CONJUNCTIVITIS
Def. Conjunctivitis is a general term for any
inflammation of the conjunctiva.
Epidemiology
• The prevalence of each is different in pediatric
and adult population. The vast majority of
pediatric cases are bacteria, while in adult’s
bacterial and viral causes are equally common.
Bacterial conjunctivitis
• Commonly caused by staphylococcus aureus,
streptococcus pneumonia, Hemophilic influenza,
and moraxella catarrhalis
• S. aureus is common in adults
• Highly contagious from secretions or with
contaminated objects and surfaces.
Symptoms:-
• Patients typically complain of redness and discharge in
one eye; although it can also be bilateral.
• The affected eye often is “stuck shut” in the morning
• Purulent discharge continues through out the day.
• The discharge is thick; it may be yellow, white or green.
• No real pain as the conjunctiva has few sensory nerve
supplies but complain of irritation, itching and
discomfort
• Vision is almost always normal.
Sign: -
• On examination, patients will typically have purulent
discharge at the lid margins and in the corners of the eye.
More purulent discharge appears within minutes of wiping
the lids
• Red eye – due to dilatation of superficial blood vessels as
apart of inflammation
• Edema of the conjunctiva (chemosis) and eyelids swelling
• Cornea is mostly clear; but if it is involved, there will be
different degree of corneal opacity it is common special in
untreated and delayed patients
Diagnosis
-Mostly clinical
- Gram stains
Course - It lasts for 1 - 2 weeks and then it
usually resolves spontaneously.
Treatment –
-Chloramphenicol eye drop or ointment QID
- Ciprofloxacillin eye drop QID
- If the above drugs are not available, one can use
tetracycline eye ointment BID
- Evaluate the patient after 48 hrs and if no improvement,
refer to ophthalmic center for better evaluation
N.B. Don’t use steroid or steroid containing antibiotic as
they will reduce local immunity and encourage micro
organism to multiply
Viral conjunctivitis
It is highly contagious, spread by direct contact with the
patient and his or her secretions or with contaminated
objects & surface
Patient usually presents with watering, photophobia,
irritation and mostly associated with upper respiratory tract
infection
Treatment
Self limiting
Prophylactic topical antibiotics, Chloramphenicol TID
Never use steroid or steroid containing antibiotics.
Allergic conjunctivitis –
Is caused by air borne allergy contacting the
eye.
With specific IgE, causes local mast cell
degranulation and the release of chemical
mediators including histamines, eosinophil
chemo tactic factors and platelets activating
factors.
Symptoms
Red eye
Severe and persistent itching of both eyes
Mucoid eye discharge
No visual reduction
Signs
V/A is normal
papillary reaction to hypertrophy on tarsal
conjunctiva
Treatment
Cold compress
Vasoconstrictor-antihistamine like cromolyn
sodium
Topical steroid -Terracortril eye suspension
