[46] Conjunctivitis

Question 1

What is conjunctivitis?

Answer 1

Inflammation or swelling of the conjunctiva

Question 2

What is the conjunctiva?

Answer 2

The thin, transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye

Question 3

What can the causes of conjunctivitis be divided into?

Answer 3

• Bacterial
• Viral
• Chlamydial
• Allergic

Question 4

What is the usual cause of viral conjunctivitis?

Answer 4

Adenovirus

Question 5

When does viral conjunctivitis most commonly occur?

Answer 5

Alongside a viral URTI

Question 6

What are the most common causes of bacterial conjunctivitis?

Answer 6

• Staph aureus
• Strep pneumoniae
• Haemophilus influenzae

Question 7

What is the most common cause of neonatal conjunctivitis?

Answer 7

Chlamydia

Question 8

What are the common triggers for allergic conjunctivitis?

Answer 8

• Pollen
• Smoke
• Perfumes
• Cosmetics

Question 9

What is the main symptom of conjunctivitis?

Answer 9

Red eye with gritty or itchy discomfort

Question 10

What are the effects of conjunctivitis on vision?

Answer 10

• Normal acuity*

Photophobia is rare

Question 11

Why is it important to look for additional symptoms of conjunctivitis?

Answer 11

They can help determine the cause

Question 12

When may loss of visual acuity occur in conjunctivitis?

Answer 12

If there is concurrent keratitis

Question 13

What is keratitis?

Answer 13

Inflammation of the cornea

Question 14

What are the additional symptoms of viral conjunctivitis?

Answer 14

• Redness of entire conjunctiva

- Watery discharge

Question 15

What are the additional symptoms of bacterial conjunctivitis?

Answer 15

• Redness maximal at inferior conjunctiva
• Purulent discharge
• Rapid onset

Question 16

What are the additional features of chlamydial conjunctivitis?

Answer 16

• Presents in first days of life
• Rapidly progressive, profuse, purulent discharge
• Lid oedema
• Cornea rapidly affected leading to ulceration

Question 17

What are the additional features of allergic conjunctivitis?

Answer 17

• Bilateral significant itching
• Usually seasonal
• Associated with swollen lids, runny nose, and positive family history of atopy

Question 18

How is conjunctivitis diagnosed?

Answer 18

Clinically

Question 19

What investigation may be required in severe resistant bacterial conjunctivitis?

Answer 19

Swabs

Question 20

What are the differentials of conjunctivitis?

Answer 20

• Keratitis
• Ophtalmia neonatorum
• Subconjunctival haemorrhage
• Anterior uveitis
• Acute glaucoma
• Trauma

Question 21

How is viral conjunctivitis managed?

Answer 21

Cold compress to help discomfort and good hand hygiene - it is usually self-limiting

Question 22

When may antibiotics be given in viral conjunctivitis?

Answer 22

Only when there is a secondary bacterial infection

Question 23

What is the treatment for bacterial conjunctivitis?

Answer 23

Antibiotic drops e.g. chloramphenicol or fusidic acid

Question 24

When are antibiotic drops given in severe cases?

Answer 24

1 drop every 2 hours

Question 25

When are antibiotic drops given for milder cases?

Answer 25

3-4 times daily

Question 26

When may systemic antibiotics be given in bacterial conjunctivitis?

Answer 26

In severe disease

Question 27

What is the management for allergic conjunctivitis?

Answer 27

• Opticrom drops

- Oral antihistamines