#21. Conjunctivitis – types, signs, treatment. Flashcards
What is Conjunctivitis?
Inflammation of the Conjunctiva (transparent membrane that lines the eyelid + eyeball)
What are the 4 TYPES of CONJUNCTIVITIS?
1) PURULENT Conjunctivitis
2) ACUTE MEMBRANOUS Conjunctivitis
3) PSEUDOMEMBRANOUS Conjunctivitis
4) CHRONIC CATARRHAL Conjunctivitis
What is PURULENT Conjunctivitis?
Characterised by VIOLENT Inflammatory Response
What are the 2 FORMS of PURULENT Conjunctivitis?
A) ADULT Purulent Conjunctivitis
B) OPHTHALMIA NEONATORUM (Infants)
What are the CAUSES of ADULT Purulent Conjunctivitis?
Bacteria
- N. Gonorrhoea
- N. Meningitidis
What are the CLINICAL SIGNS & SYMPTOMS of ADULT Purulent Conjunctivitis?
- PROFUSE Purulent DISCHARGE
- QUICK Progression
- STRONGLY MARKED Palpebral OEDEMA
- CHEMOSIS (Oedema of Conjunctiva) AROUND the LIMBUS
- Corneal INVOLVEMENT
What is the TREATMENT for ADULT Purulent Conjunctivitis?
1) SYSTEMIC Antibiotic Therapy
- NORFLOXACIN
- SPECTINOMYCIN
2) TOPICAL Antibiotic Therapy = OFLAXACIN Eye Drops
What is OPHTHALMIA NEONATORUM (Infants)?
- It is BILATERAL (Both eyes) Inflammation of Conjunctiva, IN INFANTS
- UNDER 30 Days old
- Infection occurs BEFORE / DURING / AFTER Birth
What are the CAUSES of OPHTHALMIA NEONATORUM (Infants)?
- CHEMICALS = Silver Nitrate
- BACTERIA = Gonococcal Infections
What are the CLINICAL SIGNS & SYMPTOMS of OPHTHALMIA NEONATORUM (Infants)?
- PAIN / TENDERNESS in eyeball
- PURULENT Conjunctival DISCHARGE
- SWOLLEN Eyelids
- Hyperaemia
- CHEMOSIS (Oedema of Conjunctiva)
- Corneal INVOLVEMENT
What is ACUTE MEMBRANOUS Conjunctivitis?
- ACUTE Inflammation of the Conjunctiva
- Where there’s FORMATION of TRUE MEMBRANE (Deposition of Fibrinous Exudate) on the Conjunctiva
- AFFECTS Children of 2 - 8 y/o that ARE NOT IMMUNISED AGAINST Diphtheria
What is the CAUSE of ACUTE MEMBRANOUS Conjunctivitis?
Bacteria = C. Diphtheriae
What are the CLINICAL FEATURES of ACUTE MEMBRANOUS Conjunctivitis?
Explain the Stages
1) INFILTRATION Stage
- SCANTY Conjunctival Discharge
- SEVERE Pain in the eye
- SWOLLEN / HARD eyelids
- REDNESS in Conjunctiva
- COVERED with THICK GREY-YELLOW Membrane
2) SUPPURATION Stage
- Pain DECREASES
- Lids BECOME SOFT
- Membrane is SLOUGHED OFF
- Purulent DISCHARGE
3) CICATRISATION Stage
What is the TREATMENT for ACUTE MEMBRANOUS Conjunctivitis?
1) TOPICAL Therapy
- Penicillin Eye drops
- Anti-Diphtheric Serum
- Broad Spectrum Antibiotic Ointments
2) SYSTEMIC Therapy
- Crystalline Penicillin
- Anti-Diphtheric Serum
What is PSEUDOMEMBRANOUS Conjunctivitis?
- Type of Conjunctivitis that’s characterised by PSEUDOMEMBRANE FORMATION
- Can be EASILY PEELED OFF, leaving behind INTACT Conjunctival Epithelium
What are the CAUSES of PSEUDOMEMBRANOUS Conjunctivitis?
1) BACTERIAL
- C. Diphtheriae
- Staphylococci + Streptococci
- H. Influenzae
2) VIRAL
- Herpes Simplex
- Adenovirus
3) CHEMICALS
- Acids
- Ammonias
- Silver Nitrate
What is the PATHOLOGY of PSEUDOMEMBRANOUS Conjunctivitis?
1) The AGENTS produce inflammation on the Conjunctiva
2) Where FIBRINOUS EXUDATE is spread on the surface of the Conjunctiva
3) LEADING to FORM a PSEUDOMEMBRANE
What is the CLINICAL PICTURE of PSEUDOMEMBRANOUS Conjunctivitis?
- Has a THIN, YELLOW-WHITISH Membrane
- Seen in FORNICES & PALPEBRAL CONJUNCTIVA
- Peeled off EASILY
- DOES NOT Bleed!
What is CHRONIC CATARRHAL Conjunctivitis?
Conjunctivitis that’s characterised by MILD CATARRHAL inflammation
What is the CAUSE of CHRONIC CATARRHAL Conjunctivitis?
- CHRONIC Exposure to
a. Dust
b. Smoke
c. Chemical Irritants - FOREIGN Body
- BACTERIA
a. S. Aureus
b. E. Coli
c. K. Pneumoniae
How does CHRONIC CATARRHAL Conjunctivitis work?
1) CONTINUATION of ACUTE Mucopurulent Conjunctivitis = Left UNTREATED
2) CHRONIC Infection from ASSOCIATED Chronic RHINITIS / UPPER Respiratory Catarrh
3) MILD EXOGENOUS Infx, DUE to Direct Contact / Air-borne
What is the CLINICAL PICTURE of CHRONIC CATARRHAL Conjunctivitis?
- Burning
- Mild Chronic Redness
- Feeling Heat / Dryness on Lid Margins
- Difficulty keep eyes open
- MILD Mucous DISCHARGE
- SURFACE of Conjunctiva looks STICKY
What is the TREATMENT for CHRONIC CATARRHAL Conjunctivitis?
- Predisposing Factors to TREATED / ELIMINATED
- TOPICAL Antibiotics
- ASTRINGENT Eye Drops (Symptomatic Relief)
