Allergic conjunctivitis

Clinical Features

1. Itching
2. Watery discharge
3. Injected and edematous conjunctiva
4. Papillae on inferior conjunctival fornix
5. Red, swollen eyelids

Diagnosis

Clinical diagnosis of conjunctivitis

Conjunctivitis

	Bacterial	Viral	Allergic
Bilateral	50%	25%	Mostly
Discharge	Mucopurulent	Clear, Watery	Cobblestoning, none
Redness	Yes	Yes	Yes
Pruritis	Rarely	Rarely	Yes
Additional	Treatment: Antibiotics	Treatment: Hygiene	Seasonal

Differential Diagnosis

Conjunctivitis Types

• Viral conjunctivitis
  • Epidemic keratoconjunctivitis
  • Herpes zoster ophthalmicus
  • Herpes simplex keratitis
• Bacterial conjunctivitis
  • Gonorrheal conjunctivitis
  • Chlamydia conjunctivitis
• Allergic conjunctivitis
• Caustic keratoconjunctivitis

Treatment

1. Mild: avoid triggers, cool compresses x 15 minutes QID
2. Moderate: Histamine-blocking drops (e.g. olopatadine, pemirolast, or ketotifen)
3. Severe: referral to opthalmology for possible steroid therapy

Disposition

• Outpatient ophthalmology follow-up

See Also

• Conjunctivitis
• Eye Algorithm (Main)

Source

• Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am 2008;26
• Tintinalli