CONJUNCTIVITIS
INTRODUCTION
• Conjunctivitis is an inflammation of the conjunctiva. It is
characterized by a pink appearance (pink eye) because of
subconjunctival blood vessel hemorrhages.
• Conjunctivitis is by far the commonest cause of red eyes.
• Conjunctivitis can affect one or both eyes. However, it usually
starts with one eye then spreads to the other through hand contact.
Clinical manifestations of
conjunctivitis
• Scratchy or burning sensation
• Itching
• Photophobia
• Foreign body sensation
• Discharge- Watery, mucoid, mucopurulent or purulent.
Types of conjunctivitis
Conjunctivitis is classified • Mechanical conjunctivitis
according to its cause: • Allergic conjunctivitis
• Bacterial conjunctivitis • Toxic conjunctivitis
• Viral conjunctivitis • Conjunctivitis associated
• Fungal conjunctivitis with other systemic
• Chlamydial conjunctivitis disorders
• Parasitic conjunctivitis • Conjunctivitis due to
ophthalmic conditions
1. Bacterial conjunctivitis
• Bacterial conjunctivitis can be acute or chronic, unilateral or bilateral.
Acute conjunctivitis lasts less than three weeks and may settle on its
own without treatment. If it lasts for more than four weeks, it is
considered chronic.
• The Causative microorganisms include:
• Streptococcus bacteria
• Staphylococcus aureus
• Pneumococcus bacteria
• Gonococcus bacteria
• Hemolytic streptococcus
Signs and symptoms of bacterial conjunctivitis
• Acute onset of redness of the eye, burning sensation and eye
discharge. Eye discharge occurs especially in the morning. The
patient wakes up with difficulty to open the eye as the eyelids are
stuck together.
• Eyelids appear red and inflamed
• Photophobia
• Foreign body sensation
• Tearing
Treatment of bacterial conjunctivitis
• Bacterial conjunctivitis is mostly is self-limiting. However, staphylococcal and
gonococcal conjunctivitis if left untreated can cause corneal perforation and
blindness
• Clean eyes with cool boiled water twice daily
• Eyedrops and ointments for nighttime application
• If only one eye is affected, prevent cross-infection by vigilant handwashing, use of
separate towels, use disposable tissues instead of handkerchief, change pillowcases
• No use of eyepads as they create a conducive environment for microbial growth
• Discard eye cosmetics/change brands
Complications of bacterial conjunctivitis
• Conjunctival scarring
• Chronic blepharitis
• Corneal ulceration
Assignment
• Revise and make notes on ophthalmia neonatorum
2. Viral conjunctivitis
• Viral conjunctivitis can be caused by adenovirus, measles,
varicella, herpes simplex, etc.
Signs of viral conjunctivitis
• Red/pink eye
• Photophobia
• Irritation
• Chemosis- swelling (or edema) of the conjunctiva
Treatment of viral conjunctivitis
• The goal of treatment is to relieve symptoms and is mainly
supportive as the infection is self-limiting. It includes:
• Eye cleaning twice daily
• For eye dryness, use artificial tears
• Vigilant handwashing to prevent spreading of the disease to the other eye
and to others
• For photophobia use dark glasses
• Use disposable tissues, avoid sharing towels, facecloths and eye drops
4. Allergic conjunctivitis
• Allergic conjunctivitis can be caused by hay fever, exposure to eye medications and allergy
to contact lenses cleaning solutions and climatic changes. You are more likely to find
allergic conjunctivitis in a person with a history of allergy to pollen and other
environmental allergens.
Signs and symptoms of allergic conjunctivitis
• Extreme itching
• Chemosis – swelling of the conjunctiva
• Red eye- blood shot eye appearance
• Irritation to the eye and feeling of burning sensation
• Watering of the eye (excessive secretion of tears)
• Nasal signs
• Photophobia
Treatment of allergic conjunctivitis
• Allergic conjunctivitis is usually self-limiting and requires no
treatment unless the case is severe.
• Antihistamine drops
• Corticosteroid ophthalmic preparations
• If severe, oral medications may be indicated
• To reduce swelling use cold compresses, icepacks, cool
ventilation
4. Fungal conjunctivitis
• Fungal conjunctivitis is caused by Candida albicans.
Babies can contract the infection during birth.
Signs and symptoms of fungal conjunctivitis
• Fine white plaques on the conjunctiva
Treatment of fungal conjunctivitis
• Nystatin drops and ointment
5. Parasitic conjunctivitis
• Can occur in conditions such as onchocerciasis.
6. Mechanical conjunctivitis
Mechanical conjunctivitis occurs when the eye is exposed to:
• Wind
• Fumes
• Smoke
• Dust
• Dirt particles
• Chemicals etc
8. Toxic conjunctivitis
• Toxic conjunctivitis can be as a result of medications,
exposure to toxic fumes, irritants such as smoke, hair
sprays, acids, alkalis etc
• Treatment is immediate profuse irrigation with saline or
sterile water.
