Conjunctivitis history and symptoms: Difference between revisions

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__NOTOC__
__NOTOC__
{{Conjunctivitis}}
{{Conjunctivitis}}
{{CMG}} {{SaraM}}
{{CMG}}; {{AE}} {{SaraM}}


==Overview==
==Overview==
[[Image:Pinkeye_twoangles.jpg|thumb|left|225px|Eyes with conjunctivitis]]
The symptoms of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and eyelid swelling are variable. Complete history will help determine whether the condition is associated with any specific environmental or work-related exposure.<ref name="pmid17696792">{{cite journal| author=Rose P| title=Management strategies for acute infective conjunctivitis in primary care: a systematic review. | journal=Expert Opin Pharmacother | year= 2007 | volume= 8 | issue= 12 | pages= 1903-21 | pmid=17696792 | doi=10.1517/14656566.8.12.1903 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17696792  }} </ref><ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref>
A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient include exposure history, recent infection, contact lens use, history of [[sexually transmitted disease|sexually transmitted disease (STD)]], history of [[autoimmune diseases]], and any specific environmental or work-related exposure.
The symptoms of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and [[eyelid]] [[swelling]] are variable.
 


==History==
==History==
Complete history will help determine the correct therapy. A detailed and thorough history from the patient is necessary.  
A detailed and thorough history from the patient is necessary in order to determine the correct therapy.<ref name="pmid17696792">{{cite journal| author=Rose P| title=Management strategies for acute infective conjunctivitis in primary care: a systematic review. | journal=Expert Opin Pharmacother | year= 2007 | volume= 8 | issue= 12 | pages= 1903-21 | pmid=17696792 | doi=10.1517/14656566.8.12.1903 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17696792  }} </ref>
The history of a patient with conjunctivitis should include a thorough ocular, medical and medication history. The history establish whether the condition is acute, subacute, chronic or recurrent, and whether it is associated with any specific environmental or work-related exposure.


===Viral Conjunctivitis===
===Viral Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref><ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
*Exposure history
*History of contact with the infected person’s eye drainage
*Recent [[upper respiratory infection|upper respiratory infection (URI)]]  
*Recent [[upper respiratory infection|upper respiratory infection (URI)]]  
*Swimming in contaminated pools
*Swimming in contaminated pools
*Contact lens use
*[[Contact lens]] use
 
===Bacterial Conjunctivitis===
===Bacterial Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid17585426">{{cite journal| author=| title=Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective. | journal=Prescrire Int | year= 2007 | volume= 16 | issue= 89 | pages= 120-1 | pmid=17585426 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17585426  }} </ref><ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]]
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]]
*Exposure history (contaminated fingers, [[oculogenita]]l spread, and contaminated [[fomites]])
*History of exposure (contaminated fingers, oculogenital spread, and contaminated fomites)
*Contact lens use
*[[Contact lens]] use
*Chronic use of topical medications
*Chronic use of topical medications
===Neonatal Conjunctivitis===
===Neonatal Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref><ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]] in mother
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]] in mother
*[[Ocular]] [[prophylaxis]] with silver nitrate
*Ocular prophylaxis with silver nitrate
 
===Allergic Conjunctivitis===
===Allergic Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref><ref name="pmid18282546">{{cite journal| author=Jun J, Bielory L, Raizman MB| title=Vernal conjunctivitis. | journal=Immunol Allergy Clin North Am | year= 2008 | volume= 28 | issue= 1 | pages= 59-82, vi | pmid=18282546 | doi=10.1016/j.iac.2007.12.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18282546  }} </ref><ref name="pmid15245362">{{cite journal| author=Bonini S| title=Atopic keratoconjunctivitis. | journal=Allergy | year= 2004 | volume= 59 Suppl 78 | issue=  | pages= 71-3 | pmid=15245362 | doi=10.1111/j.1398-9995.2004.00570.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15245362  }} </ref>
*Family history of [[atopic disease]] such as:
*Family history of atopic disease such as:
**[[Allergic rhinitis]]
**[[Allergic rhinitis]]
**[[Bronchial asthma]]  
**[[Bronchial asthma]]  
**[[Atopic dermatitis]]
**[[Atopic dermatitis]]
===Keratoconjunctivitis Sicca===
===Keratoconjunctivitis Sicca===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid19506195">{{cite journal| author=Schaumberg DA, Dana R, Buring JE, Sullivan DA| title=Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies. | journal=Arch Ophthalmol | year= 2009 | volume= 127 | issue= 6 | pages= 763-8 | pmid=19506195 | doi=10.1001/archophthalmol.2009.103 | pmc=2836718 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19506195  }} </ref><ref name="pmid9820935">{{cite journal| author=Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC| title=The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. | journal=Cornea | year= 1998 | volume= 17 | issue= 6 | pages= 584-9 | pmid=9820935 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9820935  }} </ref>
*History of [[connective tissue disease]]  
*History of [[connective tissue disease]]  
*History of [[sjögren syndrome]]
**[[Sjögren's syndrome]]
*History of [[rheumatoid arthritis]]
**[[Rheumatoid arthritis]]
*History of [[thyroid abnormalities]]
*History of [[thyroid]] abnormalities
*Contact lens use
*[[Contact lens]] use
*History of neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] problem)
*History of neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] problem)
*Prior eye surgery
*Prior eye surgery
===Superior limbic keratoconjunctivitis===
===Superior limbic keratoconjunctivitis===
Specific areas of focus when obtaining a history from the patient include:
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </ref><ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351  }} </ref>
*Prolonged condition with gradual clearing
*History of prolonged condition with gradual clearing
*Often have seen numerous eye specialists
*History of [[thyroid]] abnormalities


