Conjunctivitis Flashcards
What is conjunctivitis?
inflammation of the conjunctiva caused by a bacterial/ viral infection
What is the conjunctiva?
the external layer covering the outer surface of the globe and the inner surface of the eyelids.
Give 5 general presentations associated with conjunctivitis:
1) red, bloodshot eye(s)
2) itchy or gritty sensation
3) discharge
4) chemosis
5) epiphora
What is chemosis?
swelling of the conjunctiva
What is epiphora?
Excessive watering of the eye
What are the 2 classifications of conjunctivitis?
- Non-infectious
- Infectious
Describe the discharge seen in bacterial conjunctivitis:
purulent (green/yellow) which is typically worse in the morning (the eyes may be stuck together)
Describe the discharge seen in viral conjunctivitis:
clear discharge
True or false: both bacterial and viral conjunctivitis are highly contagious
true
What are 3 viral symptoms that often present alongside conjunctivitis?
- Dry cough
- Sore throat
- Blocked nose
What are most cases of viral conjunctivitis caused by?
adenovirus
Does viral conjunctivitis tender to present unilateral or bilateral?
Bilateral
What lymph nodes are tender in viral conjunctivitis?
pre-auricular (infront/above ear)
True or false: conjunctivitis causes pain
false
Name 5 viruses that can cause conjunctivitis:
- Adenovirus
- Herpes
- Measles
- Enterovirus
- Coxsackie virus
What two viruses cause acute haemorrhagic viral conjunctivitis?
1) enterovirus
2) coxsackie virus
What are the two types of presentations of adenoviral conjunctivitis?
- Pharyngoconjunctival fever
- Epidemic keratoconjunctivitis
How does pharyngoconjunctival fever present?
- Pharyngitis
- Conjunctivitis
- Fever
How does Epidemic keratoconjunctivitis present?
More severe, associated with corneal involvement and photophobia
Give 3 bacterial genera that commonly cause conjunctivitis:
1) Staphylococcus
2) Streptococcus
3) Haemophilus
Give two sexually transmitted bacteria that cause conjunctivitis typically in neonates:
1) Chlamydia trachomatis
2) Neisseria gonorrhoea
What is opthalmia neonatorum?
N. gonorrhea vertical transmission during birth that leads to sticky eye discharge and may cause blindness
What two conjunctivitis bacteria also cause reactive arthritis?
1) Chlamydia trachomatis
2) Neisseria gonorrhoea
What is the triad of symptoms seen in reactive arthritis?
- Arthritis
- Conjunctivitis
- Urethritis
What is urethritis?
An inflammation of the urethra, the tube that carries urine from the bladder to the outside of the body.
Give 3 presentations associated with bacterial conjunctivitis:
- Unilateral
- Sticky purulent discharge
- Rapidly and very inflamed conjunctiva
Which type of infection is associated with profuse discharge?
Gonococcal infections
What type of conjunctivitis tends to be associated with follicles and pre-auricular lymphadenopathy?
chlamydial conjunctivitis
What type of sensitivity reaction is allergic conjunctivitis?
type 1 hypersensitivity
Give 3 presentations associated with allergic conjunctivitis:
1) bilateral
2) intense itching
3) examination of the eyelid will reveal papillae (cobblestone appearance)
What are the 4 subtypes of allergic conjunctivitis?
- Seasonal allergic conjunctivitis - secondary to hay fever, therefore most common in summer
- Perennial allergic conjunctivitis - caused by allergens such as house dust mite
- Vernal keratoconjunctivitis - most common in young males living in hot dry climates
- Atopic keratoconjunctivitis - most common in middle aged men.
What management can be given for viral conjunctivitis?
tends to be self- limiting and rarely requires treatment
What investigations can be used for conjunctivitis?
Conjunctival scrape
Name 3 groups of patients that may require a conjunctival scrape?
- Immunosuppressed
- Post-corneal transplant
- Sexual active young people
Severe cases of bacterial conjunctivitis may be treated with eye drops - give two examples of agents used in these eyedrops:
1) chloramphenicol
2) fusidic acid
Give 3 hygiene measures used to decrease conjunctivitis transmission:
1) avoiding towel sharing
2) avoid close contact
3) regular handwashing
True or false: neonates with conjunctivitis need urgent ophthalmology assessment
True
What are complications of bacterial conjunctivitis?
Certain bacteria such as Neisseria have a propensity to invade the cornea, which can lead to keratitis and endophthalmitis. These conditions can subsequently cause reduced vision or blindness if not treated promptly.
How can allergic conjunctivitis be treated?
Treatment includes allergen avoidance, topical and oral antihistamine as well as topical mast-cell stabilisers and occasionally, mild steroids
