often associated with infective conjunctivitis e.g. Acyclovir oral and both topical 800mg 5x a day. Oral famciclovir 500mg + ds ‘’ Valacyclovir 1g + ds a day 7 – 10 days
  17. 17. Clinical Features 1. Irritation 2. Pain 3. Eye discharge 4. Photophobia 5. Visual Impurments 6. Epiphoria (teaning)
  18. 18. Nursing Management - Obtain History - Visual acuity - Pera lyht exammation (Lids of Conjunction) - Serve prescribed medications - Health educates patient on the discase and treaties plan - Anti-viral eyedrops/medications e.g. Acyclovir and oral may be effective. - Others are supportive care such as Artificial tear days
  19. 19. Corneal Scanning The cornea is resilient and can typically heal from mini abrasions. However, major cornea damage can result in a cornea scar. After major damage, clear corneal tissue may be replaced by scar tissue or become occluded by new blood vessels (a problem called Neovascularization).
  20. 20. Clinical Manifestation - Pain - FB sensation - Epiphora - Blurred vision - Photophobia - Buring sensation in the eye - Eye lid swelling – Redness
  21. 21. 1. Therapeutre - contact lens - Tatooing - Corneal Transplant Optic Neuritis:- Inflammation of the optic neuritis is a rare complication of measles that tayets the optic nerve. The optic nerve is responsible to taking visual information produced by the retina and sending it to the brain to be processed. When the optic gets inflamed. It can cause eye pain, loss of colour vision and temporary blindness. In adults usually one eye is affected but in children both eyes are affected.
  22. 22. Signs and Symptoms - Pain - Loss of colour vision - Visual field loss - Blurring vision - Loss of vision
  23. 23. Treatment Optic Neuritis may resolve spontaneously without treatment. If visual function is poor; a course of IV methyl prednisolone may be given as prescribed. This has been shown to spread recovery of visual function. The usual course is 3 days, followed by a few days of oral medications.
  24. 24. Some Helpful Investigation OCT – Optical Coherence Tomography. It uses reflected light to create pictures of the back of the eye. Visual Evoked Response: - The doctor attaches electro delusive to one’s head with small patches. The wire records one’s brains response as he/she watch a screen that displays an altemaling checkboard pattern. The test measures the speed at which your optic nerve sends signals to your brain, its damaged. They will more more slowly. Mostly, used in patients’ multiple sclerosis.
  25. 25. Retinopathy: - Refers to disease of the Betina – this involves the retina blood vessels. While rare; there are documented cases where the measles virus destroys the retina.
  26. 26. Signs and Symptoms - Gradual worsening vision - Loss of vision (colour) - Floaters
  27. 27. Blindness Measles is a leading cause of childhood blindness in developing countries where immunization programs for this disease are less established or often interrupted by conflict. When compounded by malnutrition, particularly vitamin A deficiency. Measles is an associated with corneal scanning from ulceration and keratitis, two of optic neuritis has also been noted.
  28. 28. Prevention: - There is no specific anti-viral treatment for measles making vaccination the best means of limiting the spread of this disease. CDC! Centre for Disease Control and Prevention, and World Health Organization recommends measles vaccination. Vit A treatment; children with severe cases (include those requiring hospitalization) WHO suggest treatment of vit A on the day of diagnosis and day after to prevent visual loss due to eye complications.
  29. 29. 1. 50,000 IV for infants younger than 6 months of age 2. 100,000 IV for infants younger than 6 to 11 months of age 3. 200,000 IV for children 12 months of age and older.
  30. 30. Conclusion Measles infections can harm the front and even down to the back of the eye and possibly causing vision loss or blindness. The need for proper and safe adherence to childhood immunization cant be over emphasized accurate and early diagnosis plus prompt intervention can go along way.
  31. 31. References - American Academy of Opthalmology - Clinical Significance of Measles, A review, Journal of infectious - International Opthalmology March 2014 - Measles Blindness, Survey of Opthalmology, 2014 - Mayo Clinic - Comprehensive Opthalmology A-K Khurana - Concise textbook ophthalmology – Affiong Awana
  32. 32. Thank you for listening.