Conjunctivitis

Question 1

What symptoms are present in bacterial conjunctivitis?

Answer 1

Sore, red eye
Purulent discharge
Eyes ‘stuck together’ in morning

Question 2

What symptoms are present in viral conjunctivitis?

Answer 2

Sore, red eye
Serous (watery) discharge
Recent URTI
Preauricular lymph nodes

Question 3

What symptoms are present in allergic conjunctivitis?

Answer 3

Bilateral red eyes with conjunctival swelling (chemosis)
Itchy eyes
Eyelids may be swollen

History of allergies (hay fever, eczema)
May be seasonal (due to pollen) or perennial (due to dust mites, washing powder or other allergens)

Question 4

What is the management for infective (bacterial + viral) conjunctivitis?

Answer 4

Self-limiting condition that settles within 1-2 weeks

Offer topical Abx e.g. chloramphenicol drops every 2-3 hours, while chloramphenicol ointment is given QDS

Alternative is topical fusidic acid BD - use in pregnant women

Avoid contact lens
Avoid sharing towels

Question 5

What is the management for allergic conjunctivitis?

Answer 5

1st line = topical or systemic antihistamines

2nd line = topical mast-cell stabiliser e.g. sodium cromoglicate, nedocromil

Question 6

What investigation should be carried out in suspected conjunctivitis?

Answer 6

Bacterial, viral and chlamydial swabs