Conjunctivitis risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
The most potent risk factor in the development of conjunctivitis is an | The most potent risk factor in the development of infective conjunctivitis is a direct or indirect contact with an infected person’s eye drainage. | ||
Common risk factors in the development of conjunctivitis are poor hygienic habits,contaminated personal articles, history of ocular diseases ([[dry eye]], [[blepharitis]], and anatomic abnormalities of the ocular surface), recent ocular surgery, medication use, and history of [[autoimmune disorders]]. Additionally, vaginal delivery is a risk factor for conjunctivitis in babies born to mothers infected with either ''[[Neisseria gonorrhoeae]]'' or ''[[Chlamydia trachomatis]]''.<ref name="pmid21718563">{{cite journal| author=Epling J| title=Bacterial conjunctivitis. | journal=BMJ Clin Evid | year= 2010 | volume= 2010 | issue= | pages= | pmid=21718563 | doi= | pmc=2907624 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21718563 }} </ref><ref name="pmid20082509">{{cite journal| author=Cronau H, Kankanala RR, Mauger T| title=Diagnosis and management of red eye in primary care. | journal=Am Fam Physician | year= 2010 | volume= 81 | issue= 2 | pages= 137-44 | pmid=20082509 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20082509 }} </ref> | Common risk factors in the development of conjunctivitis are poor hygienic habits, contaminated personal articles, history of ocular diseases ([[dry eye]], [[blepharitis]], and anatomic abnormalities of the ocular surface), recent ocular surgery, medication use, and history of [[autoimmune disorders]]. Additionally, vaginal delivery is a risk factor for conjunctivitis in babies born to mothers infected with either ''[[Neisseria gonorrhoeae]]'' or ''[[Chlamydia trachomatis]]''.<ref name="pmid21718563">{{cite journal| author=Epling J| title=Bacterial conjunctivitis. | journal=BMJ Clin Evid | year= 2010 | volume= 2010 | issue= | pages= | pmid=21718563 | doi= | pmc=2907624 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21718563 }} </ref><ref name="pmid20082509">{{cite journal| author=Cronau H, Kankanala RR, Mauger T| title=Diagnosis and management of red eye in primary care. | journal=Am Fam Physician | year= 2010 | volume= 81 | issue= 2 | pages= 137-44 | pmid=20082509 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20082509 }} </ref> | ||
==Risk Factors== | ==Risk Factors== | ||
===Infective Conjunctivitis=== | ===Infective Conjunctivitis=== | ||
Common risk factors in the development of infective conjunctivitis include:<ref name="pmid20082509">{{cite journal| author=Cronau H, Kankanala RR, Mauger T| title=Diagnosis and management of red eye in primary care. | journal=Am Fam Physician | year= 2010 | volume= 81 | issue= 2 | pages= 137-44 | pmid=20082509 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20082509 }} </ref><ref name="pmid6970802">{{cite journal| author=Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M et al.| title=Etiology of acute conjunctivitis in children. | journal=J Pediatr | year= 1981 | volume= 98 | issue= 4 | pages= 531-6 | pmid=6970802 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6970802 }} </ref><ref name="pmid24681609">{{cite journal| author=Tagliaferri A, Love TE, Szczotka-Flynn LB| title=Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear. | journal=Eye Contact Lens | year= 2014 | volume= 40 | issue= 3 | pages= 117-22 | pmid=24681609 | doi=10.1097/ICL.0000000000000019 | pmc=4113198 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24681609 }} </ref> | Common risk factors in the development of infective conjunctivitis include:<ref name="pmid20082509">{{cite journal| author=Cronau H, Kankanala RR, Mauger T| title=Diagnosis and management of red eye in primary care. | journal=Am Fam Physician | year= 2010 | volume= 81 | issue= 2 | pages= 137-44 | pmid=20082509 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20082509 }} </ref><ref name="pmid6970802">{{cite journal| author=Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M et al.| title=Etiology of acute conjunctivitis in children. | journal=J Pediatr | year= 1981 | volume= 98 | issue= 4 | pages= 531-6 | pmid=6970802 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6970802 }} </ref><ref name="pmid24681609">{{cite journal| author=Tagliaferri A, Love TE, Szczotka-Flynn LB| title=Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear. | journal=Eye Contact Lens | year= 2014 | volume= 40 | issue= 3 | pages= 117-22 | pmid=24681609 | doi=10.1097/ICL.0000000000000019 | pmc=4113198 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24681609 }} </ref> | ||
