Conjunctivitis Flashcards
Define Conjunctivitis
Inflammation of the lining of the eyelids and eyeball
Aetiology of Conjunctivitis
Bacteria: pneumococcus, s. aureus, H. influenzae
Viral: adenovirus, HSV, EBV, VZV
Contact lens wear: prolonged wearing time, infrequent replacement, poor hygiene
Mechanical: chronic irritation due to floppy eyelid syndrome
Toxic/chemical: irritation by exposure to chemicals
Neoplastic: sebaceous gland carcinoma
Symptoms of Conjunctivitis
Discharge (Watery (viral) | Ropy, mucoid (allergic) | Purulent (bacterial) - copious purulent discharge over 12-24 hours indicates hyerpracute gonorrhoeal infection)
Itching (more predominant allergic)
Eyelids stuck together in the morning (bacterial or viral)
Vesicular skin rash (may indicate herpes zoster)
Superficial punctate keratopathy - red, watery, and sensitive to light
Signs of conjunctivitis on examination
Discharge (Watery (viral) | Ropy, mucoid (allergic) | Purulent (bacterial) - copious purulent discharge over 12-24 hours indicates hyerpracute gonorrhoeal infection)
Tender, pre-auricular lymphadenopathy (more common in viral than bacterial)
Vesicular skin rash
Conjunctival follicles
Corneal subepithelial infiltrates
Corneal pannus (growth of fine blood vessels onto corneal surface)
Investigations for Conjunctivitis
Rapid adenovirus immunoassay: +ve in adenovirus infection
Cell culture: bacterial or viral isolation
Gram stain: ?bacterial cause
PCR: viral or bacterial
ocular pH: suspected chemical cause