Conjunctivitis Flashcards
Presentation of Conjunctivitis
Conjunctivitis presents with:
Unilateral or bilateral
Red eyes
Bloodshot
Itchy or gritty sensation
Discharge from the eye
Conjunctivitis does not cause pain, photophobia or reduced visual acuity. Vision may be blurry when the eye is covered with discharge, however when the discharge is cleared the acuity should be normal.
Bacterial conjunctivitis presents with a purulent discharge and an inflamed conjunctiva. It is typically worse in the morning when the eyes may be stuck together. It usually starts in one eye and then can spread to the other. It is highly contagious.
Viral conjunctivitis is common and usually presents with a clear discharge. It is often associated with other symptoms of a viral infection such as dry cough, sore throat and blocked nose. You may find tender preauricular lymph nodes (in front of the ears). It is also contagious.
Painless Red Eye?
Painless Red Eye
Conjunctivitis
Episcleritis
Subconjunctival Haemorrhage
painful red eye?
Glaucoma
Anterior uveitis
Scleritis
Corneal abrasions or ulceration
Keratitis
Foreign body
Traumatic or chemical injury
Treating conjunctivitis
Conjunctivitis usually resolves without treatment after 1-2 weeks.
Advise on good hygiene to avoid spreading (e.g. avoid sharing towels or rubbing eyes and regularly washing hands) and avoiding the use of contact lenses. Cleaning the eyes with cooled boiled water and cotton wool can help clear the discharge.
If bacterial conjunctivitis is suspected then antibiotic eye drops can be considered, however bear in mind it will often get better without treatment. Chloramphenicol and fuscidic acid eye drops are both options.
Patients under the age of 1 month of age with conjunctivitis need urgent ophthalmology review as neonatal conjunctivitis can be associated gonococcal infection and can cause loss of sight and more severe complications such as pneumonia.
Treating allergic conjunctivitis
Antihistamines (oral or topical) can be used to reduce symptoms.
Topical mast-cell stabilisers can be used in patients with chronic seasonal symptoms. They work by preventing mast cells releasing histamine. These require use for several weeks before showing any benefit.
