Conjunctivitis Diagnosis: Clinical Features

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Questions and Answers

What is the typical discharge associated with viral conjunctivitis?

Purulent

Mucoid or mucopurulent

Watery (correct)

Blood-stained

What is the cause of oedema of the conjunctiva in anaemia?

Obstruction to the orbital circulation

Abnormal blood conditions (correct)

Acute inflammation of the conjunctiva

All of the above

What is the typical location of intense redness in conjunctivitis?

At the cornea

At the pupil

At the fornices (correct)

At the limbus

What type of membrane is formed in diphtheric conjunctivitis?

True membrane Signup and view all the answers

What is the cause of chemosis in conjunctivitis?

All of the above Signup and view all the answers

What type of conjunctivitis is associated with a purulent discharge?

Gonococcal conjunctivitis Signup and view all the answers

What is the typical age range for Phlyctenular conjunctivitis to occur?

3-12 years Signup and view all the answers

What is the aetiologic factor of Spring catarrh?

Exogenous allergens Signup and view all the answers

What is the characteristic appearance of the bulbar form of Vernal conjunctivitis?

Gelatinous masses on the limbus Signup and view all the answers

What is the primary immune response involved in Vernal conjunctivitis?

Combination of IgE and cell-mediated delayed immune response Signup and view all the answers

What is the treatment for Phlyctenular conjunctivitis?

Local application of steroids and antibiotics Signup and view all the answers

What is the characteristic symptom of Vernal conjunctivitis?

All of the above Signup and view all the answers

What is the function of the goblet cells in the conjunctiva?

Producing mucus Signup and view all the answers

What is the most common cause of spontaneous subconjunctival hemorrhage in older adults?

Rupture of a weak blood vessel Signup and view all the answers

Which part of the conjunctiva lines the posterior surface of the eyelid?

Palpebral conjunctiva Signup and view all the answers

What is the typical duration for the absorption of blood in subconjunctival hemorrhage?

2-4 weeks Signup and view all the answers

Which of the following is NOT a cause of subconjunctival hemorrhage?

Asthma Signup and view all the answers

What is the term for the reflection of the palpebral conjunctiva onto the anterior part of the eyeball?

Fornix Signup and view all the answers

Study Notes

Conjunctivitis

Inflammation of the conjunctiva is characterized by specific clinical features, including:
Type of conjunctival discharge
Type of conjunctival reaction
Lymphadenopathy

Conjunctival Discharge

The nature of the discharge is determined by the causative micro-organism:
Watery discharge: viral conjunctivitis
Mucoid or mucopurulent discharge: bacterial conjunctivitis
Purulent discharge: gonococcal infection and other virulent microorganisms
Blood-stained discharge: diphtheric conjunctivitis

Conjunctival Reaction

Redness of the conjunctiva is most intense at the fornices and fades towards the limbus
Oedema of the conjunctiva (chemosis) may occur due to:
Acute inflammation of the conjunctiva
Obstruction to the orbital circulation (e.g., orbital tumor)
Abnormal blood conditions (e.g., anemia)

Membrane and Pseudomembrane

Membrane and pseudomembrane formation may occur with virulent microorganisms
True membrane formation is classic in diphtheric conjunctivitis
Pseudomembrane formation may occur with strep or staph infections

Spring Catarrh

An allergic condition excited by exogenous allergens and enhanced by physical factors
A combination of IgE and cell-mediated delayed immune response
Symptoms: itching, photophobia, lacrimation, discolouration of the conjunctiva, and ropy discharge
Signs: three clinical forms of vernal conjunctivitis:
Palpebral form: cobblestone appearance
Bulbar form (limbal): gelatinous masses on the limbus and Trantas spots

Treatment

Dark glasses
Cold compresses
Local antihistamine and mast cell stabilizer (Na cromoglycate)
Local steroids

Phlyctenular Conjunctivitis

An acute nodular affection of the conjunctiva, commonly at the limbus, surrounded by vascular engorgement
Occurs mainly in children (3-12 years) as an allergic response to some endogenous toxins
Symptoms: irritation, photophobia, blepharospasm, and lacrimation
Signs: a small pinkish-white nodule surrounded by localized vascular engorgement
Treatment: local application of steroids and local antibiotics if secondary bacterial infection

Pterygium

A degenerative process in which a triangular fold of the conjunctiva actively invades the cornea

Anatomy of the Conjunctiva

The conjunctiva is a thin mucous membrane lining the posterior surface of the lid, reflected on the anterior aspect of the eyeball as far as the limbus
Divided into:
Palpebral conjunctiva: lines the under surface of the eyelids and extends to the fornix
Fornix conjunctiva: formed by the reflection of the palpebral conjunctiva onto the anterior portion of the eyeball
Bulbar conjunctiva: covers the anterior portion of the eyeball until the corneo-scleral junction (limbus)
Contains the accessory lacrimal glands and goblet cells

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Description

Learn about the key clinical features to consider when diagnosing conjunctivitis, including types of conjunctival discharge and reaction. Understand the differences between viral and bacterial conjunctivitis and their characteristic symptoms. Test your knowledge on the diagnosis of conjunctivitis.