Conjunctivitis Flashcards

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1
Q

What is conjunctivitis?

A

irritated red eye with a watery or purulent discharge

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2
Q

What are the common bacterial pathogens than cause conjunctivitis?

A
  1. Pneumococcus
  2. Staph,aureus
  3. Moraxella catarrhalis
  4. Haemophilus influenzae
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3
Q

What STI’s can cause conjunctivitis?

A
  1. neisseria gonorrhoea can also transfer

2. chlamydia cause persistent conjunctivitis

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4
Q

What are viral causes of conjunctivitis?

A
  1. Adenovrius
  2. Herpes simplex
  3. EBV
  4. Variculla zoster
  5. Molluscum contagiosum
  6. Coxscakkie
  7. Enterovrusis
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5
Q

What type of conjunctivitis can contact lens wear lead to?

A
  1. keratoconjunctivitis

2. giant cell papillary conjunctivitis

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6
Q

How common in conjunctivitis?

A

1% of all primary care consultations

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7
Q

What are common RF for conjunctivitis?

A
  1. Infected contact exposure
  2. Allergen exposure
  3. Upper resp tract symptoms
  4. Exposure to environmental irritants
  5. Hx of atopic dermatitis
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8
Q

What are the conjunctiva like in conjunctivitis?

A
  • Conjunctiva vessels injected greatest toward fornices, but blanching on pressure
  • Mobile over sclerae
  • Purulent discharge
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9
Q

Are both eyes usually affected by conjunctivitis?

A

yes

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10
Q

What is the rest of the eye like in conjunctivitis?

A

iris, pupil, cornea, anterior chamber, intracranial pressure all normal

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11
Q

What are the symptoms and signs of conjunctivitis?

A
  1. Watery discharge
  2. Ropy, mucoid discharge
  3. Purulent discharge
  4. Itching predominant symptoms
  5. Red eye
  6. Eyelids stuck together in morning
  7. Tender, peri-auricular lymphadenopathy
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12
Q

What are possible DDx for conjunctivitis?

A
  1. Dry eyes
  2. Blepharitis
  3. Episcleritis
  4. Contact lens over-wear
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13
Q

What are investigations for conjunctivitis?

A
  • Rapid adenovirus immunoassay

- Mostly clinical: can do culutres or PCR if persistent or severe

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14
Q

What management is used for conjunctivitis?

A
  1. Mast cell stabiliser + antihistamine
  2. Topical corticosteroid
  3. Topical or systemic antibiotics for bacterial conjunctivitis
  4. Most do not require treatment
  5. Consider chloramphenicol (antibtioic) ointment or drops
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15
Q

What are possible complications of conjunctivitis?

A
  1. Dry eyes/foreign body sensation
  2. Keratitis
  3. Subepithelial corneal infiltrates
  4. Lacrimal drainage problems
  5. Symblepharon
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16
Q

What is the most common cause of conjunctivitis?

A

viral

17
Q

What are other causes for conjuncitvits not just viral and bacterial?

A
  1. Contact lens
  2. Allergic
  3. Mechanical: floopy eyelid syndrome causes irritation whilst sleeping
18
Q

What is the discharge like in different types of conjunctivtis?

A
  1. Viral: clear watery discharge
  2. Bacterial: thick purulent yellow, white or green discharge with severe crusting
  3. Allergic: clear watery discharge
19
Q

What is eye involvement like in different types of conjuncitvitis?

A
  1. Viral: : begins unilateral but usually progresses to bilateral (highly infectious)
  2. Bacterial: unilateral can rarely progress to bilateral
  3. Allergic: bilateral
20
Q

What is the conjunctival appearance like in different types of conjuncitvitis?

A
  1. Viral: Mostly peripheral injection with conjunctival follicles – (small swollen papules usually on the palpebral and bulbar conjunctiva)
  2. Bacterial: diffuse injection, non-follicular
  3. Allergic: diffuse injection with chemosis and conjunctival follicles
21
Q

What are the other symptoms in different types of conjuncitvtis?

A
  1. Viral: extraocular signs of viral infection (fever, lymphadenopathy, pharyngitis, rash)
  2. Bacterial: signs of bacterial infection, depending on etiology
  3. Allergic: sneezing, itching, atopic dermatitis
22
Q

What is the treatment for viral conjunctivitis?

A
  1. Self-limiting
  2. Antihistamine drops
  3. Topical antiviral (acyclovir) if herpes simplex is the causative organism
23
Q

What is the treatment for bacterial conjuntivitis?

A
  1. Broad spectrum antibiotics
  2. Specific antibiotics if causative organism known i.e. if it is chlamydial infection that has spread, or following culture
24
Q

What is the treatment for allergic conjunctivitis?

A
  1. Avoid allergen
  2. Cold compress
  3. Antihistamines drops