==Symptoms==
==Symptoms==
The symptoms of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and [[eyelid]] [[swelling]] are variable.
The [[symptoms]] of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and [[eyelid]] [[swelling]] are variable.
 
===Viral Conjunctivitis===
===Viral Conjunctivitis===
''[[Adenovirus]]'' is the most common cause of viral conjunctivitis. It has [[Acute]] or [[subacute]] [[onset]], and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye.
[[Adenovirus]] is the most common cause of viral conjunctivitis. It has [[acute]] or [[subacute]] onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye.
[[Symptoms]] of [[viral]] conjunctivitis may include the following:
Symptoms of viral conjunctivitis may include the following:<ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref><ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
====Pharyngoconjunctival Fever====  
*[[Fever]]  
*High [[fever]]
*[[Sore throat]]  
*[[Pharyngitis]]
*Eye redness
*[[Bilateral]] conjunctivitis  
*Periauricular [[lymphadenopathy]]
*[[Itchy]] eyes
*Tearing
*Minimal pain level
*[[Light sensitivity]] (with [[corneal]] involvement)
====Epidemic Keratoconjunctivitis====
*Watery discharge
*Watery discharge
*[[Hyperemia]]
*Eyelids swelling
*[[Chemosis]]
*[[Swollen lymph node]] ([[ipsilateral]])
*Ipsilateral [[lymphadenopathy]]
*Itchy eyes
*[[Itchy]] eyes
*Tearing
*Tearing
*Minimal pain level
*Minimal [[eye pain]]
 
*[[Light sensitivity]] (with corneal involvement)
====Acute Hemorrhagic Conjunctivitis====
====Acute Hemorrhagic Conjunctivitis====
Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive and contagious viral infection.The infection resolves within 5-7 days, during which the symptoms of pain and irritation are present. [[Symptoms]] of acute hemorrhagic conjunctivitis may include the following:
Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive. The infection starts [[ipsilaterally]], but rapidly involves the fellow eye within 1 or 2 days. [[Symptoms]] of acute hemorrhagic conjunctivitis may include the following:<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref>
*[[Chemosis]]
*Eyelids swelling
*Tearing
*Tearing
*[[Redness]]
*Eye redness
*Severe pain level
*Severe [[eye pain]]
*[[Purulent]] discharge
*[[Purulent]] discharge
*Subconjunctival [[hemorrhaging]]
*Subconjunctival [[hemorrhage]]
===Bacterial Conjunctivitis===
===Bacterial Conjunctivitis===
Bacterial conjunctivitis has Hyperacute, [[acute]], and [[chronic]] onset. Symptoms of [[bacterial]] conjunctivitis may include the following:
Bacterial conjunctivitis has hyperacute, [[acute]], and [[chronic]] onset. [[Symptoms]] of bacterial conjunctivitis may include the following:<ref name="pmid17585426">{{cite journal| author=| title=Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective. | journal=Prescrire Int | year= 2007 | volume= 16 | issue= 89 | pages= 120-1 | pmid=17585426 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17585426  }} </ref><ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
*[[Itchy]] eyes
*Itchy eyes
*Tearing
*[[Tearing]]
*[[Redness]]
*[[Eye redness]]
*Minimal eye pain  
*Minimal eye pain  
*[[Purulent]] discharge (grey or yellowish)
*[[Purulent]] discharge (grey or yellowish)
*[[Chemosis]]
*Eyelids swelling


