Conjunctivitis Flashcards

1
Q

Define conjunctivitis.

A

Inflammation of the conjunctiva, the membranes lining the inside of the eyelid and sclera.

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2
Q

How common is conjunivitis? Who is most affected?

A

Males and females of all ages

~13/1000 cases per year in England

Bacterial conjunctivitis is more common in children, and viral conjunctivitis is more common in adults.

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3
Q

What is a common name for conjunctivitis?

A

Conjunctivitis is the common cause of “pink eye” (conjunctival hyperaemia)

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4
Q

What are the causes of conjunctivitis?

A

Bacterial - usually caused by Pneumococcus, Staph Aureus, Moraxella catarrhalis, Haemophilus influenzae . Rarely N. gonorrhoea, chlamydia.

Viral - adenovirus, herpes simples, Epstein-Barr, varicella zoster, molluscum contagiosum, coxsackie and enterovirus.

Allergic - atopic, seasonal, vernal

Contact lens wear –> keratoconjunctivitis/giant cell papillary conjunctivitis secondary to infrequent replacement.

Mechanical conjunctivitis - floppy eyelid syndrome in obesity, sleep apnoea, upper eyelid laxity and lid imbrication

Toxic/chemical conjunctivitis - exposure to chemicals

Ocular cicatrical pemphigoid - genetic predisposition or in response to certain topical medicines such as idoxuridine, pilocarpine, epinephrine

Neoplastic conjunctivitis is caused by a sebaceous gland carcinoma; secondary radiotherapy may also induce a chronic conjunctivitis.

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5
Q

What are the symptoms of conjunctivitis?

A
  • Conjunctival hyperaemia - “pink eye”
  • Chemosis - oedema of the eyelid.
  • Crust and discharge
  • “Foreign body sensation”
  • Photophobia
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6
Q

How is conjunctivitis diagnosed?

A

Usually clinical diagnosis

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7
Q

How do you distinguish between bacterial and viral conjunctivitis?

A

The most 2 common types are bacterial and viral, you can see bacterial on the left – the giveaway is the yellow discharge/pus. Pus is typical of a bacterial infection because it is composed of dead neutrophils

Viral on the right has clear discharge

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8
Q

What are 4 differences between bacterial and viral conjunctivitis?

A

For bacterial, one cause is an STD and so you may also have urethritis or bacterial discharge from the vagina

Viral may be associated with fever and lymphadenopathy

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9
Q

What type of hypersensitivity reaction is allergic conjunctivitis? What other symptoms would you have?

A

Type 1 Hypersensitivity (IgE)

  • pollen
  • dust
  • chemical scents

Other symptoms: itching, sneezing, red/water and oedematous eyes.

USUALLY BILATERAL

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10
Q

What investigation can you do for diagonsing adenovirus conjunctivitis?

A

Rapid adenovirus immunoassay - from tear sample

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11
Q

What should you suspect in newborns with a red eye?

A

Neonatal chlamydial conjunctivitis is a notifiable disease in the UK and should be suspected in newborns with a red eye. Mothers should be asked about sexually transmitted infections.

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12
Q

Why is chlamydial conjunctivitis dangerous?

A

Spreads by direct/indirect contact of eye with genital secretions.

Caused by chlamydia trichomatis which can lead to progressive scarring, trichiasis, entropion and subsequent corneal scarring –> visual impairment or blindness.

Common cause of blindness worldwide; found mainly in tropic and the Middle East.

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