*Poor | *Poor [[hygiene]] | ||
* | *Contact lens misuse | ||
*Contaminated personal articles | *Contaminated personal articles | ||
*Crowded living or social conditions (elementary schools, military barracks) | *Crowded living or social conditions (elementary schools, military barracks) | ||
*History of | *History of ocular diseases including [[dry eye]], [[blepharitis]], and anatomic abnormalities of the ocular surface and lids | ||
*Recent ocular surgery, exposed sutures, or ocular foreign bodies | *Recent ocular surgery, exposed sutures, or ocular foreign bodies | ||
*Chronic use of [[topical medications]] | *Chronic use of [[topical medications]] | ||
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===Neonatal Conjunctivitis=== | ===Neonatal Conjunctivitis=== | ||
Common risk factors in the development of neonatal conjunctivitis include:<ref name="pmid19995198">{{cite journal| author=Gichuhi S, Bosire R, Mbori-Ngacha D, Gichuhi C, Wamalwa D, Maleche-Obimbo E et al.| title=Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers. | journal=Ophthalmic Epidemiol | year= 2009 | volume= 16 | issue= 6 | pages= 337-45 | pmid=19995198 | doi=10.3109/09286580903144746 | pmc=3223245 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19995198 }} </ref><ref name="pmid15871630">{{cite journal| author=Zar HJ| title=Neonatal chlamydial infections: prevention and treatment. | journal=Paediatr Drugs | year= 2005 | volume= 7 | issue= 2 | pages= 103-10 | pmid=15871630 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15871630 }} </ref><ref name="pmid982267">{{cite journal| author=Nahmias AJ, Visintine AM, Caldwell DR, Wilson LA| title=Eye infections with herpes simplex viruses in neonates. | journal=Surv Ophthalmol | year= 1976 | volume= 21 | issue= 2 | pages= 100-5 | pmid=982267 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=982267 }} </ref> | Common risk factors in the development of neonatal conjunctivitis include:<ref name="pmid19995198">{{cite journal| author=Gichuhi S, Bosire R, Mbori-Ngacha D, Gichuhi C, Wamalwa D, Maleche-Obimbo E et al.| title=Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers. | journal=Ophthalmic Epidemiol | year= 2009 | volume= 16 | issue= 6 | pages= 337-45 | pmid=19995198 | doi=10.3109/09286580903144746 | pmc=3223245 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19995198 }} </ref><ref name="pmid15871630">{{cite journal| author=Zar HJ| title=Neonatal chlamydial infections: prevention and treatment. | journal=Paediatr Drugs | year= 2005 | volume= 7 | issue= 2 | pages= 103-10 | pmid=15871630 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15871630 }} </ref><ref name="pmid982267">{{cite journal| author=Nahmias AJ, Visintine AM, Caldwell DR, Wilson LA| title=Eye infections with herpes simplex viruses in neonates. | journal=Surv Ophthalmol | year= 1976 | volume= 21 | issue= 2 | pages= 100-5 | pmid=982267 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=982267 }} </ref> | ||
*[[Maternal infections]] | *[[Maternal infections]] harbored in the mother's [[birth canal]] | ||
*[[HIV]] infected mothers | *[[HIV]] infected mothers | ||
*Exposure of the infant to infectious organisms | *Exposure of the infant to infectious organisms | ||
*[[Premature rupture of membranes|Premature rupture of membranes (PROM)]] | |||
*Inadequacy of ocular prophylaxis after birth | *Inadequacy of ocular prophylaxis after birth | ||
*Silver nitrate exposure | *[[Silver nitrate]] exposure | ||
*Ocular trauma during delivery | *Ocular trauma during delivery | ||
*[[Mechanical ventilation]] | *[[Mechanical ventilation]] | ||
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===Allergic Conjunctivitis=== | ===Allergic Conjunctivitis=== | ||
