Conjunctivitis

Background

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

Types

1. Viral conjunctivitis
2. Bacterial conjunctivitis
3. Allergic conjunctivitis
4. Herpes Zoster Ophthalmicus
5. HSV Conjunctivitis
6. Gonorrheal Conjunctivitis
7. Chlamydia Conjunctivitis
8. Caustic Keratoconjunctivitis

Differential Diagnosis

Conjunctivitis

	Bacterial	Viral	Allergic
Bilateral	50%	25%	Mostly
Discharge	Mucopurulent	Clear, Watery	Cobblestoning, none
Redness	Yes	Yes	Yes
Pruritis	Rarely	Rarely	Yes
Additional	Tx: Abx	Tx: 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