Conjunctivitis Overview

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Questions and Answers

Which mast cell stabilizer should not be used in children under 1 year of age?

Nedocromil sodium

Lodoxamide

Ketotifen

Sodium cromoglicate 2% (correct)

What is the common discharge type associated with bacterial conjunctivitis?

Sticky, purulent, and mucous (correct)

Watery and mucous

Thick and yellow

Clear and watery

Which pathogens are most likely responsible for bacterial conjunctivitis in adults?

Haemophilus influenzae

Streptococcus pneumoniae

Chlamydia spp.

Staphylococcus species (correct)

Chlamydial conjunctivitis may require medical referral primarily due to which of the following reasons?

Scarring is a possible complication Signup and view all the answers

What treatment is recommended for acute bacterial conjunctivitis if there is a sticky discharge?

Gentle cleansing with water-soaked cotton wool Signup and view all the answers

What is the primary symptom associated with allergic conjunctivitis?

Itching Signup and view all the answers

Which treatment is considered first-line for allergic conjunctivitis?

Artificial tears Signup and view all the answers

Which type of conjunctivitis is more common in children?

Bacterial conjunctivitis Signup and view all the answers

What is the recommended duration to avoid rebound effects when using sympathomimetic decongestants for eye treatment?

7 days Signup and view all the answers

Which condition is least likely to cause red eye?

Acute closed-angle glaucoma Signup and view all the answers

What is a key symptom of keratitis that differentiates it from other eye conditions?

Photophobia Signup and view all the answers

Which of the following is a condition associated with poor contact lens hygiene?

Keratitis Signup and view all the answers

What is the most common management strategy for an external stye?

Warm compress application Signup and view all the answers

Which eye condition is characterized by inflammation of the iris and surrounding ciliary body?

Uveitis Signup and view all the answers

What may cause keratitis from ultraviolet light exposure?

Welding torch or sunbeds Signup and view all the answers

Which of the following best describes the appearance of an external stye?

Swollen eyelid with pus formation Signup and view all the answers

Which of the following conditions is NOT typically associated with styes?

An allergic reaction Signup and view all the answers

What is the recommended duration for continuing treatment after resolution of symptoms for viral conjunctivitis?

48 hours Signup and view all the answers

Which of the following symptoms is NOT typically associated with viral conjunctivitis?

Severe eye pain Signup and view all the answers

Which organism is most commonly implicated in viral conjunctivitis?

Adenovirus Signup and view all the answers

When should a patient with a subconjunctival hemorrhage be referred to a physician?

If there is associated high blood pressure or unexplained bleeding Signup and view all the answers

What is a common misconception about subconjunctival hemorrhage?

It causes significant pain Signup and view all the answers

In the management of viral conjunctivitis, what is an effective non-pharmaceutical option for symptom relief?

Cold compresses on the eyes Signup and view all the answers

What measure should be taken by patients to prevent the spread of viral conjunctivitis?

Not sharing towels and frequent hand washing Signup and view all the answers

What is the main symptom of a corneal ulcer?

Pain Signup and view all the answers

Study Notes

Conjunctivitis

Conjunctivitis is a common eye condition caused by infection, allergy, or irritation
It leads to redness, irritation, itching, pain, discharge, and vision loss
Affects both sexes and all ages
Bacterial conjunctivitis is more common in children, and viral conjunctivitis is more common in adults
Conjunctivitis is usually self-limiting, though viral conjunctivitis can be recurring and persistent
Common causes include bacterial, viral, or allergic conjunctivitis, subconjunctival hemorrhage, episcleritis, scleritis, keratitis, uveitis, neonatal conjunctivitis, and acute closed-angle glaucoma

Allergic Conjunctivitis

Pollen is a common trigger for seasonal allergic conjunctivitis
Main symptom is itching, with a watery discharge
Management involves removing the allergen, using cold compresses (3-4 times/day), and oral antihistamines for relief

Bacterial Conjunctivitis

Symptoms include redness, a gritty sensation, and a sticky, purulent discharge
Eyelids can stick together on waking
Symptoms generally affect both eyes within a few hours, though initially it may affect one eye (suggestive of a foreign object)
Pathogens differ between children and adults
In adults, Staphylococcus species are the most common pathogens, with Streptococcus pneumoniae a possible cause for 20% of cases
Haemophilus and Moraxella are common in children

Viral Conjunctivitis

Often accompanied by other signs of respiratory tract infection, such as a cough and a cold
Features watery discharge, redness, and discomfort
Common viral cause is adenovirus
Usually self-limiting, with symptoms resolving within 2-3 weeks

Acute Bacterial Conjunctivitis

Self-limiting, resolving within 2-5 days with or without treatment
If discharge is sticky, cleaning eyes with cotton wool soaked in water is advisable
Management includes Chloramphenicol eye drops 0.5% every 2 hours for the first 24 hours, then 4 times daily, or chloramphenicol eye ointment 1% (OTC adults & children over 2 years), which is usually enough for 5 days
Treatment should be continued for 48 hours after symptoms cease
Propamidine eye drops (four times daily) or dibromopropamidine isethionate eye ointments (twice daily) can be used for adults 12+ years

Subconjunctival Hemorrhage

A very common cause of a red eye
Usually harmless and resolves within 1-2 weeks
Referral is advised if there is any suspected high blood pressure, unexplained bleeding/bruising elsewhere, or if symptoms last longer than 1 week

Referral Points

Painful eye conditions
Symptoms persisting for more than a week.
Photophobia (discomfort in bright light)
Marked redness
Vision problems

Corneal Ulcers

Caused by infection or traumatic abrasion
Main symptom is pain due to corneal sensitivity
May exhibit scleral inflammation
It can be caused by contact lens wear

Keratitis

Inflammation of the cornea, often with infection
Presentation is a unilateral, acutely painful red eye, with discomfort from bright light (photophobia)
Could be due to UV light damage (e.g., welding torch/sunbeds) infection (herpes simplex virus or bacteria)
Important to note: Acanthamoeba keratitis can affect contact lens wearers

Uveitis

Inflammation of the iris and surrounding ciliary body
Can be associated with other conditions (arthritis, sarcoidosis, or tuberculosis), or be an isolated event

Glaucoma

Increased fluid pressure within the eye

Sties and Chalazia

Stye (Hordeolum): Localized painful swelling, usually acute, that develops over a few days, commonly caused by bacterial infection, and can resolve on its own.
Chalazion: Related to blocked meibomian glands, tends to be painless, a longer-term, slow-developing swelling, typically resolving without intervention

Blepharitis

Inflammation of the eyelid margin
Symptoms: Itchy, stinging, and sticky eyes, resembling conjunctivitis; intermittent
Commonly chronic condition with underlying infection.

Dry Eye Disease

Tear production/composition change, leading to irritation.
Symptoms: Gritty, scratchy, burning eyes, excessive tearing, blurred vision, especially in the mornings.
Factors include windy/dry climates, prolonged computer use, and medications

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Description

This quiz covers the various types and causes of conjunctivitis, including allergic and bacterial forms. Learn about symptoms, management strategies, and common triggers for this common eye condition affecting all ages. Test your knowledge on how to identify and manage conjunctivitis effectively.