Common risk factors in the development of allergic conjunctivitis include:<ref name="pmid27224053">{{cite journal| author=Hsieh VC, Liu CC, Hsiao YC, Wu TN| title=Risk of Allergic Rhinitis, Allergic Conjunctivitis, and Eczema in Children Born to Mothers with Gum Inflammation during Pregnancy. | journal=PLoS One | year= 2016 | volume= 11 | issue= 5 | pages= e0156185 | pmid=27224053 | doi=10.1371/journal.pone.0156185 | pmc=4880316 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27224053 }} </ref><ref name="pmid14657851">{{cite journal| author=Borish L| title=Allergic rhinitis: systemic inflammation and implications for management. | journal=J Allergy Clin Immunol | year= 2003 | volume= 112 | issue= 6 | pages= 1021-31 | pmid=14657851 | doi=10.1016/j.jaci.2003.09.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14657851 }} </ref> | Common risk factors in the development of allergic conjunctivitis include:<ref name="pmid27224053">{{cite journal| author=Hsieh VC, Liu CC, Hsiao YC, Wu TN| title=Risk of Allergic Rhinitis, Allergic Conjunctivitis, and Eczema in Children Born to Mothers with Gum Inflammation during Pregnancy. | journal=PLoS One | year= 2016 | volume= 11 | issue= 5 | pages= e0156185 | pmid=27224053 | doi=10.1371/journal.pone.0156185 | pmc=4880316 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27224053 }} </ref><ref name="pmid14657851">{{cite journal| author=Borish L| title=Allergic rhinitis: systemic inflammation and implications for management. | journal=J Allergy Clin Immunol | year= 2003 | volume= 112 | issue= 6 | pages= 1021-31 | pmid=14657851 | doi=10.1016/j.jaci.2003.09.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14657851 }} </ref> | ||
*[[Pollen]] from trees | *[[Pollen]] from trees and grass | ||
*Animal skin and secretions such as saliva | *Animal skin and secretions, such as saliva | ||
*Perfumes | *Perfumes | ||
*Cosmetics | *Cosmetics | ||
*[[Air pollution]] | *[[Air pollution]] | ||
* | *Smoke | ||
*Spring/Summer months | *Spring/Summer months | ||
===Keratoconjunctivitis Sicca=== | ===Keratoconjunctivitis Sicca=== | ||
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*[[Thyroid]] eye conditions | *[[Thyroid]] eye conditions | ||
*[[Blepharitis]] | *[[Blepharitis]] | ||
*Medication use ( | *Medication use ([[antihistamines]], [[beta-blockers]], [[pain relievers]], [[sleep aid]], [[diuretics]], hormone replacement, and [[oral contraceptives]]) | ||
*[[Autoimmune disorders]] ([[Sjogren's syndrome]], [[ | *[[Autoimmune disorders]] ([[Sjogren's syndrome]], [[lupus]], and [[rheumatoid arthritis]]) | ||
*Eye surgery | *Eye surgery | ||
*Infrequent blinking (staring at computer and [[Parkinson's]]) | *Infrequent blinking (e.g., frequent staring at computer and [[Parkinson's]]) | ||
*Environmental (dusty or windy) | *Environmental (dusty or windy) | ||
*Contact lens use | *Contact lens use | ||
*Neurologic conditions ([[stroke]], [[Bell's palsy]], Parkinson's, [[trigeminal nerve]] | *Neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] dysfunction) | ||
*[[Uveitis]] | *[[Uveitis]] | ||
*[[Iritis]] | *[[Iritis]] | ||
*[[Diabetes]] | *[[Diabetes]] | ||
*[[Vitamin A deficiency]] | *[[Vitamin A deficiency]] | ||
===Superior Limbic Keratoconjunctivitis=== | ===Superior Limbic Keratoconjunctivitis=== | ||
Common risk factors in the development of [[Superior limbic keratoconjunctivitis| | Common risk factors in the development of [[Superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]] include:<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><ref name="pmid25792798">{{cite journal| author=Chelala E, El Rami H, Dirani A, Fakhoury H, Fadlallah A| title=Extensive superior limbic keratoconjunctivitis in Graves' disease: case report and mini-review of the literature. | journal=Clin Ophthalmol | year= 2015 | volume= 9 | issue= | pages= 467-8 | pmid=25792798 | doi=10.2147/OPTH.S79561 | pmc=4362972 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25792798 }} </ref> | ||
*Mechanical soft-tissue microtrauma (conjunctiva laxity) | *Mechanical soft-tissue microtrauma (conjunctiva laxity) | ||
*Morphologic changes in superior conjunctival | *Morphologic changes in superior conjunctival | ||
*Prolonged eyelid closure | *Prolonged eyelid closure | ||
*[[Thyroid]] abnormalities | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
The most potent risk factor in the development of infective conjunctivitis is a direct or indirect contact with an infected person’s eye drainage. Common risk factors in the development of conjunctivitis are poor hygienic habits, contaminated personal articles, history of ocular diseases (dry eye, blepharitis, and anatomic abnormalities of the ocular surface), recent ocular surgery, medication use, and history of autoimmune disorders. Additionally, vaginal delivery is a risk factor for conjunctivitis in babies born to mothers infected with either Neisseria gonorrhoeae or Chlamydia trachomatis.[1][2]
Risk Factors
Infective Conjunctivitis
Common risk factors in the development of infective conjunctivitis include:[2][3][4]
- Poor hygiene
- Contact lens misuse
- Contaminated personal articles
