Conjunctivitis

Jameel Mushtaq does a thorough (yet quick!) overview of all you need to know about conjunctivitis - including the important anatomy, sub-types and treatment.

 

Lecture by

Video Duration: 7 minutes

  • Conjunctivitis
    Created by Helen Bartlett
    General
    Epidemiology

    Inflammation of the conjunctiva. One of the most common conditions of the eye that affects all ages.

    Pathology

    Infective conjunctivitis occurs via reduced host defences and external contamination. Adenovirus is the most common viral contamination, and bacterial can be due to Staph. epidermidis, Staph. aureus, Strep. Pneumoniae or H. influenza

    Allergic conjunctivitis is a Type 1 hypersensitivity reaction.

    Top three causes
    • Viral
    • Bacterial
    • Allergic
    Clinical Features
    Symptoms

    Viral conjunctivitis

    • Red watery gritty eyes
    • Hx of URTI
    • Initially one sided but cross infection occurs days later

    Bacterial conjunctivitis

    • Crusty lids (mucopurulent discharge) which can cause eyelashes to stick together in the morning
    • Red, gritty, sticky eye

    Allergic conjunctivis

    • Itching
    • Watery discharge
    • Hx of atopy/allergies
    Signs

    Viral conjunctivitis

    • Conjunctivial injection
    • Follicles (small blisters on the inferior eyelid - lymphatic response)
    • Preauricular lymphadenopthy
    • Watery discharge

    Bacterial conjunctivitis

    • Conjunctivial injection
    • Mucopurulent discharge
    • Papillae

    Allergic conjunctivitis

    • Diffuse redness
    • Lid and conjunctivial oedema
    • Watery discharge
    Investigations
    Cultures

    Viral

    • Consider conjunctival swabs

    Bacterial

    • Severe cases require swabs

    Allergic

    • Consider conjunctival swabs
    Bloods

    None

    Imaging

    None

    Scopic/Biopsy

    None

    Functional

    Viral and bacterial - none

    Allergic - consider allergy testing

    Treatment
    Conservative

    Infective conjunctivitis

    • Supportive - including artificial tears
    • Patient education on hygiene

    Allergic conjunctivitis

    • Avoidance of allergens
    • Artificial tears
    Medical

    Viral

    • Abx to prevent secondary infection
    • If keratitis suspected - topical corticosteroids

    Bacterial

    • Topical abx - e.g. chloramphenicaol, sodium fusidate

    Allergic

    • Moderate: Antihistamine or Mast cell stabiliser
    • Severe: Steroids
    Surgical

    None