Conjunctivitis Flashcards
Conjunctivitis
It typically presents with eye discomfort, itchiness, and a red eye, but without significant visual changes or severe pain.
- Commonly seen during the winter and spring months (November through April)
Conjunctivitis
commonly known as “pink eye,” is the inflammation of the conjunctiva. It is often a result of infectious or allergic reactions and is the most frequently encountered eye disease in medicine.
Clinical Presentation Conjunctivitis
Symptoms**: Redness, discomfort, and possible discharge. The discharge can be watery (viral/allergic) or purulent (bacterial).
- Patients often report eyelid sticking after sleep due to dried discharge.
- It can be unilateral or bilateral; bilateral is more common with allergic conjunctivitis.
Bacterial Conjunctivitis
Common agents are Staphylococcus and Streptococcus. Presents with purulent discharge.
important to take a sexual history due to the risk of
gonococcal conjunctivitis in sexually active patients.
*Viral Conjunctivitis
: Often caused by adenovirus and associated with watery discharge and a recent respiratory tract infection. Highly contagious.
Allergic Conjunctivitis*
Presents with itchy, red eyes, often with a history of allergies, asthma, or atopic dermatitis. Typically no discharge, could have tearing.
Diagnosis
Primarily clinical; based on history and physical examination.
- Red eye without changes in visual acuity and no severe pain typically suggests conjunctivitis.
Differential Diagnosis
Anterior uveitis, acute angle-closure glaucoma, keratitis, each associated with different additional symptoms (severe pain, blurred vision).
Supportive care** is often sufficient, including saline lavage and artificial tears.
treatment
treatment bacterial
May use topical antibiotics like ciprofloxacin in addition to support.
treatment chlamydial
Erythromycin for newborns, azithromycin for adults.
treatment gonococcal
Intramuscular ceftriaxone and oral azithromycin.
treatment viral
Supportive care, unless caused by specific agents (e.g., herpes), in which antiviral therapy is needed.
treatment allergic
Topical antihistamines or NSAIDs. Severe cases may require corticosteroids.
Management Strategies
- Assessing for red eye: Determine if severe pain or vision changes are present; this may suggest conditions other than conjunctivitis.
Severe itchiness** tends to indicate allergic conjunctivitis.
- Use simple clinical indicators and history to differentiate conjunctivitis from other causes of red eye.
Recognizing the type of conjunctivitis is pivotal for appropriate treatment, especially when differentiating between non-urgent and urgent referrals (e.g., for herpes simplex or zoster complications)
Which of the following symptoms is NOT commonly associated with conjunctivitis?**
- A) Eye redness
- B) Severe eye pain
- C) Discharge from the eye
- D) Gritty sensation in the eye
Answer: B) Severe eye pain
Explanation: Conjunctivitis generally does not present with severe eye pain. Severe pain may suggest other conditions such as acute angle-closure glaucoma or uveitis.
*What is the most common cause of viral conjunctivitis?**
- A) Herpes simplex virus
- B) Varicella-zoster virus
- C) Adenovirus
- D) Cytomegalovirus
Answer: C) Adenovirus**
Explanation: Adenovirus is the most common cause of viral conjunctivitis, seen frequently with associated respiratory tract infections.
A patient presents with purulent eye discharge and is sexually active. Which causative agent should be considered?**
- A) Herpes simplex virus
- B) Adenovirus
- C) Chlamydia trachomatis
- D) Neisseria gonorrhoeae
D) Neisseria gonorrhoeae**
Explanation: Purulent discharge in sexually active patients warrants consideration of gonococcal conjunctivitis caused by Neisseria gonorrhoeae.
Which treatment is appropriate for bacterial conjunctivitis not caused by Neisseria gonorrhoeae or Chlamydia trachomatis in immunocompetent individuals?**
- A) Oral azithromycin
- B) Topical ciprofloxacin
- C) Intramuscular ceftriaxone
- D) Topical corticosteroids
*Answer: B) Topical ciprofloxacin**
Explanation: Topical antibiotics like ciprofloxacin are often used for bacterial conjunctivitis to expedite resolution, although it might be self-limiting in healthy individuals.
Which feature most strongly suggests allergic conjunctivitis?**
- A) Unilateral presentation
- B) Profuse purulent discharge
- C) Severe itchiness
- D) Photophobia
*Answer: C) Severe itchiness**
Explanation: Severe itchiness is a hallmark of allergic conjunctivitis, distinguishing it from other forms of conjunctivitis.
What is the primary modality used to diagnose conjunctivitis?**
- A) Slit-lamp examination
- B) Laboratory cultures
- C) Fluorescein staining
- D) Clinical history and physical examination
Clinical history and physical examination**
Explanation: Diagnosis of conjunctivitis is generally clinical, based on the characteristic signs and symptoms identified during the history and examination.
A newborn presents with bilateral eye discharge, and the mother has a history of untreated sexually transmitted infections. What is the most appropriate treatment?**
- A) Topical fluoroquinolones
- B) Oral erythromycin
- C) Intramuscular ceftriaxone
- D) Topical antihistamines
intramuscular ceftriaxone**
Explanation: Intramuscular ceftriaxone is used to treat neonatal gonococcal conjunctivitis and prevent further complications.
In which scenario would you refer a patient with conjunctivitis for an urgent ophthalmology consultation?**
- A) Mild itchy eye discharge, especially associated with seasonal allergies
- B) Red eye with vesicular eruptions around the eyelids
- C) Watery discharge after a recent cold
- D) History-defying symptoms suggesting blepharitis
Answer: B) Red eye with vesicular eruptions around the eyelids**
Explanation: Vesicular eruptions around the eyelids may indicate herpes simplex virus, requiring urgent ophthalmology evaluation and treatment.
When should supportive treatment alone suffice for conjunctivitis?**
- A) Bacterial conjunctivitis in an elderly patient
- B) Chlamydial conjunctivitis in a sexually active adolescent
- C) Viral conjunctivitis with no evidence of herpes
- D) Allergic conjunctivitis that is refractory to oral antihistamines
Answer: C) Viral conjunctivitis with no evidence of herpes
Explanation: Viral conjunctivitis (typically from adenovirus) is mainly managed with supportive care as it is self-limiting.
Which of the following risk factors is associated with the development of conjunctivitis?**
- A) Wearing contact lenses overnight
- B) Age over 65
- C) History of atopic dermatitis
- D) All of the above
Answer: D) All of the above**
Explanation: Each of these factors increases the risk of developing conjunctivitis—contacts for keratitis, older age for dry eyes, and atopy for allergic conjunctivitis.