- Crowded living or social conditions (elementary schools, military barracks)
- History of ocular diseases including dry eye, blepharitis, and anatomic abnormalities of the ocular surface and lids
- Recent ocular surgery, exposed sutures, or ocular foreign bodies
- Chronic use of topical medications
- Immune compromise
- Winter/Summer months (bacterial conjunctivitis peaks in the winter and viral conjunctivitis peaks in the summer)
Neonatal Conjunctivitis
Common risk factors in the development of neonatal conjunctivitis include:[5][6][7]
- Maternal infections harbored in the mother's birth canal
- HIV infected mothers
- Exposure of the infant to infectious organisms
- Premature rupture of membranes (PROM)
- Inadequacy of ocular prophylaxis after birth
- Silver nitrate exposure
- Ocular trauma during delivery
- Mechanical ventilation
- Prematurity
- Poor prenatal care
- Poor hygienic delivery conditions
Allergic Conjunctivitis
Common risk factors in the development of allergic conjunctivitis include:[8][9]
- Pollen from trees and grass
- Animal skin and secretions, such as saliva
- Perfumes
- Cosmetics
- Air pollution
- Smoke
- Spring/Summer months
Keratoconjunctivitis Sicca
Common risk factors in the development of keratoconjunctivitis sicca (dry eye syndrome) include:[10][11][12]
- Allergies
- Decreased hormones (aging and pregnancy)
- Thyroid eye conditions
- Blepharitis
- Medication use (antihistamines, beta-blockers, pain relievers, sleep aid, diuretics, hormone replacement, and oral contraceptives)
- Autoimmune disorders (Sjogren's syndrome, lupus, and rheumatoid arthritis)
- Eye surgery
- Infrequent blinking (e.g., frequent staring at computer and Parkinson's)
- Environmental (dusty or windy)
- Contact lens use
- Neurologic conditions (stroke, Bell's palsy, Parkinson's, trigeminal nerve dysfunction)
- Uveitis
- Iritis
- Diabetes
- Vitamin A deficiency
Superior Limbic Keratoconjunctivitis
Common risk factors in the development of superior limbic keratoconjunctivitis (SLK) include:[13][14]
- Mechanical soft-tissue microtrauma (conjunctiva laxity)
- Morphologic changes in superior conjunctival
- Prolonged eyelid closure
- Thyroid abnormalities
References
- ↑ Epling J (2010). "Bacterial conjunctivitis". BMJ Clin Evid. 2010. PMC 2907624. PMID 21718563.
- ↑ 2.0 2.1 Cronau H, Kankanala RR, Mauger T (2010). "Diagnosis and management of red eye in primary care". Am Fam Physician. 81 (2): 137–44. PMID 20082509.
- ↑ Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M; et al. (1981). "Etiology of acute conjunctivitis in children". J Pediatr. 98 (4): 531–6. PMID 6970802.
- ↑ Tagliaferri A, Love TE, Szczotka-Flynn LB (2014). "Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear". Eye Contact Lens. 40 (3): 117–22. doi:10.1097/ICL.0000000000000019. PMC 4113198. PMID 24681609.
- ↑ Gichuhi S, Bosire R, Mbori-Ngacha D, Gichuhi C, Wamalwa D, Maleche-Obimbo E; et al. (2009). "Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers". Ophthalmic Epidemiol. 16 (6): 337–45. doi:10.3109/09286580903144746. PMC 3223245. PMID 19995198.
- ↑ Zar HJ (2005). "Neonatal chlamydial infections: prevention and treatment". Paediatr Drugs. 7 (2): 103–10. PMID 15871630.
- ↑ Nahmias AJ, Visintine AM, Caldwell DR, Wilson LA (1976). "Eye infections with herpes simplex viruses in neonates". Surv Ophthalmol. 21 (2): 100–5. PMID 982267.
- ↑ Hsieh VC, Liu CC, Hsiao YC, Wu TN (2016). "Risk of Allergic Rhinitis, Allergic Conjunctivitis, and Eczema in Children Born to Mothers with Gum Inflammation during Pregnancy". PLoS One. 11 (5): e0156185. doi:10.1371/journal.pone.0156185. PMC 4880316. PMID 27224053.
- ↑ Borish L (2003). "Allergic rhinitis: systemic inflammation and implications for management". J Allergy Clin Immunol. 112 (6): 1021–31. doi:10.1016/j.jaci.2003.09.015. PMID 14657851.
- ↑ Gumus K, Cavanagh DH (2009). "The role of inflammation and antiinflammation therapies in keratoconjunctivitis sicca". Clin Ophthalmol. 3: 57–67. PMC 2709015. PMID 19668545.
- ↑ 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.
- ↑ Zhang X, Zhao L, Deng S, Sun X, Wang N (2016). "Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics". J Ophthalmol. 2016: 8201053. doi:10.1155/2016/8201053. PMC 4861815. PMID 27213053.
- ↑ Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.
- ↑ Chelala E, El Rami H, Dirani A, Fakhoury H, Fadlallah A (2015). "Extensive superior limbic keratoconjunctivitis in Graves' disease: case report and mini-review of the literature". Clin Ophthalmol. 9: 467–8. doi:10.2147/OPTH.S79561. PMC 4362972. PMID 25792798.