Conjunctivitis Flashcards
What is conjunctivitis and what are the main types?
Inflammation of the conjunctiva.
Bacterial, viral, and allergic.
What is the typical presentation of conjunctivitis?
Unilateral/bilateral red painless eyes. Itchy/gritty sensation, discharge from the eye. Normal acuity.
What is the typical presentation of bacterial conjunctivitis?
Purulent discharge and inflamed conjunctiva. Worse in the morning (eyes stuck together). Starts in one eye and spreads to the other. Highly contagious.
What is the typical presentation of viral conjunctivitis?
Clear discharge, other viral infection symptoms (dry cough, sore throat, blocked nose). Tender preauricular lymph nodes sometimes. Contagious.
What are the differentials for an acute painless red eye?
Conjunctivitis, episcleritis, subconjunctival haemorrhage.
What are the differentials for an acute painful red eye?
Glaucoma, anterior uveitis, scleritis, corneal abrasions/ulceration, keratitis, foreign body, traumatic/chemical injury.
What is the management for conjunctivitis?
- Resolves without treatment in 1-2 weeks.
- Good hygiene to stop spread, avoid using contact lenses, clean eyes with cool water and cotton wool.
- Antibiotic eye drops in bacteria conjunctivitis (often not needed). Chloramphenicol/fuscidic acid.
In what circumstance does conjunctivitis need urgent ophthalmology referral and why?
In patients under the age of 1 month. Neonatal conjunctivitis can be associated with gonococcal infection and can cause a loss of sight and more severe complications (e.g. pneumonia).
What is the typical presentation of allergic conjunctivits?
Swelling of conjunctival sac and eye lid with a significant watery discharge and itch.
How is allergic conjunctivitis treated?
- Oral or topical antihistamines to reduce symptoms.
2. Topical mast-cell stabilisers in those with chronic seasonal symptoms (need several weeks use before benefit seen).
