Conjunctivitis Flashcards
What is conjunctivitis?
irritated red eye with a watery or purulent discharge
What are the common bacterial pathogens than cause conjunctivitis?
- Pneumococcus
- Staph,aureus
- Moraxella catarrhalis
- Haemophilus influenzae
What STI’s can cause conjunctivitis?
- neisseria gonorrhoea can also transfer
2. chlamydia cause persistent conjunctivitis
What are viral causes of conjunctivitis?
- Adenovrius
- Herpes simplex
- EBV
- Variculla zoster
- Molluscum contagiosum
- Coxscakkie
- Enterovrusis
What type of conjunctivitis can contact lens wear lead to?
- keratoconjunctivitis
2. giant cell papillary conjunctivitis
How common in conjunctivitis?
1% of all primary care consultations
What are common RF for conjunctivitis?
- Infected contact exposure
- Allergen exposure
- Upper resp tract symptoms
- Exposure to environmental irritants
- Hx of atopic dermatitis
What are the conjunctiva like in conjunctivitis?
- Conjunctiva vessels injected greatest toward fornices, but blanching on pressure
- Mobile over sclerae
- Purulent discharge
Are both eyes usually affected by conjunctivitis?
yes
What is the rest of the eye like in conjunctivitis?
iris, pupil, cornea, anterior chamber, intracranial pressure all normal
What are the symptoms and signs of conjunctivitis?
- Watery discharge
- Ropy, mucoid discharge
- Purulent discharge
- Itching predominant symptoms
- Red eye
- Eyelids stuck together in morning
- Tender, peri-auricular lymphadenopathy
What are possible DDx for conjunctivitis?
- Dry eyes
- Blepharitis
- Episcleritis
- Contact lens over-wear
What are investigations for conjunctivitis?
- Rapid adenovirus immunoassay
- Mostly clinical: can do culutres or PCR if persistent or severe
What management is used for conjunctivitis?
- Mast cell stabiliser + antihistamine
- Topical corticosteroid
- Topical or systemic antibiotics for bacterial conjunctivitis
- Most do not require treatment
- Consider chloramphenicol (antibtioic) ointment or drops
What are possible complications of conjunctivitis?
- Dry eyes/foreign body sensation
- Keratitis
- Subepithelial corneal infiltrates
- Lacrimal drainage problems
- Symblepharon
What is the most common cause of conjunctivitis?
viral
What are other causes for conjuncitvits not just viral and bacterial?
- Contact lens
- Allergic
- Mechanical: floopy eyelid syndrome causes irritation whilst sleeping
What is the discharge like in different types of conjunctivtis?
- Viral: clear watery discharge
- Bacterial: thick purulent yellow, white or green discharge with severe crusting
- Allergic: clear watery discharge
What is eye involvement like in different types of conjuncitvitis?
- Viral: : begins unilateral but usually progresses to bilateral (highly infectious)
- Bacterial: unilateral can rarely progress to bilateral
- Allergic: bilateral
What is the conjunctival appearance like in different types of conjuncitvitis?
- Viral: Mostly peripheral injection with conjunctival follicles – (small swollen papules usually on the palpebral and bulbar conjunctiva)
- Bacterial: diffuse injection, non-follicular
- Allergic: diffuse injection with chemosis and conjunctival follicles
What are the other symptoms in different types of conjuncitvtis?
- Viral: extraocular signs of viral infection (fever, lymphadenopathy, pharyngitis, rash)
- Bacterial: signs of bacterial infection, depending on etiology
- Allergic: sneezing, itching, atopic dermatitis
What is the treatment for viral conjunctivitis?
- Self-limiting
- Antihistamine drops
- Topical antiviral (acyclovir) if herpes simplex is the causative organism
What is the treatment for bacterial conjuntivitis?
- Broad spectrum antibiotics
- Specific antibiotics if causative organism known i.e. if it is chlamydial infection that has spread, or following culture
What is the treatment for allergic conjunctivitis?
- Avoid allergen
- Cold compress
- Antihistamines drops