====Hyperacute Bacterial Conjunctivitis====
====Hyperacute Bacterial Conjunctivitis====
Hyperacute bacterial conjunctivitis is a severe, sight-threatening ocular infection that warrants immediate ophthalmic work-up and management. The infection has an abrupt onset and rapid progression. Symptoms of Hyperacute Bacterial conjunctivitis may include the following:
Hyperacute [[bacterial]] conjunctivitis (HBC) is a severe, sight-threatening [[ocular]] infection that warrants immediate [[ophthalmic]] work-up and management. The infection has an abrupt [[onset]] and rapid progression. [[Symptoms]] of hyperacute bacterial conjunctivitis may include the following:<ref name="pmid21160459">{{cite journal| author=Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC)| title=Sexually transmitted diseases treatment guidelines, 2010. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-12 | pages= 1-110 | pmid=21160459 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21160459  }} </ref>
*[[Chemosis]]
*Eyelids swelling
*Tearing
*Tearing
*[[Redness]]
*Diffuse eye redness
*Eye pain
*[[Eye pain]]  
*Decreased [[vision]]
*Decreased vision
*Severe [[purulent]] discharge (yellow-green)
*Severe purulent discharge (yellow-green)
*Preauricular [[lymphadenopathy]]
*[[Swollen lymph nodes]] (preauricular)


===Neonatal Conjunctivitis===   
===Neonatal Conjunctivitis===   
Symptoms of various types of neonatal conjunctivitis or [[ophthalmia neonatorum]] may include the following:<ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref>  
Symptoms of neonatal conjunctivitis ([[ophthalmia neonatorum]]), based on causality, may include the following:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref><ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
====''Gonococcal'' Conjunctivitis====
====Gonococcal Conjunctivitis====
Gonococcal conjunctivitis is more severe than chlamydial conjunctivitis. The incubation period is 2-5 days. It is usually bilateral. Symptoms of ''gonococcal'' conjunctivitis may include the following:
[[Gonococcal]] conjunctivitis is more severe than [[chlamydial]] conjunctivitis in [[newborns]]. The [[incubation period]] is 2-5 days. It is usually [[bilateral]]. Symptoms of gonococcal conjunctivitis may include the following:
*Severe [[bilateral]] [[purulent]] conjunctivitis
*Severe purulent discharge ([[bilateral]])
*Tearing, 
*[[Tearing]]
*[[Chemosis]]
*Eyelids swelling
 
====Chlamydial Conjunctivitis====
====''Chlamydial'' Conjunctivitis====
[[Chlamydial]] conjunctivitis has a later onset than gonococcal conjunctivitis in newborns. The [[incubation period]] is 5-14 days and the colonization of the eye after birth does not always result in infection. [[Symptoms]] of chlamydial conjunctivitis may include the following:
It has a later onset than gonococcal conjunctivitis. The incubation period is 5-14 days and the colonization of the eye after birth does not always result in infection. Symptoms of ''chlamydial'' conjunctivitis may include the following:
*[[Eye redness]]
*Mild [[hyperemia]],
*Watery or mild mucoid discharge
*Watery or mild mucoid discharge
*[[Chemosis]]
*Eyelids swelling


====Chemical conjunctivitis====
====Chemical conjunctivitis====
[[Chemical]] conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of 'chemical conjunctivitis may include the following:
Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:
*Eyelids swelling  
*Eyelids swelling  
*Redness
*[[Eye redness]]
*[[Tearing]]


===Allergic Conjunctivitis===
===Allergic Conjunctivitis===
Symptoms of [[allergic]] conjunctivitis may include the following:
Symptoms of [[allergic conjunctivitis]] may include the following:<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref><ref name="pmid18786127">{{cite journal| author=Kumar S| title=Vernal keratoconjunctivitis: a major review. | journal=Acta Ophthalmol | year= 2009 | volume= 87 | issue= 2 | pages= 133-47 | pmid=18786127 | doi=10.1111/j.1755-3768.2008.01347.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18786127  }} </ref>
*[[Itchy]] eyes (most impotant)
*Itchy eyes (most prominant)
*Tearing
*[[Tearing]]
*[[Bilateral]] [[redness]]
*[[Eye redness]] ([[Bilateral]])
*Watery discharge
*Watery discharge
*Photophobia (with [[corneal]] involvement)
*[[Light sensitivity]] (with [[corneal]] involvement)
*[[Foreign body]] sensation
*Foreign body sensation


