Conjunctivitis Flashcards
What is conjunctivitis?
Inflammation of the conjunctiva (thin layer of tissue which covers the inside of the eyelids and the sclera of the eye), there are three main types= bacterial, viral, allergic
What is the presentation of conjunctivitis?
NO REDUCED VISUAL ACUITY (if they do it must be caused by something else!!!)
It is either unilateral or bilateral Red eyes Bloodshot Itchy or gritty sensation Discharge from the eye
Conjunctivitis does not cause pain, photophobia or reduced visual acuity.
What is the management of conjunctivitis?
Conjunctivitis usually resolves without treatment after 1-2 weeks
You should advise on good hygiene to prevent the spread- avoid sharing towels, rubbing eyes, regularly washing hands, avoid contact lens use, clearing the eyes with cooled boiled water and cotton wool can help clear the discharge.
If it is bacterial then you can consider abx eye drops, however it will often get better without treatment (chloramphenicol and fusidic eye drops are both options).
What should you do if a patient under the age of 1 month is presenting with conjunctivitis?
They will need urgent opthalmology review as neonatal conjunctivitis can be associated with gonococcal infection and cause loss of sight and more severe complications such as: pneumonia
What is allergic conjunctivitis caused by?
Contact with allergens
It causes swelling of the conjunctival sac and eye lid with significant watery discharge and itch
Antihistamines (oral or topical) can be used to reduce symptoms
Typical mast cell stabilisers can be used in patients with chronic seasonal symptoms, they prevent mast cells from releasing symptoms and take weeks to work.
How does bacterial conjunctivitis present?
It presents with a purulent discharge and an inflamed conjunctiva, typically worse in the morning when the eyes are stuck together. It usually starts in one eye and then spreads to the other, highly contagious.
How does viral conjunctivitis present?
Common and usually presents with a clear discharge. It is often associated with other symptoms of viral infection like dry cough, sore throat and blocked nose
You may find tender preauricular lymph nodes
It is also contagious
What is the differential diagnosis of acute red eye which is painless?
Conjunctivitis
Episcleritis
Subconjunctival haemorrhage
What is the differential diagnosis of a painful red eye?
Glaucoma Scleritis anterior uveitis Corneal abrasions or ulceration Keratitis Foreign body Traumatic or chemical injury
