Conjunctivitis (Allergic, Bacterial, Viral) Flashcards
What are 4 symptoms of allergic conjunctivitis?
- Red, itchy, watery eyes
- Conjunctival oedema
- No discharge
- Commonly associated hay fever or allergic rhinitis
Does allergic conjunctivitis require a counselling room?
No
What are 13 red flags for referral with allergic conjunctivitis?
- Severe eye pain/swelling
- Loss of, reduced or blurred vision
- Restricted eye movement
- Photophobia
- Injury to eye/presence of foreign body
- General systemic features
- Visual disturbances
- Copious yellow-green purulent discharge
- Glaucoma
- Dry eye syndrome
- Recent trauma i.e., welding without protection/laser eye surgery
- Age < 2 years
- Red/painful, particularly in contact lens wearers
Does allergic conjunctivitis have a PSA self-care card?
Yes (Red and Dry Eyes)
What is the preferred treatment option for allergic conjunctivitis?
Loratadine (Claratyne)
What are the directions for loratadine (Claratyne) in allergic conjunctivitis for adults and children over 30 kg?
Oral, 10 mg once daily.
What are the directions for loratadine (Claratyne) in allergic conjunctivitis for adults and children aged 2 to 12 years (and under 30 kg)?
Oral, 5 mg once daily.
What are the directions for loratadine (Claratyne) in allergic conjunctivitis for adults and children aged 1 to 2 years?
Oral, 2.5 mg once daily
What are 2 non-preferred options for allergic conjunctivitis and why?
- Levocabastine 0.05% (Livostin): avoided in pregnancy, harder to use, less likely to help with other symptoms.
- Isotonic saline wash: questionable efficacy
Is loratadine (Claratyne) safe in pregnancy?
Yes
Is loratadine (Claratyne) safe in breastfeeding?
Yes
What is the age range for loratadine (Claratyne)?
Safe in children over 1
What are 11 pieces of non-pharmacological advice for allergic conjunctivitis?
- Avoid allergens or irritants where possible.
- Stay inside during the morning hours when pollen counts are highest.
- Avoid outdoor activities when trees, flowers or molds that trigger the allergy are present.
- Shower after outdoor exposure to remove pollen that adheres to the hair and skin.
- Close house and car windows to exclude pollen.
- Use an air conditioner in warmer months to reduce indoor humidity; and prevent mould growth.
- Clear air filters regularly.
- Cover pillows and mattresses with impermeable covers to reduce exposure to house dust mites.
- Wash bedding weekly in hot water.
- Limit the presence of dust- collecting furnishing such as curtains, bed skirts, carpeting, and soft toys.
- Vacuuming frequently (at least once a week).
What should you always do for eye complaints?
Request to look at the patient’s eye
What is the most effective way to manage allergic conjunctivitis?
Avoid triggers
What are 5 symptoms of viral conjunctivitis?
- Watery, itchy, irritated eye
- Bilateral, mild discomfort
- Foreign body sensation
- Redness
- Commonly associated with an upper respiratory tract infection
Does viral conjunctivitis require a counselling room?
Yes
What are 13 red flags for referral with viral conjunctivitis?
- Severe eye pain/swelling
- Loss of, reduced or blurred vision
- Restricted eye movement
- Photophobia
- Injury to eye/presence of foreign body
- General systemic features
- Visual disturbances
- Copious yellow-green purulent discharge
- Glaucoma
- Dry eye syndrome
- Recent trauma i.e., welding without protection/laser eye surgery
- Age < 2 years
- Red/painful, particularly in contact lens wearers
Does viral conjunctivitis have a PSA self-care card?
Yes (Red and Dry Eyes)
What is the preferred treatment option for viral conjunctivitis?
SYMPTOMATIC TREATMENT ONLY: Cold compress to the affected eyes, Lubricating eye drop on an hourly basis if needed, Simple analgesia (paracetamol), Avoid bright lights
Are lubricant eye drops safe in pregnancy?
Yes
Are lubricant eye drops safe in breastfeeding?
Yes
What are 4 pieces of non-pharmacological advice for viral conjunctivitis?
- Viral conjunctivitis is contagious: appropriate hygiene is essential.
- Refrain from attending work/school until discharge from the eye has stopped or a doctor has diagnosed a non- infectious conjunctivitis.
- Discard all eye makeups/cosmetics.
- Refrain from using contact lenses whilst experiencing symptoms.
Describe the common timeline with viral conjunctivitis.
Commonly occurs after recovery from viral common cold and cough/ URTI.
What is the exclusion period with viral conjunctivitis?
Children should be excluded from school until discharge has stopped (usually 10-12 days)
What are 5 symptoms of bacterial conjunctivitis?
- Rapid onset
- Mucopurulent/ sticky discharge
- Eye irritation and redness
- Burning or gritty sensation in eye
- Eyelids sticking together due to dried crust (worse in morning)
Does bacterial conjunctivitis require a counselling room?
Yes
What are 13 red flags for referral with bacterial conjunctivitis?
- Severe eye pain/swelling
- Loss of, reduced or blurred vision
- Restricted eye movement
- Photophobia
- Injury to eye/presence of foreign body
- General systemic features
- Visual disturbances
- Copious yellow-green purulent discharge
- Glaucoma
- Dry eye syndrome
- Recent trauma i.e., welding without protection/laser eye surgery
- Age < 2 years
- Red/painful, particularly in contact lens wearers
Does bacterial conjunctivitis have a PSA self-care card?
Yes (Red and Dry Eyes)
What is the preferred treatment option for bacterial conjunctivitis?
Chlorsig (Chloramphenicol) eye drops 0.5%
What are the directions for Chlorsig (Chloramphenicol) eye drops 0.5% in bacterial conjunctivitis?
Instil 1 drop every 2 hours for the first 48 hours. If there is improvement, continue with 1 drop 4 times daily for a further 5 days. Treatment should continue for at least 2 days after the eye appears normal. If no improvement after the second day, see your doctor
What are 2 non-preferred options for bacterial conjunctivitis and why?
- Chlorsig (chloramphenicol) eye ointment 0.5%: impairs vision transiently
- Propamidine 0.1% (Brolene eye drops): what the hell is this
Are Chlorsig (Chloramphenicol) eye drops 0.5% safe in pregnancy?
Yes
Are Chlorsig (Chloramphenicol) eye drops 0.5% safe in breastfeeding?
Yes
What is the age range for Chlorsig (Chloramphenicol) eye drops 0.5%?
Safe in children over 2 years
What are 8 pieces of non-pharmacological advice for bacterial conjunctivitis?
- Bacterial conjunctivitis is contagious: appropriate hygiene is essential.
- Wash your hands regularly
- Try to avoid touching the infected eye
- Clean the eye with a single use gentle wipe.
- Others may contract the infection if they come into contact with contaminated fingers or objects
- Keep children out of school until discharge from eyes have stopped
- Refrain from using contact lenses for the duration of treatment
- Eye drops or ointments should never be shared with another person, likewise, with the sharing of towels or face washers.
Can Chlorsig (chloramphenicol) eye drops be kept out of the fridge?
Yes: Once opened, they can remain out of fridge for 28 days.
Describe the prevalence of bacterial conjunctivitis.
Conjunctivitis is more common among children under 5 years, and the incidence decreases with age
Describe the symptom duration with bacterial conjunctivitis
Symptoms can take 1-3 days to develop and can last anywhere from 2 days to 3 weeks
