The Surge In STD And STI Infection

Julie Tyler, OD, FAAO talks about the surge in STD and STI infection.

Cara Moore: Hi everybody. Thanks for joining us on Optometry TV. I’m Cara Moore joined now by Dr. Julie Tyler. Thanks so much for being here.

Dr. Julie Tyler: It’s my pleasure. Thanks for having me.

Cara Moore: So we are here talking about systemic disease and STDs, STIs, and really the surge in all infection.

Dr. Julie Tyler: Exactly. We have presented this information so it is very much an area of interest for me. I think it’s fascinating how these infections that are in the body can manifest in different ways in the eye. Syphilis for example, which is one of these sexually transmitted infections is called the great imitator because it can do so many different things in the eyes. So with a colleague of mine, Dr. Cheryl Reynolds, she and I both have an area of interest in this, we’ve been researching and looking up information to get everything up to date. And unfortunately just this past month they released the new information from the past year and every sexually transmitted infection that we are talking about, Syphilis, gonorrhea, chlamydia and HIV are all on the rise.

Cara Moore: So why does that pose such a challenge to practitioners?

Dr. Julie Tyler: Well I think it’s two fold. One is that you need to be able to identify the different findings that are associated. And a lot of these conditions actually mimic other conditions. So it’s very easy at first to think something looks like a simple conjunctivitis, whether it be viral or bacterial. And in fact it is related to a sexually transmitted infection in the body and it’s just manifesting in the eye. So that I think creates one issue. And then the other thing is how do we manage these patients and how do we have conversations with them? Because it can be a little awkward, but it’s important to remember that this is in our list of differentials.

Cara Moore: And that’s really the takeaway for practitioners, right?

Dr. Julie Tyler: Yes. Basically keeping it in mind, especially as we identify the high risk groups, so younger people that are sexually active, they are a lot of times the same people that are having contact lens related issues. But if you have something and it’s not being managed the way or responding the way that you anticipate it, then maybe there’s something else going on. And so this is a really good condition or an example of where you can have mimickers chlamydia, syphilis, they all can, they both can look like different things. HIV, you have manifestations of conditions that you wouldn’t normally see. And so that can be quite interesting. So really interesting, really important for practitioners to keep it in their list and be concerned about that for their patients.

Cara Moore: And the same goes for ocular injuries, right?

Dr. Julie Tyler: Right, so and for Ocular injuries it’s a little bit different. Usually the patients know that they’re coming in, they had an injury. But as practitioners we need to think about what else could be happening. And so in that way they’re both, you know, one of the things I love about being an optometrist is putting on my sleuth hat, trying to figure things out. And so we definitely do that with these conditions. And with Ocular injuries, again, we may know what happened, but we might not know how severe the injury is. And it’s important to educate our patients on what they should anticipate and if something isn’t responding the way that we think it should be. Interestingly enough, I actually had a patient that had an Ocular injury and because of their injury we discovered that they had a sexually transmitted infection. Because originally we thought that they had an inflammation, a uveitis from the trauma, but it didn’t go away. And over time we figured out that in fact the patient was positive for a sexually transmitted infection. So it can, they can certainly be drawn together. And as optometrists we need to keep our minds thinking about what else could be happening.

Cara Moore: Especially in things that used to be rare. Now are not so rare anymore.

Dr. Julie Tyler: Right. Like with STIs. Yeah, we definitely have an increase in infections and things that I never honestly thought that I would see, congenital syphilis it has a hundred and I think 45% increase in four years. That’s not anything I ever thought I was going to have to deal with. And now these infants, if they’re born and survive, we may have to be dealing with their ocular complications going forward. So really interesting, unfortunate, but educating our Doctors and therefore our patients is key.

Cara Moore: And challenging for practitioners, no doubt.

Dr. Julie Tyler: For sure.

Cara Moore: All right, Dr. Tyler, thanks for being here.

Dr. Julie Tyler: It was my pleasure.

Cara Moore: Yeah. Appreciate it. Thank you all for watching Optometry TV.

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