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Y3 Ophthalmology > Conjunctivitis > Flashcards

Conjunctivitis Flashcards

1
Q

What is Conjunctivitis?

A

Conjunctivitis is the inflammation of the lining of the eyelids and eyeball caused by:

  • bacteria
  • viruses
  • allergic or immunological reactions
  • mechanical irritation
  • medicines
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2
Q

What are the common organisms that cause Conjunctivitis>

A
  • Pneumococcus
  • Staphylococcus aureus
  • Moraxella catarrhalis
  • Haemophilus influenzae
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3
Q

What organism is the cause of persistent conjunctivitis?

A

Chlamydia

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4
Q

Which organisms are the cause of viral Conjunctivitis?

A
  • adenovirus
  • herpes simplex
  • Epstein-Barr
  • varicella zoster
  • molluscum contagiosum
  • coxsackie
  • enteroviruses
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5
Q

How does viral Conjunctivitis spread?

A

Highly contagious

direct contact w

  • patients
  • contaminated surfaces exposed to secretions
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6
Q

What causes mechanichal Conjunctivitis?

A

chronic conjunctival irritation (especially while sleeping)

It is often caused by:

floppy eyelid syndrome, assiociated w

  • obesity
  • sleep apnoea
  • upper eyelid laxity
  • lid imbrication (upper eyelid excursion over lower eyelid).
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7
Q

Which drugs can cause conjunctivitis?

A
  • glaucoma medicines
  • antibiotics
  • antivirals

(often contain preservatives e.g. benzalkonium chloride –> accumulates)

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8
Q

What type of hypersensitivity is allergic conjunctivitis?

A

Type 1 Hypersensitivity (IgE)

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9
Q

What are the 3 classifications of allergic Conjunctivitis?

A
  • Atopic keratoconjunctivitis
  • Seasonal/perennial allergic conjunctivitis
  • Vernal conjunctivitis
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10
Q

What are the 3 classifications of bacterial Conjunctivitis?

A
  • Gonococcal (hyperacute) bacterial conjunctivitis
  • Non-gonococcal bacterial conjunctivitis
  • Chlamydial conjunctivitis
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11
Q

What are the 3 classsifications of viral Conjunctivitis?

A
  • Adenoviral conjunctivitis
  • Herpetic conjunctivitis
  • Molluscum contagiosum
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12
Q

What are the 3 other major classifications of Conjunctivitis (rarer)?

A
  1. Mechanical/irritative/toxic conjunctivitis
  2. Immune-mediated conjunctivitis
  3. Neoplastic
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13
Q

What are the risk factors for Conjunctivitis?

A

exposure to infected person

infection in one eye (usually viral)

Mechanical/irritative/toxic conjunctivitis

  • environmental irritants
  • contact lens use
  • ocular prosthesis
  • mechanical irritation

Allergic conjunctivitis

  • allergen exposure
  • Asian or Mediterranean young male (vernal)
  • atopy

Viral conjunctivitis

  • camps, swimming pools, military bases
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14
Q

What are the presenting symptoms of conjunctivitis?

A

Allergic

  • ropy, mucoid discharge
  • Itching

Viral:

  • burning sensation
  • watery discharge
  • eyelids stuck together
  • tender, pre-auricular lymphadenopathy

Bacterial

  • purulent discharge
  • eyelids stuck together
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15
Q

What can copious purulent discharge developing over 12 to 24 hours indicate?

A

hyperacute gonorrhoeal infection

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16
Q

What other pathology can bacterial conjunctivitis be associated with?

A

concurrent otitis media.

17
Q

Hyperacute bacterial conjunctivitis is likely to be caused by Neisseria gonorrhoeae

What are the presenting symptoms?

A

develops over 12 to 24 hours

  • copious, purulent discharge,
  • eyelid swelling
  • chemosis (conjunctiva swelling)
  • peripheral corneal ulcers
18
Q

How is bacterial conjunctivitis, hyperacute (gonorrhoeal) diagnosed?

A
  • presence of risk factors (e.g. young, sexually active)
  • Gram stain for diplocci
19
Q

Bacterial conjunctivitis (chlamydial) is also sexually transmitted.

What are the presenting symptoms?

A
  • stringy or mucous discharge
  • conjunctival follicles
  • corneal pannus (abnormal layer of fibrovascular tissue/granulation)
  • corneal infiltrates
  • Pre-auricular lymphadenopathy
20
Q

What is a specific feature of viral conjunctivitis?

A

usually starts in one eye and spreads to the other several days later

21
Q

What is the first investigation to be ordered for ?conjunctivitis ?

A
  • rapid adenovirus immunoassay
    • as adenoviruses are the most common cause
22
Q

What other investigations should be considered if the 1st investigation was negative?

A
  • cell culture
  • gram stain
  • PCR

Y3 Ophthalmology (2 decks)

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