Conjunctivitis Overview

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

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.