2: Conjunctivitis Flashcards
Define conjunctivitis
Inflammation of the conjunctiva
What is the most common ophthalmological complaint in primary care
Conjunctivitis
How can the causes of conjunctivitis be divided
Infectious (Viral + Bacterial)
Allergic
Chemical
Autoimmune
What is the most common infectious cause of conjunctivitis
Adenovirus
what is the most common type of conjunctivitis
Allergic conjunctivitis
what is allergic conjunctivitis usually associated with
Allergic rhinitis
what chemical usually causes conjunctivitis
Silver nitrate
when may conjunctivitis be seen in autoimmune conditions
Steven-Johnson syndrome
in infectious conjunctivitis how will the eye present
- Red
- Discharge (varies if bacterial/viral)
- Gritty sensation
- No photophobia
- No loss of vision
describe discharge in viral conjunctivitis
Watery
describe discharge in bacterial conjunctivitis
Sticky
describe presentation of allergic conjunctivitis
Bilateral
Conjunctival oedema
Conjunctival erythema
Itchy
What are the 5 most common bacterial causes of conjunctivitis
- Staphylococcus epidermis
- Staphylococcus aureus
- S. pneumonia
- H, Influenza
- N. Gonorrhoea
How does bacterial conjunctivitis present
Unilateral
Thick mucopurulent discharge
Extra-ocular signs
How will gonococcal conjunctivitis present
Unilateral
Thick mucopurulent discharge
Eye lid swelling
How will chlamydia conjunctivitis present
Mucopurulent discharge
What are two causes of viral conjunctivitis
HSV
Adenovirus
What is the most common cause of viral conjunctivitis
Adenovirus (80%)
How will viral conjunctivis present
Bilateral (one-eye spreads to other)
Watery discharge
Normal vision
Conjunctival follicles
What are conjunctiva follicles
Yellow-appearing hyperplasia of lymphatic follicle tissue
Describe the onset of gonococcal neonatal conjunctivitis
Acute: 1-3d
How will gonococcal neonatal conjunctivitis present clinically
Chemosis
Mucopurulent discharge
What investigations are performed for neonatal gonococcal conjunctivitis
Swab or scrapings for giemsa stain and MC+S
What is used to treat neonatal gonococcal conjunctivitis
Cefotaxime
Describe symptom onset of chlamydia neonatal conjunctivitis
Sub-acute: 4-28d
How does chlamydia neonatal conjunctivitis present clinically
- Mucopurulent discharge
- Papillae
How is neonatal chlamydia conjunctivitis investigated
Swabs for immunofluorescence and giemsa staining
How is neonatal chlamydia conjunctivitis treated
Erthromycin
How is conjunctivitis normally diagnosed
clinically
What is second line for conjunctivitis
conjunctival scrapings
When are conjunctival scrapings considered
if persistent or severe disease (eg. ulceration)
What are conjunctival scrapings sent for in suspected viral causes
PCR
What are conjunctival scrapings sent for in suspected bacterial causes
MC+S
What is first line for allergic conjunctivitis
Topical antihistamines
What are topical antihistamines called
Opatanol
What is second-line for managing allergic conjunctivitis
Topical mast cell stabilisers (sodium cromoglicate)
Name a topical mast cell stabiliser
sodium cromoglicate
What is first-line for infective conjunctivitis
advice
What advice is given to prevent spread of infectious conjunctivitis
- do not share towels
- hand washing
- clean the eye with saline-soaked cotton wool
Explain school exclusion for infectious conjunctivitis
children should not be excluded from school unless outbreak
Explain health care workers with conjunctivitis
should avoid work
What should be avoided in conjunctivitis
contact lenses
When are antibiotics given in conjunctivitis
if symptoms have persisted beyond 3 DAYS
What antibiotics are given for infectious conjunctivitis
topical chloramphenicol
What is a contraindication to topical chloramphenicol
pregnancy
What is given as an alternative to topical chloramphenicol in pregnancy
topical fusidic acid
in what time frame does bacterial conjunctivitis resolve
5-7d
in what time frame does viral conjunctivitis resolve
1-3W