===Keratoconjunctivitis Sicca===
===Keratoconjunctivitis Sicca===
Symptoms of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] may include the following:
Symptoms of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] may include the following:<ref name="pmid19506195">{{cite journal| author=Schaumberg DA, Dana R, Buring JE, Sullivan DA| title=Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies. | journal=Arch Ophthalmol | year= 2009 | volume= 127 | issue= 6 | pages= 763-8 | pmid=19506195 | doi=10.1001/archophthalmol.2009.103 | pmc=2836718 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19506195  }} </ref><ref name="pmid9820935">{{cite journal| author=Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC| title=The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. | journal=Cornea | year= 1998 | volume= 17 | issue= 6 | pages= 584-9 | pmid=9820935 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9820935  }} </ref><ref name="pmid16309672">{{cite journal| author=Zoukhri D| title=Effect of inflammation on lacrimal gland function. | journal=Exp Eye Res | year= 2006 | volume= 82 | issue= 5 | pages= 885-98 | pmid=16309672 | doi=10.1016/j.exer.2005.10.018 | pmc=1361268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16309672  }} </ref>
*Foreign-body sensation
*Foreign-body sensation
*[[Grittiness]]
*[[Grittiness]]
Line 141: Line 122:
*Mucoid discharge
*Mucoid discharge
*Excessive tearing (secondary to reflex secretion)
*Excessive tearing (secondary to reflex secretion)
*[[Photophobia]]
*[[Light sensitivity]]  
*Itchy eye
*Itchy eye
*[[Fluctuating]]] [[blurry]] vision
*Fluctuating blurry vision
*[[Malaise]]  
*[[Malaise]]  
*[[Weight loss]]
*[[Weight loss]]


===Superior Limbic Keratoconjunctivitis===
===Superior Limbic Keratoconjunctivitis===
Symptoms of superior limbic keratoconjunctivitis may include the following:
Symptoms of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]] may include the following:ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </ref><ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351  }} </ref>
*[[Foreign body sensation]]
*[[Light sensitivity]]  
*[[Photophobia]]
*Excessive [[blinking]]  
*Excessive [[blinking]]  
*Burning sensation  
*Burning sensation  
*[[Itchy]] eye
*Itchy eye
*Dry eye sensation
*Dry eye sensation


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 21:07, 29 July 2020

Conjunctivitis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [3]

Overview

The symptoms of conjunctivitis differ based on the cause of the inflammation. Redness, excessive tearing, and irritation are symptoms common to all forms of conjunctivitis. Photophobia, itching, mucopurulent or non-purulent discharge, chemosis, burning eyes, blurred vision and eyelid swelling are variable. Complete history will help determine whether the condition is associated with any specific environmental or work-related exposure.[1][2]

History

A detailed and thorough history from the patient is necessary in order to determine the correct therapy.[1]

Viral Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[2][3]

Bacterial Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[4][5]

Neonatal Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[6][7][8]

Allergic Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[9][10][11]

Keratoconjunctivitis Sicca

Specific areas of focus when obtaining a history from the patient include:[12][13]

Superior limbic keratoconjunctivitis

Specific areas of focus when obtaining a history from the patient include:[14][15]

  • History of prolonged condition with gradual clearing
  • History of thyroid abnormalities

Symptoms

The symptoms of conjunctivitis differ based on the cause of the inflammation. Redness, excessive tearing, and irritation are symptoms common to all forms of conjunctivitis. Photophobia, itching, mucopurulent or non-purulent discharge, chemosis, burning eyes, blurred vision and eyelid swelling are variable.

Viral Conjunctivitis

Adenovirus is the most common cause of viral conjunctivitis. It has acute or subacute onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye. Symptoms of viral conjunctivitis may include the following:[2][3]

Acute Hemorrhagic Conjunctivitis

Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive. The infection starts ipsilaterally, but rapidly involves the fellow eye within 1 or 2 days. Symptoms of acute hemorrhagic conjunctivitis may include the following:[16]

Bacterial Conjunctivitis

Bacterial conjunctivitis has hyperacute, acute, and chronic onset. Symptoms of bacterial conjunctivitis may include the following:[4][5]

Hyperacute Bacterial Conjunctivitis

Hyperacute bacterial conjunctivitis (HBC) is a severe, sight-threatening ocular infection that warrants immediate ophthalmic work-up and management. The infection has an abrupt onset and rapid progression. Symptoms of hyperacute bacterial conjunctivitis may include the following:[17]

  • Eyelids swelling
  • Tearing
  • Diffuse eye redness
  • Eye pain
  • Decreased vision
  • Severe purulent discharge (yellow-green)
  • Swollen lymph nodes (preauricular)

