Conjunctivitis: Difference between revisions
No edit summary |
(→DDx) |
||
Line 40: | Line 40: | ||
===[[Herpes Zoster Ophthalmicus]]=== | ===[[Herpes Zoster Ophthalmicus]]=== | ||
===[[HSV Conjunctivitis]]=== | |||
*Conjunctivitis alone or involving cornea, eyelid, and skin | |||
*higher rate in HIV patients | |||
*usually unilateral | |||
#Diagnosis | |||
##Has more pain, burning, and a foreign body sensation than normal conjunctivitis | |||
#Treatment (all) | |||
##Cool compresses | |||
##Topical antiviral medication | |||
###Trifluridine 1% drops, 5x per day x 10-14 dys, OR | |||
###Vidarabine 3% ointment, 5x per day x 10-14 dys | |||
#Follow-up ophtho 2-5 days to monitor for corneal involvement | |||
==See Also== | ==See Also== |
Revision as of 21:46, 30 July 2011
Background
- Number 1 cause of acute red eye
Diagnosis
- Rarely painful, more irritated
- Limbic sparing
- viral keratoconjucitivis assoc with URI and adeno
- watery viral/discharge bacterial/consider chlamydia
DDx
Viral Conjunctivitis
- Treatment
- Artificial tears
- Cold compresses
- Consider topical antibiotics (e.g. erythromycin ophtho) if unable to differentiate from bacterial conjunctivitis
- Strict hand/general hygiene
- Follow up with ophtho if worsening or no improvement in 7 days
Bacterial Conjunctivitis
- Purulent Discharge
- adults: sulfacetamide or gent; cipro if pseudomonas; drops 10D OU
Allergic Conjunctivitis
- Diagnosis
- Itching, watery eyes, rhinnorrhea
- Treatment
- Avoidance of triggers
- NSAIDs
- oral antihistamines (e.g loratidine)
- Consider histamine-blocking drops (e.g. olopatadine, pemirolast, or ketotifen)
- Outpt ophtho
Chemical (Contact) Conjunctivitis
- Topical Meds or Cosmetics
- irrigate, naphazoline drops, outpt for tx failure
See Caustic Keratoconjunctivitis
Chlamydia Conjunctivitis
- PO erythromycin x 14D; CTX for gonorrhea
Herpes Zoster Ophthalmicus
HSV Conjunctivitis
- Conjunctivitis alone or involving cornea, eyelid, and skin
- higher rate in HIV patients
- usually unilateral
- Diagnosis
- Has more pain, burning, and a foreign body sensation than normal conjunctivitis
- Treatment (all)
- Cool compresses
- Topical antiviral medication
- Trifluridine 1% drops, 5x per day x 10-14 dys, OR
- Vidarabine 3% ointment, 5x per day x 10-14 dys
- Follow-up ophtho 2-5 days to monitor for corneal involvement
See Also
Source
- Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.