Conjunctivitis

Background

• Most common cause of acute red eye
• Viral infection is usual etiology
• Injected conjunctiva w/ perilimbal sparing
• Rarely painful; more irritated

Types

Conjunctivitis Types

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

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

Treatment

• Viral infections - most common cause of conjunctivitis, but difficult to differentiate viral from bacterial
• Many clinicians treat all presentations as bacterial conjunctivitis
  • Eye redness, lid swelling, crusting of the eye in the morning and drainage
  • Pain, loss of vision and photophobia should not be present.
• Ointments - soothing effect
  • Interfere with vision
• Drops - no interference with vision.
• Corticosteroids and eye patching - exacerbate the infections

See Also

• Conjunctivitis (Peds)
• Eye Algorithm (Main)

Source

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