Conjunctivitis

Question 1

What is conjunctivitis?

Answer 1

Inflammation of the conjunctiva 
There are 3 main types:
-Bacterial 
-Viral 
-Allergic

Question 2

What is the conjunctiva?

Answer 2

Thin layer of tissue that covers the inside of the eyelids and sclera of the eye

Question 3

Presentation of conjunctivitis?

Answer 3

Red eyes 
Sticky eye 
Unilateral or bilateral 
Bloodshot 
Itchy/gritty sensation 
-Discharge from the eye 
-Blurry vision due to discharge

Question 4

What symptoms does conjunctivitis not cause?

Answer 4

Pain
Photophobia
Reduced visual acuity

Question 5

Presentation of bacterial conjuncvtivitis?

Answer 5

Purulent discharge
Starts one eye and then spreads
Inflamed conjunctiva
Typically worse in morning

Question 6

Viral conjunctivitis presentation?

Answer 6

Clear discharge
Assoc with dry cough, sore throat, blocked nose
Possible tender pre-auricular nodes

Question 7

Differential diagnosis for a painless red eye?

Answer 7

Conjunctivitis
Episcleritis
Subconjunctival haemorrhage

Question 8

Differential diagnosis for painful red eye?

Answer 8

Glaucoma 
Anterior uveitis 
Scleritis 
Keratitis 
Corneal abrasions/ulceration 
Foreign body 
Traumatic/chemical injury

Question 9

Management of conjunctivitis?

Answer 9

Usually resolves without treatment after 1-2 weeks

Advice on hygiene & cleaning eyes with cooled boiled water & cotton wool

Question 10

If the conjunctivitis is bacterial treatment is?

Answer 10

Antibiotic eye drops

However it can get better without

Question 11

Examples of antibiotic eye drops?

Answer 11

Chloramphenicol

Fusidic acid

Question 12

What can neonatal conjunctivitis be associated with and what must be done?

Answer 12

Gonococcal infections (which can cause loss of sight)
Urgent ophthalmology referral

Question 13

Presnetation of allergic conjunctivitis?

Answer 13

Swelling of conjunctival sac and eyelid

Watery discharge and itch

Question 14

Treatment of allergic conjunctivitis?

Answer 14

Antihistamines

Topical mast cell stabilisers (stop mast cells producing histamine) for seasonal symptoms

Question 15

Causes of conjunctivitis?

Answer 15

S. Aureus, strep pneum, H. Influenzae

Chlymydia

Question 16

Causes of bacterial conjunctivitis in babies?

Answer 16

Chlamydia trachomatis

Neisseria gonorrhoea

Question 17

Diagnosis of conjunctivitis?

Answer 17

Swab

Question 18

Treatment of conjunctivitis?

Answer 18

Chloramphenicol
Fusidic acid
Pseudomonas: gentamicin
Chlamydia: oxytetracycline, azithromycin

Question 19

Causes of viral conjunctivitis?

Answer 19

Adenovirus
Herpes simplex
Herpes zoster

Question 20

Symptoms of viral conjunctivitis?

Answer 20

• Swollen and tender pre-auricular lymph nodes
• Watery eye
• Red eye
• Extreme eye movements can sometimes cause pain
• Tends to occur with URTI

Question 21

Diagnosis of viral conjunctivitis?

Answer 21

History

Lab tests if severe

Question 22

Cause of bacterial conjunctivitis is neonates?

Answer 22

Staph aureus
Neisseria Gonorrhoea
Chlamydia Trachomatis

Question 23

Cause of bacterial conjunctivitis in adults?

Answer 23

Staph aureus
Strep pneumoniae
Haemophilius influenzae

Question 24

Investigation for conjunctivitis?

Answer 24

Swab for culture

Question 25

Topical antibiotic for bacterial conjunctivitis?

Answer 25

Chloramphenicol

Question 26

What is chlamydial conjunctivitis?

Answer 26

Another type of pink eye

Question 27

Cause of chlamydial conjunctivitis?

Answer 27

C. Trachomatis

• Young adulthood
• sexual activity leading to genital infection

Question 28

When to suspect chlamydial conjunctivitis?

Answer 28

Bilateral conjunctivitis in young adults

Question 29

Treatment for chlamydial conjuncivtitis?

Answer 29

Topical oxytetracycline
OR
Systemic antibiotics if they have chlamydia (single dose of azithromycin or doxycycline 2 times a day for 7 days