Conjunctivitis

A common cause of conjunctivitis to people who ride motorbikes very fast without goggles.

Definition

Infection of conjunctiva

Epidemiology

Commoner than the common housefly. Which is common.

Pathophysiology

There are three things that commonly cause a conjunctivitis: bacteria, viruses or allergy.

Clinical Features

General features:

• Red eye
• Itch and irritation - maybe described as painful but severe pain suggests something more severe.
• Discharge

Acuity, cornea, pupil and intraocular pressure should all be normal

Bacterial

Bacterial conjunctivitis is the most common and the following are generally present in that condition:

• Previous history of bacterial conjunctivitis
• Itch
• Mucopurulent discharge (glue eye) - sometimes in viral and allergic conjunctivitis you also get sticky eyes but the discharge with bacteria is sticky, purulent but scant. If it's really badly purulent, there's a change it is gonococcal or chlamydial in which case it needs to be seen by a specialist and swabbed

Viral

Viral conjunctivitis tends to present with a watery discharge, eyelid oedema, follicles (lymphoid collections on the conjunctiva), pre-auricular lymphadeopathy. The key with viral is to check if it's herpetic: unilateral, burning, foreign body sensation.

Allergic

Itch and burning with concurrent contact dermatitis. Lid oedema and papillae (vascular bulges).

Investigation

Swab if severe bacterial infection suspected (gonorrhoea or chlamydia)

Management

Generally - discontinue contact lens wear, be careful with hygeine and don't share towels.

• Basically, if it's bacterial give chloramphenicol (alternative is fusidic acid).
• Viral needs good hygeine and it should go away (antihistamines and steroids may help).
• And if it's allergic, avoid the allergen, avoid contact lenses, use lubricants and don't rub eyes.

Refer

If gonococcal, chlamydial or herpetic infection suspected.