Neonatal Conjunctivitis

Symptoms of neonatal conjunctivitis (ophthalmia neonatorum), based on causality, may include the following:[6][7][8]

Gonococcal Conjunctivitis

Gonococcal conjunctivitis is more severe than chlamydial conjunctivitis in newborns. The incubation period is 2-5 days. It is usually bilateral. Symptoms of gonococcal conjunctivitis may include the following:

Chlamydial Conjunctivitis

Chlamydial conjunctivitis has a later onset than gonococcal conjunctivitis in newborns. The incubation period is 5-14 days and the colonization of the eye after birth does not always result in infection. Symptoms of chlamydial conjunctivitis may include the following:

  • Eye redness
  • Watery or mild mucoid discharge
  • Eyelids swelling

Chemical conjunctivitis

Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:

Allergic Conjunctivitis

Symptoms of allergic conjunctivitis may include the following:[9][18]

Keratoconjunctivitis Sicca

Symptoms of keratoconjunctivitis sicca (dry eye syndrome) may include the following:[12][13][19]

Superior Limbic Keratoconjunctivitis

Symptoms of superior limbic keratoconjunctivitis (SLK) may include the following:ref name="pmid11914237">Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237. </ref>[15]

References

  1. ↑ 1.0 1.1 Rose P (2007). "Management strategies for acute infective conjunctivitis in primary care: a systematic review". Expert Opin Pharmacother. 8 (12): 1903–21. doi:10.1517/14656566.8.12.1903. PMID 17696792.
  2. ↑ 2.0 2.1 2.2 Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425.
  3. ↑ 3.0 3.1 Drug and Therapeutics Bulletin (2011). "Management of acute infective conjunctivitis". Drug Ther Bull. 49 (7): 78–81. doi:10.1136/dtb.2011.02.0043. PMID 21733975.
  4. ↑ 4.0 4.1 "Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective". Prescrire Int. 16 (89): 120–1. 2007. PMID 17585426.
  5. ↑ 5.0 5.1 Høvding G (2004). "[Acute bacterial conjunctivitis]". Tidsskr Nor Laegeforen. 124 (11): 1518–20. PMID 15195156.
  6. ↑ 6.0 6.1 Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC; et al. (1986). "Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis". J Infect Dis. 153 (5): 862–9. PMID 3084664.
  7. ↑ 7.0 7.1 Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.
  8. ↑ 8.0 8.1 Centers for Disease Control and Prevention (2015)[1] Accessed on June 30, 2016
  9. ↑ 9.0 9.1 La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S; et al. (2013). "Allergic conjunctivitis: a comprehensive review of the literature". Ital J Pediatr. 39: 18. doi:10.1186/1824-7288-39-18. PMC 3640929. PMID 23497516.
  10. ↑ Jun J, Bielory L, Raizman MB (2008). "Vernal conjunctivitis". Immunol Allergy Clin North Am. 28 (1): 59–82, vi. doi:10.1016/j.iac.2007.12.007. PMID 18282546.
  11. ↑ Bonini S (2004). "Atopic keratoconjunctivitis". Allergy. 59 Suppl 78: 71–3. doi:10.1111/j.1398-9995.2004.00570.x. PMID 15245362.
  12. ↑ 12.0 12.1 Schaumberg DA, Dana R, Buring JE, Sullivan DA (2009). "Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies". Arch Ophthalmol. 127 (6): 763–8. doi:10.1001/archophthalmol.2009.103. PMC 2836718. PMID 19506195.
  13. ↑ 13.0 13.1 Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC (1998). "The pathology of dry eye: the interaction between the ocular surface and lacrimal glands". Cornea. 17 (6): 584–9. PMID 9820935.
  14. ↑ Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237.
  15. ↑ 15.0 15.1 Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.
  16. ↑ Yin-Murphy M (1976). "Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis)". Bull World Health Organ. 54 (6): 675–9. PMC 2366581. PMID 1088513.
  17. ↑ Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC) (2010). "Sexually transmitted diseases treatment guidelines, 2010". MMWR Recomm Rep. 59 (RR-12): 1–110. PMID 21160459.
  18. ↑ Kumar S (2009). "Vernal keratoconjunctivitis: a major review". Acta Ophthalmol. 87 (2): 133–47. doi:10.1111/j.1755-3768.2008.01347.x. PMID 18786127.
  19. ↑ Zoukhri D (2006). "Effect of inflammation on lacrimal gland function". Exp Eye Res. 82 (5): 885–98. doi:10.1016/j.exer.2005.10.018. PMC 1361268. PMID 16309672.


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